Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: When compared to ___ portable chest radiograph , the left IJ has been removed and there is a new small right apical pneumothorax . The small left pleural effusion , moderate right pleural effusion has increased in size when compared to most recent study . There is moderate cardiomegaly without overt pulmonary edema . Tip of the right PICC line terminates at the cavoatrial junction . Sternotomy wires are aligned and intact .
    OUTPUT:
    
1 . New small right apical pneumothorax , not unexpected . 2 . Interval worsening of the small left pleural effusion a moderate right pleural effusion since ___ .