Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A single portable AP chest radiograph was obtained . There is a large left and small - to - moderate right pleural effusion . There is diffuse bilateral hilar interstitial opacity . An asymmetric opacity is seen in the central left upper lobe . Median sternotomy wires , mediastinal clips and right lung chain suture are stable .
    OUTPUT:
    
1 . Large left and moderate right effusions and pulmonary vascular congestion suggest moderate - to - severe pulmonary edema . 2 . Asymmetric opacity in the central left upper lobe has somewhat of a " butterfly " appearance of pulmonary edema . However , given the unilateral distribution , the presence of an additional consolidation or mass is likely . Repeat radiographs should be taken after diuresis . Cross sectional imaging may be considered at that point if the diagnosis remains in doubt .