Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Severe cardiomegaly is again noted . There is pulmonary vascular congestion , worse when compared to prior . There is no significant effusion or focal consolidation . Left chest wall single lead pacing device is new since ___ , with lead tip at the right ventricular apex . No acute osseous abnormalities .
    OUTPUT:
    
Severe cardiomegaly and pulmonary vascular congestion .