Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Poor positioning of the head obscures the right upper lung field . Heart size is top - normal . The mediastinal contours are unremarkable . A right pleural effusion is significantly increased in size compared to the prior exam . Lung volumes are improved with bibasilar atelectasis . The right hemidiaphragm is markedly elevated . ETT appears low , terminating near the level of the carina , but the head is also down , which causes caudal migration of ETT . An enteric tube is noted with tip terminating in the stomach . A left axillary pacemaker is noted , but the pacemaker lead tip is not definitely visualized .
    OUTPUT:
    
Limited exam given poor head position . No definite evidence of aspiration . Increased right pleural effusion .