Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There is stable severe cardiomegaly with a new large right - sided pleural effusion . The left lung is well inflated , without focal opacities but vascular cephalization is apparent - although improved from prior . A pacemaker is noted in the left axilla with leads ending in the right atrium and right ventricle , unchanged .
    OUTPUT:
    
Large right - sided pleural effusion . Mild interstitial edema in the setting of chronic congestive heart failure and severe cardiomegaly .