Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Single AP upright portable view of the chest was obtained . Single lead left - sided AICD is again seen with lead extending to the expected position of the right ventricle . Patient is status post median sternotomy . There is blunting of the bilateral costophrenic angles , left greater than right , consistent with bilateral pleural effusions . Prominence of the perihilar vasculature is consistent with pulmonary vascular congestion . Left retrocardiac opacity may relate to the combination of atelectasis and effusion , although underlying consolidation can not be excluded . The cardiac silhouette is enlarged . The aortic knob is calcified . Marked degenerative changes are seen at the right humerus which may be post-traumatic , although underlying avascular necrosis can not be excluded . There is diffuse osteopenia .
    OUTPUT:
    
1 . Enlarged cardiac silhouette , bilateral pleural effusions and pulmonary vascular congestion suggests CHF . 2 . Irregularity of the right humeral head may be degenerative , although underlying avascular necrosis can not be excluded .