Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Markedly rotated positioning . Allowing for this , a right IJ Swan - Ganz catheter has been placed . The tip overlies a right inferior pulmonary . No obvious pneumothorax is identified . Cardiac silhouette appears larger than on the prior study . In addition , there is new confluent increased retrocardiac opacity , with new obscuration of the left left hemidiaphragm , consistent with left lower lobe collapse and / or consolidation . Obscured blunting of the right costophrenic angle is compatible with a left effusion . Hazy density at the left base laterally could reflect either a layering effusion or additional atelectasis . There is evidence of CHF , with vascular plethora and vascular blurring . There is focal patchy opacity in the right cardiophrenic region less well seen due to patient rotation . There is new hazy density in the right cardiophrenic angle suggesting a small right pleural effusion .
    OUTPUT:
    
Tip of right IJ Swan - Ganz catheter overlies the right inferior pulmonary artery . Clinical correlation regarding retraction is requested . New left lower lobe collapse and / or consolidation and interval increase in bilateral effusions . Cardiac silhouette appears larger . CHF again noted , probably similar prior . Patchy opacity right cardiophrenic region is less well seen due to rotation , but likely remains present .