Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: An ET tube remains present , tip approximately 3 .5 cm of a above the carina . An orogastric type tube is present , tip extending beneath diaphragm , off film . Right IJ central line tip overlies the right atrium . A left subclavian a left - sided single lead pacemaker , with lead tip over right ventricle . No pneumothorax is detected . Marked enlargement of the cardiomediastinal silhouette is again seen , similar to prior . Today 's examination is obtained with less oblique positioning . Rounded density projecting lateral to the aortic arch is noted . , the appearance is similar to ___ at 15 : 46 . This may reflect tortuosity and unfolding of the aorta with the patient still somewhat obliquely positioned . However , attention to this area on followup films is requested . New on today 's exam , there is hazy opacity at in the right mid and lower zones , with obscuration of the right hemidiaphragm . The appearance is suggestive of a layering pleural effusion with underlying collapse and / or consolidation . Pleural fluid is now seen tracking along the right lung apex laterally . Increased retrocardiac density , with obscuration of left hemidiaphragm persists , compatible left lower lobe collapse and / or consolidation . A small left effusion can not be entirely excluded . There is mild vascular and plethora and vascular blurring , consistent with interstitial edema .
    OUTPUT:
    
New right effusion , with underlying collapse and / or consolidation . Persistent left lower lobe collapse and / or consolidation . Small left effusion can not be excluded . CHF with interstitial edema . I suspect this is more pronounced than on the most recent prior film . Persistent marked cardiomegaly . Rounded opacity adjacent to the left aortic knob is similar to ___ and may reflect a tortuous on unfolded aorta . However , attention to this area on followup films is requested .