Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Portable AP upright chest radiograph is obtained . There is a right arm PICC line with tip in the region of the superior vena cava . Please note a line was seen in the same position on prior exam . A dual - lead right chest wall pacer is unchanged with proximal lead in the right atrium and distal lead in the expected location of the right ventricle . The heart is mildly enlarged . Mild vascular engorgement is seen without frank pulmonary edema . An area of scarring is again noted at the left lower lobe . No large pleural effusions are seen . No pneumothorax . An azygos fissure is noted . Mediastinal contour appears stable . Bony structures are intact .
    OUTPUT:
    
Mild vascular engorgement . Appropriately positioned right arm PICC line .