Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There are low lung volumes . Mild pulmonary edema and small bilateral pleural effusions seen , similar to prior exam . There is no pneumothorax . Severe cardiomegaly is noted . The upper mediastinum is again noted be wide , unchanged from ___ and of indeterminate importance . There is a left - sided pacemaker is seen with intact leads in appropriate positions . Median sternotomy wires and mediastinal clips are noted .
    OUTPUT:
    
Mild pulmonary edema and small bilateral pleural effusions , similar to prior exam .