Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: AP and lateral chest radiograph demonstrates an enlarged heart with a cardiac pacing device , its leads which appear in similar orientation relative to prior examination , noting that 1 lead is discontinuous . Central vasculature appears engorged without over pulmonary edema . There is no pleural effusion . Opacity within the medial aspect of the right lower lung zone with air bronchograms is somewhat more conspicuous relative to prior examination for which acute infectious process is difficult to exclude . There is no pneumothorax . There is no air under the right hemidiaphragm .
    OUTPUT:
    
Cardiomegaly with central vascular engorgement . No overt edema . Opacity within the medial aspect of the right lower lung zone is more conspicuous relative to prior examination for which acute infectious process is difficult to exclude .