Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: As compared to the prior examination , the right pleural effusion has increased in size and is now moderate - severe with adjacent atelectasis . Bilateral pulmonary edema is now moderate - severe . The heart is enlarged and the aortic arch is heavily calcified . A large , calcified right goiter is again noted , deviating the trachea towards the left .
    OUTPUT:
    
Interval worsening of now moderate - severe right pleural effusion and now moderate - severe bilateral pulmonary edema . Stable cardiomegaly .