Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Left - sided dual - chamber pacemaker device is noted with leads terminating in right atrium and right ventricle . Severe cardiomegaly with marked left atrial enlargement is re - demonstrated . There is mild pulmonary vascular congestion . The mediastinal and hilar contours are relatively unchanged , with mild atherosclerotic calcification of the thoracic aorta noted . The lungs are hyperinflated which suggests underlying COPD . No pleural effusion , focal consolidation or pneumothorax is present . There are mild multilevel degenerative changes in the thoracic spine .
    OUTPUT:
    
Mild pulmonary vascular congestion .