Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Portable single view chest x-ray shows stable moderate to severe right pleural effusion , small to moderate left pleural effusion is also unchanged . Heart size is mildly enlarged . vascular congestion is mild . Patient is after cardiac surgery . Sternal metal wires are intact . Right pectoral pacemaker has leads following the expected course and ending in the right atrium and right ventricle . There is no pneumothorax .
    OUTPUT:
    
Mild vascular congestion , exam otherwise unchanged .