Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Left - sided pacer device is noted with leads terminating in the regions of the right atrium , right ventricle , and coronary sinus , unchanged . Moderate enlargement of the cardiac silhouette persists . The aorta remains mildly tortuous . The mediastinal and hilar contours are unchanged . Pulmonary vasculature is not engorged . No focal consolidation , pleural effusion or pneumothorax is present . No acute osseous abnormality is visualized .
    OUTPUT:
    
Moderate cardiomegaly without congestive heart failure .