Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The patient has a dual - lead pacemaker / ICD device , as before , without change . The cardiac , mediastinal and hilar contours also appear unchanged . The lungs appear clear . The extreme left costophrenic angle is excluded . There is no definite pleural effusion or pneumothorax , however .
    OUTPUT:
    
No evidence of acute disease .