Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: AP and lateral views of the chest . There is engorgement of the left central vasculature and indistinct pulmonary vascular markings . Small - moderate bilateral pleural effusions are seen , increased from prior . Cardiac silhouette is enlarged but difficult to fully assess given adjacent basilar opacities . Superiorly there is no confluent consolidation . Pleural - based lesion superiorly on the left is unchanged . No acute osseous abnormalities detected . Dual lead pacing device is again seen .
    OUTPUT:
    
Findings suggestive of congestive failure with edema and small to moderate bilateral effusions .