Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Patient is rotated slightly to the left . Patient is status post median sternotomy . Single lead left - sided pacemaker is stable in position . Bilateral pleural effusions with overlying atelectasis persist . There is moderate pulmonary edema . Marked cardiomegaly persists . Prominence of the hila persists .
    OUTPUT:
    
Continued bilateral pleural effusion , cardiomegaly , and pulmonary edema .