Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Compared to ___ , a small right effusion is now larger , likely with an element of underlying collapse and / or consolidation at the right base . Otherwise , I doubt significant interval change . Again seen is background COPD and chronic cardiomegaly , with sternotomy wires . One pacemaker device overlies the right chest , with apparent abandoned lead and additional lead overlying the right heart . Another pacemaker overlies the right upper abdomen and is associated with epicardial leads , which are similar in configuration . Mild vascular plethora , though doubt overt CHF . No left - sided effusion . Probable slight interval improvement in atelectasis at the left base . Subtle parenchymal abnormalities might not be apparent radiographically . Left IJ central line tip overlies the lower SVC . No pneumothorax is detected .
    OUTPUT:
    
Small right pleural effusion as increased compared with ___ , with probable underlying collapse and / or consolidation . Otherwise , doubt significant interval change .