Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Frontal and lateral chest radiograph demonstrate new large left pleural effusion with diffuse bilateral pulmonary nodules better seen on CT dated ___ . There is additional shift of the mediastinum to the right with an enlarged heart . Question pleural effusion . No evidence of tamponade . There is collapse of the left lower lobe . There is no pleural effusion on the right . There is no pneumothorax . A single chamber pacemaker is identified with its tip terminating in the right ventricle in standard position .
    OUTPUT:
    
New left large pleural effusions with pulmonary nodules bilaterally . Question enlarged heart with pleural effusion . No evidence to suggest tamponade . These findings were communicated to the ordering physician ___ . ___ by Dr . ___ at 15 : 20 on ___ .