Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Single portable frontal view of the chest . The ET tube and NG tube are in adequate position . A pacer is noted overlying the left chest with intact leads in appropriate positions . The lungs are hyperinflated . The previously seen pulmonary vascular congestion / interstitial edema is similar to prior exam . There is a small right pleural effusion . The cardiomediastinal silhouette is enlarged but stable .
    OUTPUT:
    
Unchanged pulmonary vascular congestion / interstitial edema with a small right pleural effusion .