Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: In comparison to the prior radiograph on ___ , there has been worsening of the substantial left - sided pleural effusion with adjacent atelectasis . Right lung is essentially clear . No evidence of pneumothorax bilaterally . Severe cardiomegaly is unchanged . Median sternotomy wires are intact . Hemodialysis catheter terminates in the right atrium . No acute osseous abnormalities are identified .
    OUTPUT:
    
Substantial increase in left pleural effusion with adjacent atelectasis .