Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Dual - lead left - sided pacemaker is again seen unchanged in position with leads extending to the expected positions of the right atrium and right ventricle . Cardiac silhouette enlargement remains . The aortic knob remains calcified . There is pulmonary edema which appears improved compared to the prior study , there is slight blunting of the costophrenic angles may be due to trace pleural effusions . No definite focal consolidation is seen . There are no findings to suggest pneumothorax . There has been interval removal of a right internal jugular central venous catheter .
    OUTPUT:
    
Enlarged cardiac silhouette and pulmonary edema . Mild - to - moderate pulmonary edema appears decreased as compared to the prior study . Possible trace pleural effusions .