Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: AP portable upright view of the chest . Cardiomegaly is again noted with pulmonary vascular congestion and severe pulmonary edema . Small pleural effusion is difficult to exclude . Difficult to assess for underlying pneumonia . No large pneumothorax . Bony structures are intact .
    OUTPUT:
    
Severe pulmonary edema .