Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Moderate - to - severe cardiomegaly has increased since ___ . There are small bilateral pleural effusions . Perihilar interstitial opacity likely represents pulmonary edema . A retrocardiac opacity represents a hiatal hernia .
    OUTPUT:
    
Moderate - to - severe cardiomegaly and moderate pulmonary edema , increased since ___ .