Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: AP upright portable view of the chest was obtained . Single lead left - sided AICD is again seen . Patient is status post median sternotomy . The patient is rotated to the right . There is blunting of bilateral costophrenic angles , left greater than right , consistent with moderate left and small right pleural effusions with overlying atelectasis . Evaluation of the left mid to lower lung fields is partially obscured by overlying battery pack . The cardiac silhouette is enlarged . There is moderate pulmonary edema .
    OUTPUT:
    
Large cardiac silhouette , pulmonary edema , bilateral pleural effusions suggests CHF which appears worse as compared to the prior study , given differences in inspiration / technique .