Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Frontal and lateral views of the chest demonstrate stable left pectoral cardiac pacer with leads terminating in the right atrium and right ventricle . Median sternotomy wires appear intact . Post - surgical changes of prior coronary arterial bypass grafting are present . There is persistent marked cardiomegaly and left greater than right pleural effusions , somewhat improved on the right . Mild vascular congestion is present . There has been interval increased left lower lobe density , which could represent a combination of persistent large effusion and underlying consolidation . Streaky right lower lung opacity also persists . A linear density in the right upper quadrant and a subdiaphragmatic vascular stent appear unchanged since prior exams . There is thoracolumbar spondylosis and possibly bridging anterior ossification , suggestive of a diffuse idiopathic skeletal hyperostosis .
    OUTPUT:
    
1 . Large left and diminishing small right pleural effusions . 2 . Persistent marked cardiomegaly and mild interstitial edema , suggestive of a component of heart failure . 3 . Increasing confluent density in the left lower lobe may represent a combination of large effusion and underlying consolidation , possibly atelectasis versus infection . Persistent right lower lobe opacity , could also represent infection versus atelectasis .