Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: AP portable semi upright view of the chest . Dual lead pacemaker is unchanged with leads extending to the region the right in right ventricle . Catheter tubing projects over the left upper quadrant likely representing a drain as seen on prior chest CT from ___ . There is a partially layering right pleural effusion which is moderate to large in size . A left pleural effusion is small to moderate in size . Overall , there has been no significant change from prior exam . Heart size can not be assessed . No large pneumothorax . Bony structures intact .
    OUTPUT:
    
Unchanged from prior .