Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: AP upright and lateral views of the chest provided . Dual lead pacer is unchanged with leads extending to the region the right atrium and right ventricle . Bilateral pleural effusions are again noted , left greater than right with associated compressive lower lobe atelectasis . Minimal residual aeration in the left upper lobe is noted . The possibility of underlying pneumonia is difficult to exclude . No large pneumothorax . The heart size can not be assessed . Bony structures are grossly intact .
    OUTPUT:
    
Bilateral pleural effusions left greater than right with associated compressive lower lobe atelectasis . Effusions appear increased from prior exam .