Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Heart size is moderate to severely enlarged but unchanged . The mediastinal contour remains widened superiorly , which based on the prior CT of the thoracic spine appears attributable to mediastinal fat and vascular structures . There is mild pulmonary vascular engorgement . Streaky opacities within the lung bases , more so on the left , could reflect areas of atelectasis though infection is difficult to exclude . No large pleural effusion or pneumothorax is seen . Multiple old rib fractures are re - demonstrated bilaterally . Degenerative changes of the right glenohumeral joint are also noted .
    OUTPUT:
    
Mild pulmonary vascular engorgement and bibasilar patchy opacities , possibly reflecting atelectasis though infection is difficult to exclude .