Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Right sided PICC has migrated and now terminates at the right chest wall the level of the lateral right fifth rib . Single lead left - sided AICD is stable in position . The cardiac silhouette remains severely enlarged which may be due to cardiomyopathy and / or pericardial effusion . No pleural effusion or pneumothorax is seen . No focal consolidation is seen . Stable slight prominence of the central pulmonary vasculature without overt pulmonary edema .
    OUTPUT:
    
Right - sided PICC has withdrawn in position , now terminating at the right chest wall at the level of the lateral right fifth rib , not in appropriate position . Persistent severe enlargement of the cardiac silhouette which may be due to cardiomyopathy and / or pericardial effusion .