Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A portable upright AP radiograph of the chest demonstrates a tracheostomy catheter in unchanged position . The aortic stent graft is unchanged also . The lung volumes are low and there is a stable small left pleural effusion . Moderate cardiomegaly and retrocardiac atelectasis is stable . There is a faint linear opacity over the patient 's left upper chest , which may represent the PICC , but it could be overlapping of underlying structures . There is no pneumothorax . Persistent widening of the mediastinum and cardiac silhouettes .
    OUTPUT:
    
1 . Stable cardiomegaly , left pleural effusion , and retrocardiac atelectasis . 2 . The PICC is malpositioned and can not be seen well . A linear density over the superior posterior fourth rib , nevertheless , it is out of position . This was confirmed with a discussion with the patient 's nurse , ___ , by phone on ___ at 4 : 40 pm , who noted that there is a left PICC that appears to be pulled out significantly and which they plan to reposition or remove . 3 . No interval mediastinal widening .