Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Portable AP upright chest film ___ at 01 :01 is submitted .
    OUTPUT:
    
The heart remains enlarged . Mediastinal contours appear somewhat widened but are unchanged since ___ and therefore likely reflect a combination of prominent vascular structures and patient rotation . There is subtle streaky opacity in the retrocardiac region which may represent focal atelectasis , although early pneumonia or aspiration should also be considered . Followup imaging may be helpful . No pleural effusions , pulmonary edema or pneumothorax .