Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Medial left basilar opacity may reflect prominent para-aortic fat , a large pericardial fat pad , or atelectasis . New , dense opacification at the cardiac apex extending to the lateral chest wall likely reflects a new pleural effusion or a large fat pad given differences in patient positioning . No pneumothorax . Heart size is stable .
    OUTPUT:
    
Dense opacity at the cardiac apex extending the lateral chest wall is concerning for hemothorax given the interval change and reported history of mechanical fall . Alternatively , this may be related to changes in patient positioning and a large pericardial fat pad . Recommend repeat upright PA and lateral chest radiographs for further evaluation . If the patient is acutely hypotensive , CT should be considered .