FINDINGS:
Left-sided dual-chamber pacemaker leads terminate in the right atrium and
 right ventricle.  There is moderate enlargement of cardiac silhouette.  The
 aorta is tortuous and diffusely calcified.  Mild pulmonary edema is present. 
 No large pleural effusion or pneumothorax is identified.  Probable
 retrocardiac atelectasis is noted.  There are no acute osseous abnormalities.

IMPRESSION:
Mild congestive heart failure.