Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Portable upright chest radiograph ___ at 10 :05 is submitted .
    OUTPUT:
    
Right subclavian PICC line , VP shunt , endotracheal tube , and feeding tube are unchanged in position . The heart remains markedly enlarged which may reflect cardiomegaly , although pericardial effusion should also be considered . Lung volumes are low with layering bilateral effusions and patchy bibasilar opacities suggestive of atelectasis , although pneumonia can not be entirely excluded . No obvious pneumothorax . An IVC filter is incompletely visualized .