Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Transvenous right atrial and right ventricular pacer leads remain in unchanged position . Median sternotomy wires and mitral valve replacement are unchanged . The heart is moderately enlarged , stable . There is however a small radiolucency surrounding the heart , for which a small pericardial effusion can not be excluded . There is no new focal consolidation , pleural effusion or pneumothorax . There is mild interstitial edema . Chronic pericardial calcification is again noted .
    OUTPUT:
    
1 . Small radiolucency surrounding the heart , for which a small amount of pericardial effusion can not be excluded . If clinically indicated an ECHO should be obtained . 2 . Mild interstitial edema .