Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There has been minimal improvement in the pulmonary edema . There is a new small left pleural effusion . There is no pneumothorax or focal airspace consolidation . The cardiac silhouette is top normal in size . The mediastinal contours are unchanged . A left - sided pacemaker is again noted .
    OUTPUT:
    
Minimal improvement in moderate pulmonary edema with a new small left pleural effusion .