Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There is an unchanged position of a dual lead pacemaker with leads extending to the region the right atrium and right ventricle and pacer pack projecting over the left chest wall . Right pleural effusion has increased in size with interval progression in collapse of the right middle and lower lobes . Lung volumes are low . Mild edema is likely present . No large pneumothorax . Nodular hyperdensity projecting over the left upper lung corresponds to a bone island on a prior CT . Mild hilar congestion is likely present . Heart size can not be assessed .
    OUTPUT:
    
Increased right pleural effusion with increased atelectasis of the right middle and lower lobes . Mild edema .