Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Since ___ , no significant changes are appreciated . Severe cardiomegaly is unchanged . No pulmonary vascular congestion or pulmonary edema . Dual chamber cardiac pacemaker leads terminate in the right atrium and right ventricle . Lungs are fully expanded and clear . No pleural effusions or pneumothorax . There is an unchanged compression fracture of the inferior thoracic spine .
    OUTPUT:
    
No radiographic evidence of fluid overload .