Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Right - sided pacemaker device with leads terminate a right atrium right ventricle is unchanged . Mild cardiomegaly persists . Aortic knob is calcified . Mild pulmonary vascular congestion is not substantially changed in the interval . A moderate size left pleural effusion is relatively similar compared to the previous study . Worsening opacification the left lung base may reflect worsening pneumonia . The right lung is otherwise grossly clear . No pneumothorax is present . There are mild multilevel degenerative changes seen in the thoracic spine .
    OUTPUT:
    
Right basilar opacity appears slightly increased in the interval which may suggest worsening pneumonia . Moderate left pleural effusion is relatively unchanged . Mild pulmonary vascular congestion is also similar .