Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Lordotic positioning . There is marked cardiomegaly , overall similar to the prior film . There is vascular plethora , with interstitial and alveolar edema . The appearance is also similar to the prior film , though the degree of confluence of the opacities in the right lung appears greater on today 's exam . Minimal blunting of the costophrenic angles is compatible with small effusions , possibly slightly smaller than on the earlier study .
    OUTPUT:
    
Marked cardiomegaly and interstitial and alveolar opacities , with small effusions . The appearance is compatible with CHF / pulmonary edema , particularly in light of the degree of cardiomegaly and a history of ESRD . In the appropriate clinical setting , other etiologies could give rise to a similar appearance .