Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Portable frontal radiograph of the chest demonstrates a left - sided dual - lead pacemaker with leads in the expected location . A shunt catheter is incompletely visualized projecting over the right hemithorax and right upper quadrant . There is moderate enlargement of the cardiac silhouette with calcification of the aortic knob . Mild pulmonary vascular congestion is present without overt edema . The right costophrenic angle is not fully included and a trace pleural effusion is not excluded . No focal consolidation . Multiple old healed right rib fractures are present . Median sternotomy wires appear intact .
    OUTPUT:
    
No focal consolidation . Moderate enlargement of the cardiac silhouette with mild pulmonary vascular congestion .