Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Persistent severe cardiomegaly , unchanged since ___ . Since ___ , pulmonary interstitial edema has improved . Moderate right pleural effusion with a loculated component is mildly improved . Right pectoral pacemaker with lead in right atrium . Abdominal pacemaker with lead in left and right ventricle . There is no pneumothorax .
    OUTPUT:
    
Since ___ , improved pulmonary edema and decreased size of moderate right pleural effusion with a loculated component . Persistent severe cardiomegaly .