Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The right lung volume is significantly decreased when compared to prior studies . This may be due to worsening of right lower lobar atelectasis with possible involvement of the right middle lobe and less likely worsening of a right pleural effusion . The volume loss of atelectasis exceeds the volume replacement of the pleural effusion , evidenced by an increased right mediastinal shift . A small left pleural effusion . Moderate to severe cardiomegaly is stable . Left pacemaker is intact with leads in the appropriate location . The right central venous catheter terminates in the cavoatrial junction . A fracture of the first sternotomy wire is new . The remaining sternotomy wires are intact .
    OUTPUT:
    
1 . Worsening right lower lobe collapse ; new small right pleural effusion . 2 . New fracture of the first median sternotomy wire . Assessment for sternal instability is recommended . 3 . Stable moderate to severe cardiomegaly .