Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Lung volumes are low . Heart size is markedly enlarged , as seen previously , but may be more exaggerated on this exam by low lung volumes . Dual - lead pacing hardware is similarly positioned with generator projecting over the left upper outer chest . No focal consolidation , pleural effusion , or pneumothorax is detected . There is pulmonary vascular prominence with mild congestion . Sternal wires appear intact on these views . No rib fracture is detected on these views .
    OUTPUT:
    
1 . Persistent cardiomegaly with mild pulmonary vascular congestion . 2 . No rib fracture detected , but sensitivity is limited on routine chest radiography . If clinical suspicion is high , dedicated rib series is recommended . Findings and recommendations were discussed with ___ by ___ by telephone at 10 :20 a .m . on ___ at the time of discovery of these findings .