Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Small left apical pneumothorax is unchanged . Otherwise , the lungs appear similar to prior same day chest radiograph . Left pacemaker is in unchanged position . The heart is difficult to assess due to surrounding opacities and compressive atelectasis .
    OUTPUT:
    
Unchanged small left apical pneumothorax . Otherwise , no interval change since earlier same day chest radiograph .