Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Portable semi-erect chest radiograph ___ at 19 :36 is submitted .
    OUTPUT:
    
Left - sided single lead pacer remains in place with the lead terminating over the expected location of the right ventricle . Status post median sternotomy . The right internal jugular central line has its tip in the mid SVC . Tracheostomy tube and feeding tube are likely unchanged in position , although the tip of the feeding tube is not included on the image . There continues to be a bilateral diffuse airspace and interstitial process likely reflecting severe pulmonary edema but diffuse infection or ARDS should also be considered . The heart remains enlarged likely reflecting cardiomegaly , although pericardial effusion can not be excluded . No obvious pneumothorax .