Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Rotated positioning . ET tube tip in carina not well delineated , but the tube probably lies approximately 3 .8 cm above the carina , at the level of the lower clavicular heads . NG type tube present , tip extending beneath diaphragm , off film . Dual - lumen left IJ line tip overlies proximal SVC . The previously seen Swan - Ganz catheter is no longer visualized . Right IJ line appears to correspond to a pacer tip which overlies the right ventricle . There are low inspiratory volumes , similar to prior . The cardiomediastinal silhouette is enlarged , also similar to prior . Diffuse vascular plethora and vascular blurring is consistent with CHF with interstitial and possible pulmonary edema . Increased retrocardiac density again seen , consistent with left lower lobe collapse and / or consolidation . Probable small left effusion is also again seen . Hazy opacity at the right lung base could reflect some pleural fluid as well as a underlying atelectasis . No obvious pneumothorax detected
    OUTPUT:
    
The history refers to a femoral CVL placement , best correlated clinically . On the current examination , a right IJ line appears to accommodate a single pacer lead overlying the right ventricle . Again seen are low inspiratory volumes , left lower lobe collapse and / or consolidation , probable small effusions , right base atelectasis . CHF is also again seen , with interstitial and question alveolar edema .