ok so whats wrong in this xray? as you can see the left lung appear too small and the cardiac shadow is quite big, so if you dont focus you will say its cardiomegally and maybe pleural effusion, right? well...No, there is a endotracheal tube inserted on the right lung causing hyperinflation, this is a mistake as you should place the tube above the biforcation of bronchus, also you shouldnt judge the cardiac size if the patient was supine while taking the radiograph.