Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There is moderate cardiomegaly . Pacer leads are in standard position with tips in the right atrium and right ventricle . There is mild vascular congestion . . There is no pneumothorax or pleural effusion . There are mild degenerative changes in the thoracic spine
    OUTPUT:
    
Pacer leads in standard position . Mild vascular congestion . No pneumothorax