Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Left - sided pacemaker device is noted with epicardial leads re - demonstrated , unchanged . Moderate enlargement of cardiac silhouette is again noted . Mediastinal contours are similar . Enlargement of the main pulmonary artery is re - demonstrated . There is mild upper zone vascular redistribution without overt pulmonary edema . Elevation of the right hemidiaphragm is re - demonstrated with patchy atelectasis noted in the right lung base . No pleural effusion or pneumothorax is seen . Clips from prior cholecystectomy are demonstrated in the right upper quadrant of the abdomen .
    OUTPUT:
    
Persistent moderate cardiomegaly of mild pulmonary vascular congestion . Chronically elevated right hemidiaphragm with mild right basilar atelectasis .