Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A tracheostomy is in place . The heart is large , similar to slightly increased from prior exam . Severe pulmonary edema is present , slightly worsened from prior exam . Areas of pleural thickening / plaques are unchanged and moderate left pleural effusion is present with presumed underlying atelectasis . The left - sided central line tip terminates in the mid to upper SVC . There is no pneumothorax .
    OUTPUT:
    
Worsening cardiomegaly and pulmonary edema with left pleural effusion .