Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Left chest wall pacing leads again terminating in the right atrium and right ventricle . The lungs are normally expanded and clear . Severe cardiomegaly is unchanged . There is no pleural effusion or pneumothorax . There is no pulmonary edema . Moderate degenerate changes are again seen throughout the right glenohumeral joint .
    OUTPUT:
    
Unchanged severe cardiomegaly . No acute cardiopulmonary abnormality .