Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The lungs are clear without consolidation large effusion . Degree of pulmonary vascular congestion has improved since prior . Moderate cardiomegaly is again noted with a dual lead pacing device in stable position . No acute osseous abnormalities , multiple thoracic compression deformities are unchanged .
    OUTPUT:
    
Cardiomegaly without superimposed acute cardiopulmonary process .