Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There are small bilateral pleural effusions , which may be new since ___ . No evidence of pneumonia or pulmonary edema . No pneumothorax . The mediastinum and hila are normal . There are atherosclerotic calcifications of the aortic arch . Moderate to severe cardiomegaly , better demonstrated on CT chest dated ___ . Transvenous pacer - defibrillator is unchanged in position with leads terminating in the right atrium and right ventricle .
    OUTPUT:
    
1 . Small bilateral pleural effusions , likely new since ___ . 2 . Chronic moderate to severe cardiomegaly .