Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: AP portable upright view of the chest . Left chest wall pacer device is again seen with leads extending to the region of the right atrium and right ventricle unchanged and with an intact appearance . Midline sternotomy wires and mediastinal clips are again noted . The cardiomediastinal silhouette remains prominent though not significantly changed . Low lung volumes limit the assessment . There is mild pulmonary edema with probable small bilateral pleural effusions . No pneumothorax . Bony structures are intact .
    OUTPUT:
    
Cardiomegaly , mild edema , small bilateral pleural effusions .