Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The head partially obscures the apices . A left pacer has a single lead terminating in the right ventricle . The cardiomediastinal silhouette is grossly unchanged re-demonstrating severe cardiomegaly . A moderate to large left pleural effusion and a moderate right pleural effusion are unchanged . Mild to moderate pulmonary edema is similarly unchanged . There is no pneumothorax .
    OUTPUT:
    
Severe cardiomegaly , large left and moderate right pleural effusions , and mild to moderate pulmonary edema are unchanged and consistent with known CHF .