Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A left - sided , dual - lead pacemaker is again noted in unchanged location . There is moderate central pulmonary vascular congestion and interstitial edema , increased from the prior examination . Probable small bilateral pleural effusions and mild - moderate cardiomegaly are present . There is no lobar consolidation identified . The aortic knob contains dense atherosclerotic calcifications . The patient is status post right shoulder arthroplasty , in addition to lumbar spinal fusion and vertebroplasty .
    OUTPUT:
    
Moderate cardiomegaly , moderate interstitial pulmonary edema , new , and small bilateral pleural effusions .