Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: AP and lateral views of the chest are compared to previous exam from ___ . There are small - to - moderate bilateral pleural effusions , left greater than right . Indistinctness of the pulmonary vascular markings suggests vascular congestion . Cardiac silhouette is enlarged , but unchanged . Left chest wall triple - lead pacing device is again seen with leads in the right atrium , right ventricular apex and coronary sinus . Prosthetic valve component is also visualized . Cardiac silhouette is enlarged as seen on prior . Bones are diffusely osteopenic .
    OUTPUT:
    
Pulmonary vascular congestion with small - to - moderate left greater than right pleural effusions .