Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: AP and lateral views of the chest were compared to previous exam from ___ . There are bilateral parenchymal opacities identified , most confluent in the perihilar region . There is a small left - sided pleural effusion . Cardiac silhouette is enlarged but stable in configuration . Dual - lead pacing device again seen . Degenerative changes noted at the shoulders bilaterally . Osseous and soft tissue structures are otherwise grossly unremarkable .
    OUTPUT:
    
Findings suggestive of congestive failure .