Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Again seen is cardiomegaly and evidence of background COPD . There is upper zone redistribution , vascular plethora and mild vascular blurring , consistent with CHF . More focal opacities are seen at both lung bases and could represent either atelectasis or infectious / inflammatory opacities . Allowing for technical differences , these are similar to the prior film . Blunting of the costophrenic angles raises the possibility of small left - greater - than - right pleural effusions versus pleural thickening . Rectangular density superimposed over the lower thoracic spine likely reflects methylmethacrylate ( segment ) related to prior kyphoplasty or vertebroplasty . Curvilinear density superimposed over mid thoracic vertebral body may also represent methylmethacrylate . Curvilinear vascular calcification is considered less likely . Carotid artery calcification also noted .
    OUTPUT:
    
Cardiomegaly and CHF with interstitial edema and suspected small bilateral effusions . Patchy opacities at both lung bases , similar to the study from 1 day earlier . While this could represent atelectasis and / or scarring , infectious / inflammatory opacities are not excluded . Differential diagnosis also includes changes related to aspiration pneumonitis . This appearance is new compared with the chest x-ray from ___ .