FINDINGS:
AP and lateral views of the chest.  Left chest wall dual lead pacing device is
 seen unchanged in position.  The lungs are clear.  There is no effusion or
 pulmonary vascular congestion.  The cardiomediastinal silhouette is unchanged
 and within normal limits.  Median sternotomy wires and mediastinal clips again
 noted.  No acute osseous abnormalities.

IMPRESSION:
No acute cardiopulmonary process.