Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The lungs are hyperinflated . Moderate to severe cardiomegaly is unchanged . Prominence of the right lower lobe vasculature is grossly unchanged . A pacemaker device is identified , with leads projecting to the right atrium and right ventricle . No pneumothorax , new focal consolidation , or pleural effusion .
    OUTPUT:
    
Persistent lung hyperinflation and severe cardiomegaly . Mild pulmonary vascular congestion is likely , but there is no new focal consolidation or pleural effusion .