Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Portable semi-erect chest film ___ at 05 : 50 is submitted .
    OUTPUT:
    
Endotracheal tube has its tip at the thoracic inlet approximately 6 cm above the carina . A single lead left - sided pacing device is in place with the tip terminating over the expected location of the right ventricle . The heart is enlarged which may reflect cardiomegaly , although pericardial effusion should also be considered . Focal opacity in the mid to lower right lung would be concerning for aspiration or pneumonia , less likely pulmonary hemorrhage , given that the left lung is grossly clear . Clinical correlation is advised . No pulmonary edema or large effusions . No pneumothorax .