Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Frontal and lateral views of the chest were obtained . Dual - lead left - sided pacemaker is again seen with leads unchanged in position . The cardiac silhouette is markedly enlarged . There are small bilateral pleural effusions with overlying atelectasis . Mild pulmonary vascular congestion is also seen . The aortic knob remains calcified . Mediastinal contours are stable .
    OUTPUT:
    
Small bilateral pleural effusions with overlying atelectasis , enlarged cardiac silhouette . Mild vascular congestion .