Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Left - sided AICD device is noted with leads in unchanged positions in the right atrium right ventricle . Patient is status post median sternotomy . Moderate to severe enlargement of the cardiac silhouette is unchanged . Mediastinal hilar contours are similar . There may be mild pulmonary vascular congestion without overt pulmonary edema . No focal consolidation , pleural effusion or pneumothorax is identified . Bilateral lateral pleural thickening is unchanged . No definite pneumothorax is present although assessment of the lung apices is obscured by the patient 's neck and chin projecting over these regions . No acute osseous abnormality is identified .
    OUTPUT:
    
Possible mild pulmonary vascular congestion without overt pulmonary edema . Unchanged moderate to severe enlargement of the cardiac silhouette . No focal consolidation to suggest pneumonia .