FINDINGS:
Frontal and lateral views of the chest.  No prior.  Dual-lead
 pacing device seen with lead tips in the right atrium and right ventricle. 
 Where not obscured by left chest wall pacing device, the lungs are clear. 
 There is no effusion.  Cardiac silhouette is top normal in size, potentially
 accentuated by low lung volumes.  Hypertrophic changes seen in the spine. 
 Osseous and soft tissue structures are unremarkable.

IMPRESSION:
No acute cardiopulmonary process.