Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: PA and lateral views of the chest . The left - sided pacemaker / AICD with 3 leads is unchanged in position . Sternotomy wires are intact . Mediastinal clips are unchanged . There is severe cardiomegaly . Again seen is mild pulmonary vascular congestion , similar to prior study . Trace bilateral pleural effusions are unchanged .
    OUTPUT:
    
Severe cardiomegaly and mild pulmonary vascular congestion and trace bilateral pleural effusions are unchanged from prior study on ___ .