Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: AP and lateral views of the chest are compared to previous exam from ___ . Again seen are left greater than right pleural effusions . Indistinct pulmonary vasculature markings , particularly on the left are seen . There is no large confluent consolidation . Cardiac silhouette is enlarged but stable in configuration . Single - lead pacing device is seen with the lead tip in the right ventricle apex . Hypertrophic changes seen in the spine . Osseous and soft tissue structures are otherwise notable for left shoulder arthroplasty .
    OUTPUT:
    
Perisitent left greater than right pleural effusions not significantly changed and mild edema .