Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The lungs are hyperinflated , suggestive of emphysema . Compared with prior exam there is mild interval increase of cardiac size , with worsening of vascular congestion , more prominent in both lower lobes . There is also coarse interstitial thickening , more prominent in the left lower lobe suggestive of interstitial pulmonary edema . There is chronic minimal blunting of the left costophrenic angle but no clear effusion . No right - sided effusion is seen . There is no pneumothorax . Old healed left - sided rib fractures are re-demonstrated . Severe degenerative changes of both shoulders are seen , right worse than left , with loss of the acromiohumeral interval in the right suggestive of rotator cuff pathology .
    OUTPUT:
    
1 . Vascular congestion and interstitial pulmonary edema in the setting of slightly worsened cardiomegaly compared with ___ . 2 . Severe degenerative changes of both shoulders , right worse than left .