Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Portable AP upright chest radiograph was provided . A tracheostomy tube is again seen projecting over the superior mediastinum . The heart remains enlarged with central hilar engorgement raising concern for pulmonary vascular congestion . The lung volumes are low which limits the evaluation . There is no overt pulmonary edema or definite signs of pneumonia . No large effusion or pneumothorax is seen . Imaged osseous structures are intact .
    OUTPUT:
    
Stable cardiomegaly with central pulmonary vascular congestion . Limited exam .