Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Portable upright chest radiograph demonstrates moderate bilateral effusions , with bibasilar atelectasis . The pulmonary vasculature is engorged . The cardiac silhouette remains enlarged .
    OUTPUT:
    
Increased moderate bilateral pleural effusions with cardiomegaly and engorgement of the pulmonary vasculature , consistent with cardiac decompensation , with superimposed bibasilar atelectasis .