Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Moderate to severe cardiomegaly has increased , pulmonary vascular congestion is new and there may be mild pulmonary edema . The costophrenic sulci are mildly blunted , but there is no large pleural effusion . There is no pneumothorax .
    OUTPUT:
    
Acute congestive heart failure .