Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: AP portable upright view of the chest . Left chest wall AICD is again seen with leads extending into the region of the right atrium and right ventricle . The heart is top - normal in size . There is hilar congestion without overt pulmonary edema . Underlying emphysema is again noted . No large effusion or pneumothorax . Mediastinal contour is stable . Bony structures are grossly intact . There is severe degenerative disease at both shoulders .
    OUTPUT:
    
Mild congestion without overt edema .