Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Frontal semi-upright portable chest radiograph demonstrates lower lung volumes than were demonstrated on the prior study . There is moderate engorgement of the pulmonary vasculature , with note of septal thickening . The azygos has become engorged in the interim , and there is moderate cardiomegaly . The mediastinal contours are unremarkable . Note is made of an azygous fissure . There is no effusion or pneumothorax .
    OUTPUT:
    
Moderate cardiac decompensation .