Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Pulmonary edema has substantially worsened from the prior study . Again seen is moderate cardiomegaly and mediastinal / pulmonary vascular engorgement . There may be some left retrocardiac atelectasis and there are likely small bilateral pleural effusions .
    OUTPUT:
    
Substantially worsened pulmonary edema . These findings were communicated to Dr . ___ by telephone at 09 : 18 on ___ at the time of discovery by Dr . ___