Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Since the prior exam , a new dual - lead pacemaker has been placed . The wires appear to be in appropriate position within the right atrium and right ventricle . Since the prior exam , there has been interval increase in mild vascular congestion . There is no overt pulmonary edema . There is no focal airspace consolidation , pleural effusion , or pneumothorax . The mediastinal contours are normal . The heart size is at the upper limits of normal , although slightly bigger in comparison to the last exam .
    OUTPUT:
    
1 . Mild vascular congestion . 2 . Interval increase in the heart size , which remains at the upper limits of normal .