Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: AP single view of the chest has been obtained with patient in semi-upright position . Comparison is made with the next preceding similar study of ___ . The patient is extubated as previously visible ETT can not be identified anymore . A right subclavian approach central venous line is now seen reaching to the lower SVC area . An NG tube is seen as before reaching well below the diaphragm . Marked cardiomegaly as before and deviation of the endogastric tube in the esophagus to the left , indicative of left atrial enlargement . Comparison is made with the lung fields with the preceding examination , there is now much more marked perivascular haze surrounding the pulmonary vasculature indicative of pulmonary edema . Increased haze on the bases can also be explained by increasing pleural effusions layering posteriorly . No pneumothorax is seen . Advanced degenerative changes in both shoulder joints as described before .
    OUTPUT:
    
Markedly increased pulmonary congestion with signs indicative of pulmonary edema and pleural effusions . Telephone report was delivered at 1 :45 p .m .