Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Mild pulmonary edema and moderate to severe cardiomegaly is unchanged since ___ . A left pectoral pacemaker is again seen with a transvenous lead in the right ventricle . Bilateral small pleural effusions are tiny , if any . No pneumothorax . Median sternotomy wires are intact and well aligned .
    OUTPUT:
    
1 . Unchanged appearance of mild pulmonary edema and moderate to severe cardiomegaly since ___ . No pneumothorax