Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Single frontal view of the chest was obtained . Single lead left - sided pacemaker is again seen , with lead unchanged in position . There are relatively low lung volumes . Prominence of the central pulmonary vasculature may be due to mild pulmonary vascular engorgement . Cardiomegaly persists . The aorta is calcified and tortuous . There has been interval removal of a right - sided PICC . No focal consolidation , pleural effusion , or evidence of pneumothorax is seen .
    OUTPUT:
    
Persistent cardiomegaly with mild pulmonary vascular engorgement .