Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A dual - lead pacemaker / ICD device with leads terminating in the right atrium and right ventricle , respectively , appears unchanged . The heart is mildly enlarged . The mediastinal and hilar contours appear unchanged . There is a very similar pattern of mild interstitial pulmonary vascular congestion without significant change . Fissures appear mildly thickened . Very small persistent pleural effusions are suspected , similar to perhaps slightly decreased .
    OUTPUT:
    
Findings again consistent with mild pulmonary vascular congestion , with no findings suggestive of superimposed pneumonia .