Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: This is a slightly rotated film the heart size is mildly enlarged , larger than prior . The bilateral alveolar infiltrates are now more fluffy and hazy in appearance and more confluent . Dual lead pacemaker is present . ET tube is 5 cm above the carina . Right subclavian line tip is in the SVC .
    OUTPUT:
    
Worsened appearance to the lungs . This could be CHF or infection on top of ARDS or could be progression of ARDS .