Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Right atrial and biventricular pacemaker courses in expected position . No significant pleural effusions or pneumothorax . Moderate - to - severe cardiomegaly is unchanged . Mild central venous congestion and cephalization , but no frank edema . Tiny bilateral pleural effusions . There is no focal consolidation . Old healed rib fractures are present on the left .
    OUTPUT:
    
Cardiomegaly and venous congestion .