Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A portable frontal chest radiograph again demonstrates cardiomegaly , pulmonary edema , and bilateral pleural effusions with likely associated atelectasis . Given changes in patient position , it is difficult to assess for interval change . No pacer lead is visualized .
    OUTPUT:
    
1 . No pacer lead is visualized . 2 . Cardiomegaly , pulmonary edema , bilateral pleural effusions and likely associated atelectasis . Interval changes are unclear due to changes in patient position .