Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There is increased vascular congestion with bilateral small pleural effusions and widened mediastinum in area of the azygos vein suggestive of congestive heart failure . No evidence of pneumonia . No pneumothorax . There is increase in cardiac size compared to ___ .
    OUTPUT:
    
Vascular congestion and bilateral small pleural effusions consistent with heart failure . Increasing cardiac silhouette may suggest new cardiomegaly or pericardial effusion given patient 's history of end - stage renal disease requiring dialysis . No evidence of pneumonia