Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Supine portable AP view of the chest was provided . Endotracheal tube is seen with its tip located approximately 3 .8 cm above the carina . The NG tube courses into the left lower chest , which may reside within a hiatal hernia . The tube does not appear to follow the course of either main stem bronchus , therefore likely residing within the distal esophagus . Cardiomegaly is again noted with retrocardiac opacity , unchanged . Left CP angle excluded . Coarse calcifications in the right breast / axilla .
    OUTPUT:
    
Malpositioned NG tube with tip likely in the distal esophagus . Recommend advancement . ET tube positioned appropriately . No change in cardiopulmonary status . Findings posted and flagged to the ED dashboard at the time of this dictation .