Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Right atrial and ventricular pacemaker leads course in expected position . There is no pneumothorax . Bilateral pleural effusions have increased , now small - to - moderate on the left and small on the right . Mild cardiomegaly , central venous congestion , and interstitial edema have progressed . New hazy opacity in the left lower lobe . There is bulky superior mediastinal adenopathy , with widening of the right and left paratracheal stripes . The aorta is tortuous and calcified .
    OUTPUT:
    
1 . Worsening pulmonary edema . 2 . Left lower lobe opacity could represent aspiration / early infection . 3 . No pneumothorax .