Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The lungs are clear without consolidation or edema . There are small bilateral pleural effusions , new since ___ . Enlargement of the cardiac silhouette has also progressed since prior . Left chest wall dual lead pacing device is noted with right atrial and right ventricular leads . No acute osseous abnormalities .
    OUTPUT:
    
Interval enlargement of the cardiac silhouette raising the possibility of pericardial effusion . New small bilateral pleural effusions .