Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Frontal and lateral views of the chest are compared to portable exam from earlier the same day and two - view chest from ___ . Lower lung volumes are seen when compared to previous exam from ___ . Blunting of the costophrenic angles is compatible with small effusions . Increased interstitial markings are seen , similar in appearance when compared to prior . Cardiac silhouette is enlarged but stable . Osseous structures again notable for hypertrophic changes in the spine . Triple - lead pacer device is again seen .
    OUTPUT:
    
Increased interstitial markings and small pleural effusions , suggestive of congestive failure .