Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: PA and lateral views of the chest . Moderate - to - severe cardiomegaly is seen . A left - sided pacemaker is in place . Mediastinal wires and mediastinal clips are seen . There is mild pulmonary vascular congestion , but no focal consolidation and no evidence of pulmonary edema . There may be small bilateral pleural effusions .
    OUTPUT:
    
Moderate to severe cardiomegaly . Mild pulmonary vascular congestion and small bilateral pleural effusions .