Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: PA and lateral chest views were obtained with patient in upright position . Comparison is made with the next preceding chest examination of ___ . Heart size has increased and the configuration has been altered . Appearance of thoracic aorta is unchanged demonstrating a few calcium deposits in the wall at the level of the arch . No new contour abnormalities identified . Now evidence of bilateral pleural effusions blunting the lateral pleural sinuses and obscuring the outer thirds of the diaphragmatic contours . Although this results in a crowded appearance of the basal pulmonary vessels , exist also suspicious small patchy parenchymal densities , which clearly seen on the right base , which deserve further evaluation . On the lateral view , a mild blunting of the posterior pleural sinuses is seen and again the crowded appearance of the pulmonary vasculature makes precise evaluation of suspected small patchy densities difficult . In comparison with the previous chest examination obtained two days earlier whether findings were practically within normal limits present examination identifies the occurrence of new small amounts of bilateral pleural effusions . As the heart contours also have undergone a change in appearance with broader diameter on the bases , possibility of coinciding pericardial effusion should be considered . Comparison of the pulmonary vasculature does not indicate significant pulmonary vascular venous congestion , there is no evidence of pneumothorax in the apical area .
    OUTPUT:
    
Rather sudden onset of bilateral pleural effusions and change of cardiac contours suspicious for coinciding development of pericardial effusion . Referring physician , ___ , was paged to transmit these rather subtle sudden developing findings . ___ was paged under #___ at 4 :20 p .m .