Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The patient is status post median sternotomy and cardiac valve replacements . A single lead left - sided pacemaker is seen with lead extending to the expected position of the right ventricle . The cardiac silhouette is mild to moderately enlarged with concern for left ventricular enlargement . There is slight prominence of the central pulmonary vasculature . No pleural effusion is seen . There is no pneumothorax . No focal consolidation .
    OUTPUT:
    
Cardiomegaly and central pulmonary vascular engorgement .