Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: AP upright and lateral radiographs of the chest reveals moderate - to - severe cardiomegaly , more pronounced than on the prior study . There is moderate pulmonary edema , without pleural effusion . There is no pneumothorax . An implantable cardiac pacemaker has appropriately placed , intact leads .
    OUTPUT:
    
Findings consistent with acute decompensated congestive heart failure including moderate - to - severe cardiomegaly and moderate pulmonary edema , without pleural effusion .