Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Cardiac size is top normal . Left subclavian catheter tip is in the proximal right atrium . NG tube tip is in the stomach . There is a VP shunt . There are low lung volumes . Mild to moderate vascular congestion has worsened . Bilateral effusions larger on the left side are grossly unchanged .
    OUTPUT:
    
Mild to moderate vascular congestion