Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: An ET tube projects approximately 5 .8 cm above the carina . Left subclavian central line projects over the proximal / mid SVC . A right IJ Swan - Ganz / PA catheter tip overlies the cardiac silhouette , possibly related to the RV outflow tract . An NG type tube is present , tip extending beneath diaphragm , off film . There are surgical clips overlying much of the left chest , with subcutaneous emphysema noted adjacent to the left chest wall . Portions of the diaphragms are excluded from the film and positioning is lordotic . Allowing for this , the cardiac silhouette is enlarged . Upper zone redistribution , a vascular plethora and blurring , and scattered airspace opacities are present . The differential diagnosis includes pulmonary vascular congestion and CHF , with an element of pulmonary edema . Multifocal infection or pulmonary hemorrhage could also give rise to this appearance . In addition , there is retrocardiac opacity , consistent with left lower lobe collapse and / or consolidation . The presence of pleural fluid at the base of the left lung would be difficult to exclude . Pleural fluid and / or thickening is seen at the left lung apex . No obvious pneumothorax is identified . Truncated appearance to the anterior lateral portion of the left first rib could represent a site of surgery . Incidental note is made of increased densities adjacent to the right coracoid process likely loose bodies related to the glenohumeral joint .
    OUTPUT:
    
Upper zone redistribution , vascular plethora and blurring , and patchy bilateral airspace opacities , consistent with CHF and pulmonary edema . In the appropriate clinical setting , the differential diagnosis could include infection or hemorrhage . Evidence of prior surgery on the left , with pleural fluid and / or thickening at the left lung apex , similar to the prior study . Retrocardiac density again seen , consistent with left lower lobe collapse and / or consolidation and likely an element of left pleural fluid . Lines and tubes as described .