Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The heart is moderately enlarged . There is a moderate - sized left effusion that is increased compared to prior . There is pulmonary vascular redistribution and alveolar infiltrate suggesting an element of fluid overload ; however , in addition , there is more dense alveolar infiltrate involving the left lower lobe . It is unclear if this is due to an infectious process . Chronic right upper lobe and lower lobe lung changes are again visualized .
    OUTPUT:
    
1 . New infiltrate in the left lower lobe . 2 . Increased fluid overload .