Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Again noted is severe enlargement of the cardiac silhouette , a a pacemaker is unchanged in position . Previous median sternotomy and mitral valve replacement noted . Lung volumes are unchanged compared to the prior study . There has been slight interval improvement in the degree of pulmonary edema . There is persistent prominence of pulmonary vasculature consistent with mild pulmonary vascular congestion . No pleural effusion , pneumothorax or free air under the diaphragm .
    OUTPUT:
    
Slight interval improvement in the previously demonstrated pulmonary edema with persistent mild pulmonary vascular congestion .