Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Cardiac size is minimally enlarged , accentuated by the projection . There is mild vascular congestion . Intra-aortic balloon pump is low , tip is 9 .2 cm below the top of the aortic arch . Should be advanced approximately 4 .5 cm for more standard position . There is no pneumothorax or pleural effusion .
    OUTPUT:
    
Mild vascular congestion . Low position of the intra-aortic balloon pump , should be advanced approximately 4 .5 cm