Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The patient is status post median sternotomy . A left - sided pacemaker device is noted with single lead terminating in the right ventricle . Massive enlargement of the cardiac silhouette is again demonstrated with marked tortuosity of the thoracic aorta , unchanged . There is mild pulmonary edema , new from the prior exam . No large pleural effusion or pneumothorax is identified , though the extreme right apex is not well assessed due to obscuration by the patient 's chin . The mediastinal contours are unchanged . There are no acute osseous abnormalities .
    OUTPUT:
    
Severe cardiomegaly with mild pulmonary edema .