Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Portable upright chest x-ray is somewhat oblique in positioning accounting for differences in cardiac contour compared to prior study from ___ . Even accounting for this , the cardiac silhouette is large . Central pulmonary vasculature appears mildly full on the right , but is obscured on the left because of patient obliquity . Small left pleural effusion can not be excluded and there is obscuration of left hemidiaphragm related to some combination of small effusion and / or subsegmental retrocardiac atelectasis .
    OUTPUT:
    
Cardiomegaly with probable central pulmonary vascular congestion sggesting early CHF . If the patient is able , lateral view and or repeat better - penetrated PA view is recommended to evaluate the left lung base where there is suggestion of consolidation and / or small effusion .