Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Rotated positioning . NG tube present , tip overlying gastric fundus . The gastric fundus itself is distended and there is elevation the left hemidiaphragm . A right PICC line is present , tip in the region of the SVC / RA junction . No pneumothorax is identified . Compared to the prior study , there improved aeration in the left upper zone , though as noted , the left hemidiaphragm is quite elevated , obscuring the remainder of the lung . The presence of a left - sided effusion is suspected . The mediastinal contours and precise position of the mediastinum are not effectively evaluated . The right hemidiaphragm is obscured and there is likely a right pleural effusion with some degree of right base underlying collapse and / or consolidation . However , the right upper and mid zones are grossly clear . Doubt significant CHF -- previously seen vascular plethora has improved .
    OUTPUT:
    
Improved aeration of the left upper lung and improvement in CHF findings . Otherwise , overall appearance is similar . A Ir seen overlying the left lower chest is thought to line a distended gastric fundus , not withstanding the presence of a NG tube there . If clinically indicated , a lateral view could help to confirm that the air is in the gastric fundus .