Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Left - sided pacemaker device is noted with lead terminating in the right ventricle . The heart remains moderately enlarged with a left ventricular predominance . There is moderate pulmonary edema , worse when compared to the prior exam , with small bilateral pleural effusions . Retrocardiac opacity likely reflects compressive atelectasis though infection is difficult to exclude . No pneumothorax is identified , though the extreme lung apices medially are obscured by the patient 's chin projecting over this region . There are no acute osseous abnormalities .
    OUTPUT:
    
Moderate congestive heart failure , worse when compared to the prior study with small bilateral pleural effusions . Retrocardiac opacity likely reflects atelectasis though infection is difficult to exclude .