Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The lungs are clear where not obscured by overlying cardiac leads . The right costophrenic angle is excluded from the field of view . The cardiomediastinal silhouette is within normal limits . Hypertrophic changes are again noted in the spine . Deformity of the left scapula suggests prior fracture .
    OUTPUT:
    
No acute cardiopulmonary process .