Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Right - sided PICC has migrated proximally and terminates in the right subclavian vein , high in position . Single lead left AICD is seen , unchanged position . Severe cardiomegaly is again seen . The mediastinal contours are stable . Aortic knob calcification is again seen . Blunting of the left costophrenic angle is worrisome for a small left pleural effusion with overlying atelectasis . Previously seen right pleural effusion has decreased in the interval with possible trace remaining . No evidence of pneumothorax is seen .
    OUTPUT:
    
Right PICC has migrated proximally since the prior exam , now terminating in the region of the right subclavian vein , high in position . Persistent cardiomegaly . Small left pleural effusion . Interval decrease in right pleural effusion with possible trace remaining .