Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There is unchanged severe cardiomegaly . Mild pulmonary vascular congestion is present . There is no pleural effusion or pneumothorax . No focal consolidation is identified . A left chest pacemaker and leads are in unchanged positions .
    OUTPUT:
    
Severe cardiomegaly with mild pulmonary vascular congestion .