Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Dual lead left - sided pacer device is stable in position . The cardiac silhouette remains enlarged . There is mild to moderate pulmonary edema . Bilateral pleural effusions are likely present . No pneumothorax is seen . Mediastinal contours are stable .
    OUTPUT:
    
Large cardiac silhouette , similar to prior , underlying pericardial effusion not excluded . Bilateral pleural effusions and pulmonary edema .