Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A rim-calcified density projecting over the posterior left lower chest reflects a splenic pseudocyst based on the prior CT and appears unchanged . The heart is again markedly enlarged with a globular configuration , but unchanged . The patient is status post mitral and tricuspid valve replacements . There is a single - lead pacemaker on the right with a lead extending into the coronary sinus . Via the left - sided pacemaker box , there are two leads that terminate in the right ventricle . A mild - to - moderate interstitial abnormality in addition to enlargement of central pulmonary vessels suggests similar mild - to - moderate pulmonary edema . There is also a persistent small - to - moderate left - sided pleural effusion with some shifting but probably no substantial change in overall size as well as associated atelectasis . The bones appear demineralized . Mild degenerative changes are noted along the thoracic spine .
    OUTPUT:
    
Similar findings including mild - to - moderate pulmonary vascular congestion and left - sided pleural effusion .