Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: AP single view of the chest has been obtained with patient in semi-upright position . Comparison is made with the next preceding similar study of ___ . Permanent pacer in left anterior axillary position as before . Considerable cardiac enlargement is present . Pulmonary vasculature demonstrates perivascular haze compatible with marked congestion . There is evidence of a right - sided pleural effusion obliterating the diaphragmatic contours and blunting the lateral pleural sinus . Less prominent left - sided pleural effusion as the left lateral pleural sinus appears free . The patient is status post sternotomy and the metallic component of a mitral valve prosthesis is seen in place . Also noted is the presence of biventricular epicardial pacing wires with the left - sided electrode entered into the coronary sinus and placed in an obtuse marginal coronary vein activating the left ventricular lateral structures . The previously described ( placed on ___ ) PICC line remains in unchanged position and no pneumothorax is seen .
    OUTPUT:
    
Marked cardiac enlargement on biventricular pacing device . Chronic pulmonary vascular congestion with pleural effusions more marked on the right . No evidence of new parenchymal pulmonary abnormalities as can be identified on this single view chest examination .