Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The tracheostomy and left sided PICC line are again seen . The PICC line tip is slightly more distally now lies at the SVC / RA junction . The cardiomediastinal silhouette is enlarged . Allowing for technical differences , it is grossly unchanged . Sternotomy wires and mediastinal clips again noted . As before , there is increased retrocardiac density , with obscuration of left hemidiaphragm , consistent with left lower lobe collapse and / or consolidation , likely with a small to moderate left effusion . The degree of retrocardiac opacification is slightly worse . Also again seen is a small to moderate right pleural effusion with underlying collapse and / or consolidation , similar to the prior study . There is minimal , if any , upper zone redistribution . No pneumothorax detected .
    OUTPUT:
    
Tracheostomy tube remains present . Left - sided PICC line tip lies slightly more distal , now at the SVC / RA junction . Cardiomegaly . Minimal , if any , CHF . Left - greater - than - right lung base collapse and / or pneumonic consolidation and small to moderate left - greater - than - right pleural effusions . Retrocardiac opacity has progressed slightly compared with a film from 1 day earlier .