Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Lung volumes remain persistently low . There is mild enlargement of the cardiac silhouette . The aorta is diffusely calcified . The mediastinal contour is otherwise unchanged . Mild pulmonary vascular congestion is present , increased since the previous examination . Persistent elevation of the right hemidiaphragm has been present since the CT in ___ , however , a moderate right pleural effusion is noted , somewhat increased compared to that seen previously . There is continued atelectasis within the right lung base . No left - sided pleural effusion is present . There is no pneumothorax . Numerous clips are demonstrated in the left axilla . There are moderate multilevel degenerative changes seen in the thoracic spine .
    OUTPUT:
    
Interval worsening of mild pulmonary vascular congestion . Moderate right pleural effusion appears increased from ___ superimposed on chronic elevation of the right hemidiaphragm with associated right basilar atelectasis .