Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Left - sided pacemaker device is noted with leads terminating in the right atrium and right ventricle , unchanged . Moderate to severe cardiomegaly is re - demonstrated . The mediastinal contours are unchanged with tortuosity of the thoracic aorta again noted . Hilar contours are stable , and there is no pulmonary edema demonstrated . Vague focal opacity is seen within the right upper to mid lung field , which is nonspecific , but not clearly demonstrated on the previous exam . No focal consolidation , pleural effusion or pneumothorax is otherwise demonstrated .
    OUTPUT:
    
No evidence of congestive heart failure . Vague focal opacity projecting over the right upper to mid lung field , which is nonspecific . This could potentially reflect an inflammatory or infectious focus , but follow up radiographs are recommended to assess for resolution of this finding .