Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Left chest wall dual lead pacing device is again seen . Moderate right - sided pleural effusion is larger when compared to prior . The left lung is grossly clear noting that the costophrenic angle is excluded from the field of view . The cardiomediastinal silhouette is stable with mild cardiomegaly . Atherosclerotic calcifications noted at the aortic arch .
    OUTPUT:
    
Interval enlargement of now moderate right - sided pleural effusion . Cardiomegaly .