Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Since the chest radiograph obtained approximately 4 hours prior , substantial right middle lobe and right lower MR clearly apparent . A small , right pleural effusion is unchanged . Severe cardiomegaly and moderate pulmonary vascular congestion without pulmonary edema are unchanged . Thoracic aorta is very tortuous , but unchanged . The left lung is fully expanded and otherwise clear .
    OUTPUT:
    
Right middle lobe and right lower lobe pneumonia .