Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Left - sided AICD device is noted with single lead terminating in the region of the right ventricle , unchanged . Severe enlargement of cardiac silhouette is again noted . Mediastinal and hilar contours are unchanged . There is mild upper zone vascular redistribution with mild pulmonary vascular engorgement , not changed in the interval and likely chronic . Minimal atelectasis is noted in the right lung base . No focal consolidation , pleural effusion or pneumothorax is identified . No acute osseous abnormality is present .
    OUTPUT:
    
Severe cardiomegaly with mild pulmonary vascular congestion , likely chronic .