Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: PA and lateral views of the chest The heart is moderately enlarged , and intact median sternotomy wires and mediastinal vascular clips are again noted . Epicardial pacing leads also noted . There is mild vascular engorgement , possible mild vascular blurring , and trace thickening of the minor fissure , suggesting mild vascular plethora . A small amount of pleural fluid or thickening is seen posteriorly . There is no large pleural effusion or pneumothorax . No focal airspace opacity is seen . Minimal atelectasis left base .
    OUTPUT:
    
Mild fluid vascular plethora , progressed since the prior study . Small amount of pleural fluid or thickening posteriorly .