Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: AP and lateral chest radiographs were obtained . The lungs are well expanded and the central pulmonary vasculature is more indistinct . Cephalization of the upper lobe pulmonary vasculature has progressed since ___ . Small bilateral pleural effusions are new . Moderate cardiomegaly is unchanged . Sternotomy wires and vascular clips are in unchanged positions .
    OUTPUT:
    
Indistinct pulmonary vasculature and small pleural effusions are consistent with worsening of mild CHF since ___ .