Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The heart is mildly enlarged . Left - sided dual - chamber pacemaker device is noted with leads terminating in the right atrium and right ventricle . The aortic knob is calcified . There is mild pulmonary vascular congestion . No pleural effusion , focal consolidation or pneumothorax is present . There are mild degenerative changes in the thoracic spine . Partially imaged is hardware within the right shoulder .
    OUTPUT:
    
Mild congestive heart failure .