Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There is a moderate - to - large right - sided pleural effusion . Increased interstitial markings are seen throughout the lungs . There is no left - sided effusion . Cardiac silhouette is slightly enlarged but difficult to assess given silhouetting on the right . Right chest wall dual - lead pacing device is seen with lead tips in the right atrium and right ventricular apex . No acute osseous abnormality is identified .
    OUTPUT:
    
Moderate - to - large right effusion and pulmonary vascular congestion .