Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A right pacer has 2 leads terminating in the right atrium and right ventricle respectively . A moderate right pleural effusion is unchanged . The cardiomediastinal silhouette is unchanged with moderate cardiomegaly . A prosthetic aortic valve is again seen . There is mild vascular congestion . There is no pneumothorax .
    OUTPUT:
    
Moderate right pleural effusion , moderate cardiomegaly , and mild vascular congestion are unchanged .