Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Left - sided pacemaker / AICD device is noted with leads terminating in right ventricle and region of the coronary sinus . There is moderately severe cardiomegaly , with sternotomy wires , similar to the prior study . Compared to the prior study , there is new vascular plethora and blurring , consistent with CHF interstitial and possible early alveolar edema . In addition , there is vascular plethora blurring about both hila . There is a small to moderate right effusion , larger than on the prior study . There is atelectasis at the right base and in the right mid zone and the possibility of a subtle infectious infiltrate at the right base can not be entirely excluded . On the left , there is upper zone redistribution and mild vascular plethora , without frank consolidation , significant left base atelectasis or gross effusion . The extreme left costophrenic angle is excluded from the film .
    OUTPUT:
    
1 . Increased CHF , compared with ___ 2 . Increased right pleural effusion with underlying atelectasis . The possibility of an early pneumonic infiltrate at the right base can not be entirely excluded . 3 . Moderately severe cardiomegaly is grossly unchanged . Pacemaker / AICD device again noted .