FINDINGS:
Left-sided AICD /pacemaker seen device is noted with leads terminating in
 right atrium and right ventricle.  Cardiac silhouette size is mildly enlarged
 with a left ventricular predominance.  The aorta is tortuous and demonstrates
 diffuse atherosclerotic calcifications.  Lung volumes are low.  Pulmonary
 vascularity is within normal limits without evidence of pulmonary edema.  No
 focal consolidation, pleural effusion or pneumothorax is present.  Widening of
 the right paratracheal stripe is likely related to low lung volumes.  There
 are no acute osseous abnormalities. Mild deformity of the mid shaft of the
 left clavicle may suggest a remote healed fracture.  No free air is noted
 under the diaphragms.

IMPRESSION:
No acute cardiopulmonary process.  Low lung volumes.