Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The lungs are well expanded . Assessment of the left lower lung field is limited due to stable severe cardiomegaly . No focal opacities are noted in the remaining lung fields . A small right - sided pleural effusion is present . There is mild interstitial thickening bilaterally with vascular cephalization . An enlarged right hilum is unchanged , left is obscured by pacing device . There is a tiple lead pacemaker , with leads in stable positions . Sternotomy wires are intact .
    OUTPUT:
    
Mild interstitial edema and new right - sided pleural effusion in the setting of chronic congestive heart failure .