Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The cardiac silhouette continues to be enlarged , but without gross change . Again noted is a left - sided pacemaker type device with appropriate position of leads over the right atrium and right ventricle . There is moderate pulmonary edema , possibly slightly worse compared to the chest radiograph from 2 hours earlier . No gross effusions identified on this AP film . No pneumothoraces detected .
    OUTPUT:
    
Cardiomegaly with moderate pulmonary edema .