Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Compared with ___ and allowing for considerable differences in positioning , I doubt significant interval change . Suspect background hyperinflation / COPD . Again seen is marked cardiomegaly , vascular plethora and mild vascular blurring , consistent with CHF . Obscuration of both costophrenic angles is again present , suggestive of small bilateral effusions . Increased retrocardiac density and opacity at the right lung base likely represents a combination of collapse and / or consolidation and pleural effusions . Both hemidiaphragms are obscured . Right paratracheal / paramediastinal opacity is again seen , not fully characterized . Curvilinear opacity extending across the upper chest into both axillae is thought to represent artifact due to overlying soft tissues .
    OUTPUT:
    
1 . Doubt significant interval change . 2 . Marked cardiomegaly . 3 . CHF with evidence for interstitial edema and likely bilateral pleural effusions 4 . Bibasilar collapse and / or consolidation . 5 . Persistent right paramediastinal opacity , similar to the prior film , not fully characterized . If clinically indicated , chest CTA could help for further assessment .