Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The lungs are poorly inflated . There is bilateral diffuse airspace and interstitial opacities with an apico - basal gradient , vascular cephalization , bilateral hilar prominence , bilateral small pleural effusions in the setting of stable moderate - to - severe cardiomegaly . No pneumothorax .
    OUTPUT:
    
Constellation of findings compatible with acute - on - chronic congestive heart failure .