Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Since the prior exam , there is persistent mild vascular congestion , not significantly changed from the prior exam . There is no new opacity . Small - to - moderate bilateral pleural effusions are unchanged . There is no pneumothorax . The mediastinal contours are normal . The heart size is moderately enlarged , and unchanged . A left - sided pacemaker is present with leads in the right atrium and right ventricle .
    OUTPUT:
    
No significant change since the prior exam , with mild vascular congestion and small - to - moderate bilateral pleural effusions .