Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Compared to the previous exam there has been improvement in pulmonary edema but re-accumulation of a moderate to large right pleural effusion . A small left effusion is present . The heart remains mildly enlarged . Atrial and biventricular pacemaker leads are unchanged . Median sternotomy wires are intact .
    OUTPUT:
    
Interval increase of moderate - to - large right pleural effusion .