Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Lordotic positioning . Enlarged cardiomediastinal silhouette . The right hemidiaphragm is obscured and the possibility of an right - sided effusion , together with underlying collapse and / or consolidation , can not be excluded . There is also hazy opacity in the right lung , question due to layering pleural fluid or parenchymal opacification . The right lung apex remains relatively aerated . On the left , there is minimal upper zone redistribution , but the left lung is grossly clear . The extreme left costophrenic angle is excluded from the film , but no left effusion . No pneumothorax detected on this lordotic film . ET tube tip 4 .3 cm above the carina . NG tube likely present , but tip obscured due to over penetration . Fixation hardware overlies the cervicothoracic junction , not fully evaluated . Incidental note is made of clips over the right axilla .
    OUTPUT:
    
Cardiomegaly . Probable layering right effusion with underlying collapse and / or consolidation . Opacity in the left upper and mid zones is not fully characterized -- this could be accentuated by layering pleural fluid , but the presence of parenchymal opacity can not be excluded . Left lung grossly clear . ET tube in satisfactory position . NG tube difficult to trace beyond the mid mediastinum .