Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: PA and lateral chest views were obtained with patient in upright position . Comparison is made with the next preceding portable chest examination of ___ . The previously observed marked cardiac enlargement appears rather unchanged . Detailed evaluation is impossible because of overlying pleural densities obscuring the cardiac contours . Thoracic aorta unaltered . The pulmonary vasculature is presently distended , but does not show evidence of acute interstitial or alveolar edema . There exists bilateral pleural effusion , more marked on the left side where also the diaphragm is elevated . No evidence of new acute pulmonary infiltrates can be established . The amount of pleural effusion appears to be mild - to - moderate as judged from the appearance of the mildly blunted posterior pleural sinuses as seen on the lateral view .
    OUTPUT:
    
Marked cardiomegaly , evidence of bilateral small amounts of pleural effusion , but no evidence of new acute infiltrates . Left - sided diaphragmatic elevation as before .