Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Moderate to severe cardiomegaly is unchanged . The aorta remains tortuous and diffusely calcified . Mild to moderate pulmonary edema with perihilar enlargement and haziness as well as vascular indistinctness is re - demonstrated , slightly improved compared to the prior study . There are persistent small bilateral pleural effusions , larger on the right than the left , not substantially changed in size . Bibasilar airspace opacities may reflect atelectasis , though infection or aspiration can not be excluded . There is no pneumothorax identified . Extensive degenerative changes of both shoulders are again demonstrated with high - riding humeral heads .
    OUTPUT:
    
Mild to moderate congestive heart failure with small bilateral pleural effusions , slightly improved compared to the prior exam . Bibasilar airspace opacities could reflect atelectasis , but infection or aspiration are not excluded .