Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There is a small left pleural effusion and dense retrocardiac opacity . Heart size is mildly enlarged . There is pulmonary vascular redistribution and some patchy areas of alveolar infiltrate . The tracheostomy and left - sided PICC line are unchanged .
    OUTPUT:
    
Slight worsening in CHF .