IMPRESSION:
Severe left lower lobe atelectasis and small accompanying pleural effusion are
 unchanged since . Small to moderate right pleural effusion is slightly
 smaller. Upper lungs are clear.  Heart size top- normal. No pneumothorax. ET
 tube, transvenous right ventricular pacer defibrillator lead, and a right
 subclavian central venous catheter are in standard placements respectively. No
 pneumothorax.