Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A frontal semi-upright view of the chest was obtained portably . The endotracheal tube ends at the level of the inferior clavicular heads and is no less than 5 .2 cm above the carina . The nasogastric tube follows the expected course , although the tip is not visualized . Low lung volumes result in bronchovascular crowding . New opacification of both lower lobes despite no change in lung volumes compared to the prior study is concerning for pneuomonia . The upper lung zones are clear . There is no large pleural effusion or pneumothorax , although the left lung apex is obscured by the chin . The azygous vein is bigger than before with increased caliber of the left upper lobe vessels . The right hilus is chronically enlarged . Cardiac silhouette is stable . Flattening of the right humeral head may be due to avascular necrosis . Degenerative change is seen in the left shoulder girdle .
    OUTPUT:
    
1 . Endotracheal tube is no less than 5 .2 cm above the carina . Given that the patient 's chin is down on the radiograph , the ETT could be advanced 2 - 3 cm for better seating . 2 . Bilateral lower lobe opacification , concerning for pneumonia . 3 . Mild congestive heart failure .