Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Moderate - to - severe right pleural effusion containing a pigtail is slowly re-accumulating and has worsened since yesterday . There is no pneumothorax . Severe cardiac enlargement is unchanged .
    OUTPUT:
    
Right moderate - to - severe pleural effusion is worsening even with the pigtail in place . There is no pneumothorax . This has been discussed with the medical team at 9 a .m .