Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: PA and lateral views of the chest were provided . A left chest wall AICD is again seen with leads extending into the region of the coronary sinus and right ventricle . The heart remains stably enlarged , and mild pulmonary interstitial edema is again noted . There is a small right pleural effusion again seen . Mediastinal contour is stable . No pneumothorax . Bony structures are intact .
    OUTPUT:
    
No significant change with persistent cardiomegaly , mild edema and small right pleural effusion .