Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A single portable AP chest radiograph was obtained . Mild pulmonary edema is new over five hours . A large left pleural effusion is similar to that seen on the recent chest CT and prior radiographs dating back to at least ___ of this year . The effusion was much smaller in ___ . The right pleural effusion , larger on yesterday 's CT may have been tapped in the interim . Severe cardiomegaly and aortic tortuosity are chronic . Spinal leads are in stable position . Known nondisplaced left rib fractures are not seen on this exam . .
    OUTPUT:
    
Acute exacerbation over 5 hours in severe chronic CHF . Dr ___ was paged to discuss these findings .