Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Dual - lead left - sided pacer device is again seen with leads unchanged in position , extending to the expected locations of the right atrium and right ventricle . There is mild pulmonary vascular engorgement without overt pulmonary edema . No focal consolidation , pleural effusion , or evidence of pneumothorax is seen . The aorta remains calcified and tortuous . The cardiac silhouette is mildly enlarged . The cardiac silhouette remains enlarged with a left ventricular configuration , may be slightly increased as compared to the prior study . Degenerative changes are seen at the right acromioclavicular joint .
    OUTPUT:
    
Cardiomegaly , which appears slightly enlarged as compared to the prior study with mild pulmonary vascular engorgement .