Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A left pectoral pacemaker is unchanged with a single lead terminating in the right ventricular apex . A tracheostomy tube is in place . There is bi apical capping on the right greater than left , which may represent pleural fluid . A moderate sized layering right pleural effusion with underlying atelectasis is slightly decreased in size . A small left pleural effusion and associated atelectasis is slightly decreased in size . Improved aeration of the bilateral lung bases may also reflect differences in position between studies with more dependent pleural fluid on today 's examination . No pneumothorax is detected . The cardiac silhouette is incompletely evaluated . The mediastinal contours are prominent but stable with tortuosity of the thoracic aorta and calcification of the aortic knob .
    OUTPUT:
    
Minimal change with persistent bilateral pleural effusions on the right greater than left and underlying atelectasis .