Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There is a new left - sided dual lead pacemaker with tips projecting over the expected location . Heart there is increased right - sided pleural effusion . Moderate cardiomegaly , pulmonary vascular redistribution and alveolar infiltrates , right greater than left compatible with asymmetric pulmonary edema that has worsened compared to the film from the prior day . There is no pneumothorax .
    OUTPUT:
    
Worsened pulmonary edema .