Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: AP upright and lateral views of the chest provided . Dual lead pacemaker appears unchanged in position with leads extending to the region of the right atrium and right ventricle . There is severe emphysema , better assessed on prior CT , with acute pulmonary edema evidenced by pulmonary hilar congestion and ___ B - lines . No large effusion . No focal consolidation . There may be a tiny right pleural effusion . No pneumothorax is seen .
    OUTPUT:
    
Emphysema with superimposed pulmonary edema .