Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: AP single view of the chest has been obtained with patient in semi-upright position . Comparison is made with the next preceding similar studies obtained at 5 a .m . and 6 :30 a .m . during the same day . All three examinations performed at the bedside and with the patient in semi-erect position . There is marked cardiac enlargement and bilateral pleural effusions that obliterate the diaphragmatic contours and blunt the lateral pleural sinuses . Adjustment of a right internal jugular approach central venous line was made . On the present examination obtained at 15 : 23 hours , patient is intubated . An NG tube has been advanced and reaches well below the diaphragm including it s side port . The line terminates in a markedly air distended stomach . There is no evidence of pneumothorax . Evidence of old multiple right - sided rib trauma with corresponding deformities as before . Status post surgery in left axillary area also unchanged . A portable chest examination on the preceding day ___ demonstrated already marked cardiac enlargement and pulmonary congestion with bilateral pleural effusions clearly different from the next preceding PA and lateral chest examination of ___ . No evidence of CHF was present .
    OUTPUT:
    
The latest four portable chest examinations clearly indicate cardiac enlargement , pulmonary congestion and pleural effusions located mostly in the posterior compartments related to patient 's semi-erect position . Questions raised in the requisition to comment on presence of infiltrates versus edema can not be answered in such detail on these four recent portable single view chest examinations . Consider consultation with cardiology department with regard to patient 's obvious advanced CHF condition .