Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There is severe cardiomegaly which is significantly increased compared to ___ without evidence of vascular congestion or interstitial edema . Bilateral scattered nodular opacities are noted . Mild blunting of the costophrenic angles is likely due to pleural thickening . There is no pleural effusion or pneumothorax . Severe osteopenia is noted with compression fractures of multiple thoracic vertebral bodies with significant kyphosis of the thoracic spine .
    OUTPUT:
    
Severe cardiomegaly without pulmonary edema . No clear evidence of pneumonia . Multiple scattered nodular opacities which may represent overlapping vascular structures , however , further evaluation may be obtained with dedicated chest CT if indicated . Results were discussed over the telephone with Dr . ___ by ___ at 4 :55 p .m . on ___ at time of initial review .