Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Portable AP chest radiograph is provided . Heart size is enlarged , similar in degree to prior examinations . A left chest wall dual lead pacer is identified , leads which are intact and in unchanged position . Probable small to moderate bilateral pleural effusions are present with pulmonary vascular congestion , not significantly changed relative to examination dated same day 1 hour prior . Significant S shaped scoliosis as well as loss of thoracic and lumbar vertebral body heights as previously noted , age indeterminate .
    OUTPUT:
    
Stable cardiomegaly and degree of vascular congestion relative to most recent study obtained 1 hour prior . Small to moderate bilateral pleural effusions .