Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Right atrial and ventricular pacemaker courses in expected position . Changes of coronary artery bypass grafting are seen , with median sternotomy wires and mediastinal clips . Moderate cardiomegaly is present . There is evidence of congestive heart failure with central venous congestion , interstitial / airspace edema , and moderate bilateral pleural effusions . There is no pneumothorax . The aorta is tortuous and calcified .
    OUTPUT:
    
Congestive heart failure .