Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Cardiac silhouette size remains moderately to severely enlarged . Mediastinal and hilar contours are unchanged . There is mild pulmonary vascular engorgement . Patchy opacities within the lower lobes bilaterally may reflect areas of atelectasis but aspiration or infection can not be excluded . No pleural effusion or pneumothorax is identified . Multilevel degenerative changes are noted in the thoracic spine .
    OUTPUT:
    
Mild pulmonary vascular congestion . Bibasilar patchy opacities may reflect atelectasis but infection or aspiration can not be excluded .