Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Endotracheal tube tip terminates approximately 4 .5 cm from the carina . The heart is mildly enlarged . Calcification of the aortic knob is present . Lungs appear hyperinflated , suggestive of underlying COPD . Increased interstitial markings with indistinctness of the pulmonary vasculature suggests mild pulmonary edema . Dense opacity within the retrocardiac region may reflect infection or aspiration , with atelectasis also in the differential . Scattered ill - defined nodular opacities within the right mid lung field are also noted . Bilateral pleural effusions are present , small to moderate in size on the left and trace on the right . No pneumothorax is identified . The hila are mildly prominent . Multilevel degenerative changes are seen in the imaged spine with osteophytic spurring . No pneumothorax is identified . Chain sutures are seen projecting over the left lung apex .
    OUTPUT:
    
1 . Endotracheal tube tip is in standard position . 2 . Dense retrocardiac opacity could reflect pneumonia or aspiration with atelectasis also in the differential diagnosis . Small to moderate left pleural effusion , and trace right pleural effusion . 3 . Increased interstitial opacities with indistinctness of the pulmonary vascular markings suggestive of mild pulmonary edema . 4 . Ill - defined nodular opacities within the right mid lung could reflect additional sites of infection .