Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There is a large right and small left pleural effusion with mild pulmonary vascular redistribution and moderate cardiomegaly . The findings are compatible with CHF . Given technique , the extent of the CHF is similar compared to prior . Dual lead pacemaker with leads in similar location compared to prior is again seen . The patient is status post sternotomy with sternal wires and mediastinal clips .
    OUTPUT:
    
No significant change . CHF .