Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Cardiomediastinal contours are stable with moderate cardiomegaly . Pacer lead is in standard position . Left - sided cardiac device is in unchanged position . Large right pleural effusion tracking in the fissure has increased with increasing adjacent atelectasis . Small left effusion has also increased . Bibasilar atelectasis larger on the right side have increased . There is no pneumothorax . There is mild vascular congestion . Sternal wires are aligned . There are mild degenerative changes in the thoracic spine
    OUTPUT:
    
Increasing bilateral pleural effusions with adjacent atelectasis . Mild vascular congestion