Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There are bilateral diffuse pulmonary opacities with an apico - basal gradient and associated bilateral hilar engorgement and layering pleural effusions , left worse than right , in the setting of large cardiomegaly . Rightward deviation of the trachea appears slightly more conspicuous than in prior exam , but this may be related to semi-upright position with upward displacement of the mediastinum .
    OUTPUT:
    
1 . Findings compatible with acute pulmonary edema with associated worsening pleural effusions in the setting of cardiomegaly . 2 . Rightward deviation of the trachea appears slightly more conspicuous than on prior but is felt to be due to patient 's positioning . As before , evaluation with ultrasound is recommended . This may represent an enlarged thyroid but other mediastinal masses can not be excluded .