Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A frontal view of the chest was obtained portably . The endotracheal tube ends 4 .2 cm above the carina . The right Port - A - Cath and left internal jugular catheter end in the mid SVC . An orogastric tube follows the expected course , although the tip is not visualized . Soft tissue density adjacent to the aortic knob is again noted , unchanged in appearance from the prior study . This may represent pneumonia , but remains concerning for dissection given the unchanged left pleural effusion . A small right pleural effusion and cardiomegaly are unchanged .
    OUTPUT:
    
Soft tissue density adjacent to the aortic arch may be due to pneumonia , but could represent dissection given the left pleural fluid and history of PEA arrest . If further imaging is needed , CTA would be the next step . Findings discussed with Dr . ___ at 3 :40 p .m . on ___ .