Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Median sternotomy wires , replaced aortic valve , and left pacemaker defibrillator device are unchanged . Lung volumes have slightly decreased in the interim . There is central pulmonary vascular congestion with moderate pulmonary edema . Indistinctness of the left hemidiaphragm , descending aorta , and costophrenic angle most likely reflects a combination of the small left pleural effusion , atelectasis , and edema , worse since ___ . Moderate cardiomegaly is overall unchanged . No right pleural effusion . No pneumothorax . No definite focal consolidation , however concurrent infection , particularly in the left lower lobe , in the appropriate clinical situation can not be excluded .
    OUTPUT:
    
Findings most consistent with volume overload and / or heart failure , including moderate central in interstitial edema , cardiomegaly , and small left pleural effusion .