Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There is moderate pulmonary vascular congestion , increased since ___ . The lung volumes are low and there is a small right pleural effusion . No pneumothorax identified . Cardiomegaly is moderate to severe . The mediastinal contours are stable . A left Port - A - Cath , accessed with ___ ___ needle , ends in the right atrium . Surgical clips project over the right axilla .
    OUTPUT:
    
Moderate pulmonary vascular congestion has increased since ___ .