Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Lung volumes are low . There is severe cardiomegaly which has progressed since prior study . The azygos vein is distended . There is obscuration of the left hemidiaphragm which may be due to atelectasis and effusion . There is mild pulmonary vascular congestion . There is no pneumothorax . Calcifications of the tracheobronchial tree as well as the aortic arch are noted . Visualized upper abdomen is unremarkable .
    OUTPUT:
    
Severe cardiomegaly which has progressed since prior study as well as distended azygos vein compatible with heart failure . The degree of edema and likely left effusion is difficult to assess on the supine view . Upright and lateral views would be helpful for further evaluation .