Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: An ET tube is present , tip approximately 4 .9 cm above the carina . An enteric type tube is present , tip extends beneath the diaphragm , but can not be traced beyond this . Bilateral left - sided chest tubes are present . A left IJ central line tip overlies the proximal / mid SVC . A right sided dual lead pacemaker is present , with lead tips overlying the right atrium an right ventricle . There is an apparent prosthetic aortic valve with ? a coronary artery stent versus heavily calcified coronary artery . Thin tubing overlies the right axilla , but no PICC line is seen within the chest . Inspiratory volumes are low , with bibasilar atelectasis . The cardiomediastinal silhouette is prominent , but probably unchanged allowing for technique . There is mild vascular plethora and vascular blurring , with thickening of the minor fissure , consistent with CHF . Equivocal small bilateral effusions . At the edge of these films , note is made of a spinal fixation device and bilateral carotid artery calcifications .
    OUTPUT:
    
1 . Bibasilar atelectasis . Possibility of an early pneumonic infiltrate , particularly in the left retrocardiac region , can not be excluded . 2 . CHF with interstitial edema . The appearance is likely accentuated by low lung volumes . 3 . Lines and tubes , as described . 4 . Thin linear tubing overlying the right axilla . Of note , however , no PICC line is seen within the chest . Clinical correlation is requested as , if there is a right - sided PICC line present , it does not extend into the SVC . ( This latter finding was discussed with ___ , the nurse caring for the patient , by Dr . ___ by phone at 7 : 24 pm on ___ , several minutes after discovery . He indicated that patient does not have a PICC line . ) The etiology of this material remains unknown .