Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: As compared to prior chest radiograph from ___ , lung volumes are decreased accentuating the bronchovascular structures and the cardiomediastinal silhouette . The heart remains enlarged . There is persistent prominence of the pulmonary vascular markings . No focal consolidation is identified . No large pleural effusion or pneumothorax is identified . Tracheostomy tube tip terminates approximately 4 .5 cm above the carina .
    OUTPUT:
    
Decreased lung volumes with persistent prominence of pulmonary vascular markings and cardiomegaly . No definite focal consolidation identified .