Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Technique is limited due to underpenetration and positioning . Allowing for this limitation , there is no significant change from prioor exams , with stable moderate cardiomegaly and bilateral layering effusions , right worse than left . No pneumothorax . An ICD projects over the upper left hemithorax with a single lead in the right ventricle , unchanged from prior .
    OUTPUT:
    
Allowing for limited technique , the overall appearance is that of the patient 's baseline with small bilateral layering pleural effusions , right worse than left , and stable severe cardiomegaly .