Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Moderate size left apical pneumothorax is re - demonstrated . Mild contralateral shift of the heart is present when compared to the previous radiograph . Heart size is normal . The mediastinal and hilar contours are otherwise normal . The pulmonary vasculature is normal . Lungs are clear . No pleural effusion is seen . There are no acute osseous abnormalities .
    OUTPUT:
    
Unchanged moderate size left pneumothorax with minimal rightward shift of the heart suggesting early tension .