Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The lungs are low in volume and show a persistent left - sided effusion with associated atelectasis . The cardiac silhouette is enlarged . The mediastinal silhouette and hilar contours are normal . There may be a small right effusion as well . A right - sided pacer terminates with its leads in the right ventricle . Sternal wires are stable .
    OUTPUT:
    
Persistent small left effusion with associated atelectasis is unchanged and a small right effusion is new .