Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Left - sided dual - chamber pacemaker with leads terminating in right atrium AND right ventricle IS in unchanged position . There is mild cardiomegaly . The mediastinal contours are unchanged . There is mild pulmonary vascular congestion and small bilateral pleural effusions . No focal consolidation or pneumothorax is present . Remote right humeral neck fracture , right - sided rib fractures , and chronic fracture deformity of the distal right clavicle are again demonstrated . Compression deformity of a mid thoracic vertebral body is also unchanged . Cervical spinal fusion hardware is partially imaged .
    OUTPUT:
    
Mild pulmonary vascular congestion with small bilateral pleural effusions .