Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The left pectoral pacer is re-demonstrated , with leads terminating in the right ventricle and left ventricle . In comparison to the radiograph performed yesterday evening , the endotracheal tube has been pulled back several cm and now terminates 4 .4 cm above the carina . Lung volumes are low . The right lung is essentially clear . There is a moderate - to - severe left pleural effusion , which appears slightly worse compared to the prior radiograph performed yesterday evening . There is no pneumothorax .
    OUTPUT:
    
1 . Endotracheal tube is 4 .4 cm above the carina . 2 . Interval worsening of moderate / severe left pleural effusion .