Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Moderate cardiomegaly appears somewhat smaller than compared to ___ with mild tortuosity of thoracic aorta . Left - sided dual - lead pacer is unchanged in position . There is a central pulmonary vascular engorgement with moderate right greather than left layering bilateral pleural effusions . There is a suggestion of minimal interstitial edema . There is leftward mediastinal shift . There is no pneumothorax .
    OUTPUT:
    
Central pulmonary vascular engorgement with possible minimal interstitial edema and moderate layering bilateral pleural effusions . There is leftward mediastinal shift either caused by right sided effusion or left lower lobe collapse / infection . Lateral view would be helpful for characterization .