Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Portable semi-upright radiograph of the chest demonstrates low lung volumes with resulting bronchovascular crowding . There has been interval increase in the size of the right pleural effusion , which is now small , and there is adjacent atelectasis . There is a tiny left - sided pleural effusion with some adjacent atelectasis as well . Cardiomediastinal and hilar contours are overall unchanged . Again seen is a left pectoral pacemaker with leads in the expected location .
    OUTPUT:
    
Small right - sided pleural effusion with adjacent atelectasis and tiny left - sided pleural effusion with some adjacent atelectasis as well .