Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: PA and lateral chest views were obtained with the patient in upright position . Comparison is made with the next preceding similar study of ___ . Massive cardiac enlargement as before . Most advanced is the enlargement of the left atrium typical double contours on the frontal image , and massive extension of the posterior contour posteriorly on the lateral view resulting in corresponding deviation of the descending thoracic aorta . Right cardiac structures and position of pacemaker electrode also indicate extensive enlargement of the right atrium as well . The permanent pacer remains in unchanged position in the left anterior axillary area and the single intracavitary electrode terminates in a position compatible with the apical portion of the enlarged right ventricle . The pulmonary vascular pattern again shows typical upper zone redistribution pattern consistent with longstanding chronic pulmonary congestion . There appear now also interstitial markings on the bases consistent with interstitial edema , but no evidence of acute central edema is identified . No new local discrete pneumonic infiltrates are identified . Comparison with the next preceding study of ___ demonstrates increased accumulation of fluid in the lateral as well as posterior pleural sinuses finding which was not present at least to the same extent on the previous study . Search for intracardiac calcifications on the lateral view showed suspicious mitral valve calcifications which were confirmed also on the next preceding chest CT examination of ___ .
    OUTPUT:
    
Stable marked cardiac enlargement ( Cor Bovinum ) with evidence of chronic pulmonary congestion , increase of pleural effusions since next preceding chest examination of ___ , but no evidence of new inflammatory parenchymal abnormalities . Thus , the cause of patient 's CHF symptoms is cardiogenic and there is no radiologic evidence of acute pulmonary infection .