Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The tip of the right PICC line is again not clearly seen but likely extends to the mid SVC . The right transjugular Swan - Ganz catheter is unchanged in position , fixed in a right lower lobe pulmonary artery . A left chest wall biventricular pacemaker is present . There is a persisting small right apical pneumothorax . The size of the moderate right pleural effusion with overlying atelectasis is grossly unchanged . No left pleural effusion or pneumothorax . The size the cardiac silhouette is enlarged but stable .
    OUTPUT:
    
Persisting right apical pneumothorax . The tip of the right PICC line is not clearly identified but likely extends through the mid SVC . Moderate right pleural effusion with overlying atelectasis .