Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There is a large left pneumothorax with rightward shift of the mediastinal structures , concerning for tension physiology . The right lung is clear . The heart size is normal . There are no pleural effusions . The bony thorax is grossly intact .
    OUTPUT:
    
1 . Large left pneumothorax with rightward shift of the mediastinal structures , concerning for tension physiology . A subsequent radiograph had already been performed at the time of this dictation , demonstrating placement of a left - sided pleural catheter . 2 . Clear right lung .