Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The heart is severely enlarged , worsened from prior , with increased bulging of the right border compared with prior exam . There is bilateral diffuse interstitial opacities and hilar engorgement with associated left - sided pleural effusion . There is no pneumothorax . A biventricular pacemaker is again noted with the leads in unchanged position .
    OUTPUT:
    
1 . Acute interstitial edema with accompanying left - sided pleural effusion . 2 . Significant enlargement of the cardiac contour with increased bulging of the right border raises concern for developing pericardial effusion . These findings were entered in the ED dashboard as an Urgent flagged wet read by Dr . ___ on ___ at 8 : 10 a .m . immediately after discussion with the attending and approximately 15 minutes after image acquisition .