Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A dual lead pacemaker is noted with tips in the right atrium and right ventricle . A right internal jugular approach venous catheter is noted tip terminating in the cavoatrial junction . The patient is post CABG with median sternotomy wires in place . Aortic valve replacement is also noted , as well as heavy mitral annular calcifications . The heart size is moderately enlarged . Pulmonary arteries are chronically enlarged . There is no pneumothorax . There is a small left pleural effusion . There is no right pleural effusion . Interval worsening of pulmonary edema , now moderate . There are no new focal consolidations concerning for pneumonia .
    OUTPUT:
    
Interval worsening of pulmonary edema , now moderate , with a new small left pleural effusion . These findings are consistent with heart failure .