Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A portable upright AP radiograph of the chest demonstrates moderate cardiomegaly , moderate pulmonary edema , as well as small , left greater than right , pleural effusions . There is no pneumothorax . An implantable cardiac pacer with intact leads , appropriately placed . A 1 .3 x 1 .1 cm well - circumscribed density in the right humeral head likely represents a benign process such as a bone island .
    OUTPUT:
    
Findings consistent with acute decompensated congestive heart failure including cardiomegaly , moderate pulmonary edema , and small , left greater than right , pleural effusion .