Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Frontal and lateral views of the chest demonstrate intact median sternotomy wires and tricuspid valve replacement . Prominent cardiac silhouette is similar as compared to prior exam . There is a large right pleural effusion with associated atelectasis and subsegmental atelectasis in the right upper lung , not significantly changed since ___ . Trace right apical pneumothorax is unchanged .
    OUTPUT:
    
Unchanged tiny right apical pneumothorax and right pleural effusion with atelectasis .