Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Portable semi-erect chest film ___ at 02 :46 is submitted .
    OUTPUT:
    
Left internal jugular central line has its tip in the proximal SVC . A dual - lumen right internal jugular central line is again seen with its tip in the mid SVC . An endotracheal tube is identified with its tip approximately 7 cm above the carina . A right - sided PICC line is seen with its tip overlying the mid axilla . The heart remains enlarged which may reflect cardiomegaly or a pericardial effusion . There is an increasing layering left effusion and a smaller right effusion . The pulmonary edema may have slightly improved but remains . The retrocardiac area is under penetrated and can not be well evaluated but there is likely at least partial lower lobe atelectasis given the size of the left effusion . No large pneumothorax .