Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: 2 lead left - sided pacer device is seen with leads in expected positions of the right atrium and right ventricle . The cardiac silhouette is mild to moderately enlarged . The aorta remains calcified . There may be minimal vascular congestion without overt pulmonary edema . Small left - sided Bochdalek hernia may be present .
    OUTPUT:
    
Persistent mild to moderate enlargement of the cardiac silhouette . Possible minimal vascular congestion without overt pulmonary edema .