Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Frontal and lateral views of the chest . There are small bilateral effusions , increased since prior and larger on the right than on the left . Instinct pulmonary vascular markings are seen throughout the lungs . There is no focal consolidation suspicious for infection . Moderate - to - severe cardiomegaly . Left chest wall dual - lead pacing device is again seen . Median sternotomy wires and mediastinal clips are noted . No definite acute osseous abnormality is identified .
    OUTPUT:
    
Small right greater than left pleural effusions enlarged since prior with indistinct pulmonary vascular markings and cardiomegaly suggestive of congestive failure .