Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Dual lead left - sided pacer device is stable in position . There is persistent left - sided pleural effusion . Left base opacity / left - sided volume loss are similar in appearance compared to the prior study . Small left apical pneumothorax persists . Extensive left - sided subcutaneous emphysema has decreased slightly in the interval .
    OUTPUT:
    
Small left apical pneumothorax and left pleural effusion . Left - sided volume loss similar compared to prior study . Extensive left - sided subcutaneous emphysema appears slightly improved compared to the prior study .