Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Lungs are fully expanded and clear . No pleural abnormalities . Severe cardiomegaly and cardiomediastinal hilar silhouettes are unchanged . Pacemaker and ICD leads are unchanged in position . No evidence of displaced rib fracture .
    OUTPUT:
    
No evidence of rib fracture . Pacemaker and ICD leads are unchanged in position .