Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: New large left - sided pleural effusion . Heart size can not be reliably assessed but there is at least moderate cardiomegaly . Calcifications of the aortic knob . Left hilar contour can not be evaluated . Right hilar contour is not well evaluated . There may be mass effect from a large pleural effusion with rightward mediastinal shift . Lungs demonstrate pulmonary vascular congestion and mild edema . Bones are diffusely demineralized . Severe degenerative changes of bilateral glenohumeral joints are partially imaged .
    OUTPUT:
    
New large left - sided pleural effusion and mild pulmonary edema . Infection can not be excluded in this context . There is prominent cardiomegaly , though the cardiac contours are partially obscured by the effusion .