Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: In comparison with the study of ___ , the patient has taken a better inspiration . Dual - channel pacer device remains in place in this patient with substantial enlargement of the cardiac silhouette . Some indistinctness of engorged pulmonary vessels is again consistent with mild elevation of pulmonary venous pressure . Hazy opacification at the bases , especially on the right , is consistent with layering pleural effusions .
    OUTPUT:
    
Better inspiration , but otherwise little change .