Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Portable upright chest radiograph ___ at 08 :06 is submitted .
    OUTPUT:
    
Right internal jugular central line unchanged in position . There continues to be a large layering right effusion with associated patchy airspace disease in the right mid and lower lung most likely reflecting atelectasis , although aspiration or pneumonia can not be excluded . The heart remains markedly enlarged favoring cardiomegaly , although pericardial effusion should also be considered . The left lung is grossly clear . No pneumothorax . No pulmonary edema .