Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Upright AP and lateral images of the chest . The lungs are well expanded . The patient again demonstrates signs of early mild cardiac decompensation , consisent with recent exams which have demonstrated persistently engorged pulmonary vasculature and a larger heart than seen on earlier prior exams . There are trace bilateral pleural effusions . There is no pneumothorax . Pacer is seen with intact leads in appropriate position .
    OUTPUT:
    
1 . No acute cardiopulmonary process . 2 . Mildly engorged pulmonary vasculature and cardiomegaly , similar to prior exam but increased from more remote prior exams .