Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Left chest wall dual lead pacemaker is present . Low bilateral lung volumes . Despite the low lung volumes there is increased pulmonary vascular congestion . The previously seen right pleural effusion is probably unchanged . No pneumothorax identified . The size of the cardiac silhouette is enlarged but unchanged .
    OUTPUT:
    
Low bilateral lung volumes with persisting moderate pulmonary vascular congestion .