Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: PA and lateral views of the chest . Left - sided pacemaker wire is in appropriate position . Severe cardiomegaly is unchanged . There is pulmonary vascular congestion and possible mild interstitial pulmonary edema . There are small - to - moderate bilateral pleural effusions , increased from prior study .
    OUTPUT:
    
Severe cardiomegaly and pulmonary vascular congestion and increasing small - to - moderate bilateral pleural effusions .