Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Right - sided subclavian line has been pulled back with the tip in the low SVC . In comparison with the earlier study of this date , there is little overall change . Again there is enlargement of the cardiac silhouette in a patient with a dual - channel pacer with leads extending to the right atrium and apex of the right ventricle . No change in the degree of pulmonary edema and the bilateral layering pleural effusions with compressive atelectasis at the bases , worse on the right . The right rib fractures are difficult to see on this study , but there is no evidence of pneumothorax .
    OUTPUT:
    
No substantial change in pulmonary edema and effusions , since the most recent prior .