Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There has been previous median sternotomy and aortic valve replacement . ICD pacing device remains in place , with unchanged position of leads in the right atrium , right ventricle and an additional lead for biventricular pacing . Moderate cardiomegaly is stable in appearance , is accompanied by upper zone vascular redistribution and mild interstitial edema . The latter superimposed upon chronic pleural and parenchymal scarring within the mid and lower lungs bilaterally . Lung volumes are increased , in keeping with history of COPD . There are questionable small bilateral pleural effusions present .
    OUTPUT:
    
Congestive heart failure with interstitial edema superimposed upon chronic changes of emphysema and pleural - parenchymal scarring .