Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The endotracheal tube is difficult to visualize but may lie near the carina . Cardiac pacemaker . Shallow inspiration accentuates pulmonary vascularity . No definite pleural effusion . Increased heart size , more prominent .
    OUTPUT:
    
Endotracheal tube tip difficult to visualize but may lie near the carina . The patient was extubated per the nurse ___ .