Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Exam limited by rotation . There is a pacemaker overlying the left chest , with leads in the right atrium , right ventricle , and coronary sinus . Stable enlargement of the cardiac silhouette . The pulmonary vasculature is normal . Lungs are clear . No pleural effusion or pneumothorax is seen .
    OUTPUT:
    
Exam limited by rotation . No evidence of congestive heart failure .