Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Cardiac silhouette is enlarged , and accompanied by worsening vascular engorgement and mild - to - moderate edema . Small right and moderate left pleural effusion are again demonstrated as well as a confluent left lower lobe opacity which may relate to atelectasis and dependent edema .
    OUTPUT:
    
1 . Worsening congestive heart failure with small right effusion . 2 . Moderate left pleural effusions with adjacent left lower lobe opacity . This may reflect atelectasis and dependent edema , but coexisting infection should be considered in the appropriate clinical setting .