Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Assessment is limited due to anteroposterior projection and positioning . Allowing for these limitations : Compared with the previous exam there appears to be worsening cardiomegaly , which now is moderate to severe allowing for limitations of this AP view . Minimal interstitial edema is present . There is also a new right middle lobe opacity the , confirmed in the lateral view . No other focal opacities are identified . Bilateral pleural effusions , left worse than right is present . There is no evidence of pneumothorax . Left - sided two - lead pacemaker is reidentified , with one lead terminating in the right atrium and the other in the right ventricle . The aortic valve prosthesis appears unchanged . Severe degenerative changes of the AC joints is again seen .
    OUTPUT:
    
1 . In the setting of worsening cardiomegaly compared with ___ , there is minimal interstitial pulmonary edema and bilateral pleural effusions , left worse than right . 2 . Right middle lobe consolidation may represent pneumoniae given clinical presentation . 3 . Unchanged location of the pacemaker leads .