Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Moderate cardiomegaly is again noted and appears stable . There is prominence of the pulmonary vasculature , as seen previously consistent with moderate pulmonary edema . There are no pleural effusions . Emphysematous changes are again noted . There is a small focal opacity in the right upper lobe which may be representative of a bulla filled secretions but pneumonia can not be excluded . with There is no evidence of focal consolidation or pneumothorax . No acute fractures are identified .
    OUTPUT:
    
1 . Moderate cardiomegaly with evidence of congestive heart failure . 2 . There is a small focal opacity in the right upper lobe which may be representative of a bulla filled secretions but pneumonia can not be excluded .