Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There has been significant interval worsening of the left sided pleural effusion with associated left lower lobe collapse . A right lower lung opacity is a combination of a layering effusion and atelectasis . Vascular congestion and interstitial edema is also unchanged . Assessment of cardiac size is limited due to technique but there appears to be moderate cardiomegaly . There is no pneumothorax . Left - sided PICC line ends in the mid SVC . Severe degenerative changes of the right glenohumeral joint are reidentified .
    OUTPUT:
    
Significant worsening of the left pleural effusion with associated severe left lower lobe atelectasis . Vascular congestion and interstitial pulmonary edema not significantly worsened from the previous exam .