Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The heart is normal size and cardiomediastinal silhouette is unchanged . Calcifications are again noted in the aortic arch . Pacemaker leads are unchanged in position . Lungs are clear . In comparison to the prior examination , the pulmonary interstitial markings are more prominent , particularly along the periphery of the bases . Small pleural effusions are new . There is no pneumothorax .
    OUTPUT:
    
New small pleural effusions and increased interstitial prominence may represent congestive failure .