Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Frontal and lateral views of the chest were obtained . Left - sided pacer device is seen , with leads in the similar position . There is severe enlargement of the cardiac silhouette which may be due to cardiomyopathy versus pericardial effusion . No focal consolidation is seen . There is no pleural effusion or pneumothorax . Multilevel degenerative changes are seen . There is mild central pulmonary vascular engorgement . However , the previously seen pulmonary edema has improved and essentially resolved since the prior study .
    OUTPUT:
    
Severe enlargement of the cardiac silhouette which may be due to cardiomyopathy or pericardial effusion . Mild central pulmonary vascular engorgement without overt pulmonary edema .