Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: AP single view of the chest has been obtained with patient in sitting semi-upright position . Analysis is performed in direct comparison with the next preceding similar study of ___ . Marked cardiac enlargement unchanged . Unchanged position of previously described left - sided permanent pacer with dual intracavitary electrode system . The pulmonary congestive pattern persists and may even have increased . The lateral pleural sinuses are only mildly blunted but it is likely that the pleural effusions are layering posteriorly as the patient is in marked recumbent position . No pneumothorax identified .
    OUTPUT:
    
Persistent cardiomegaly with pulmonary congestion close to pulmonary edema .