Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Compared with the prior study , no change in the left - sided pacer device and AICD lead placement . Severe cardiomegaly is again seen , now with moderate to severe pulmonary edema , worse since the prior study . Retrocardiac opacity makes it difficult to exclude developing left lower lobe infection . No pneumothorax .
    OUTPUT:
    
Worsening pulmonary edema and retrocardiac opacity . Given worsening retrocardiac opacity , left lower lobe pneumonic infiltrate can not be entirely excluded .