Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: AP portable upright view of the chest . Left chest wall pacer device is again seen with leads extending to the region of the right atrium and right ventricle . Overall , the appearance of the chest is unchanged . Cardiomegaly is again noted with central hilar congestion and mild pulmonary edema . Bilateral pleural effusions are noted , small in overall size likely with compressive lower lobe atelectasis . Difficult to exclude pneumonia in the lower lungs . No pneumothorax is seen . The imaged osseous structures are intact .
    OUTPUT:
    
Cardiomegaly , mild pulmonary edema , small bilateral effusions with compressive lower lobe atelectasis . Findings appear unchanged from prior exam .