Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The pacemaker is in unchanged position . Bilateral mid to lower lung opacities , right more than left , have worsened . Bilateral pleural effusion with associated volume loss has increased . Superimposed pneumonia in the right hemithorax can not be ruled out , especially without lateral view . Severe cardiomegaly is unchanged . Mediastinal silhouette is unchanged .
    OUTPUT:
    
Bilateral mid to lower lung opacities , right more than left , have worsened . Superimposed pneumonia in the right hemithorax can not be ruled out .