Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Rotated positioning . Allowing for this , there is probable background COPD . Chain sutures noted in the right upper zone . There is mild to moderate cardiomegaly , similar to the prior film . Aorta is unfolded . Right paratracheal soft tissues likely represent vascular structures in someone of this age . There is upper zone redistribution and diffuse vascular blurring . There is hazy opacity at both lung bases , likely representing small layering effusions , with underlying collapse and / or consolidation . Note is made of a slightly irregular contour of the trachea .
    OUTPUT:
    
1 . Background COPD . Cardiomegaly . 2 . Diffuse vascular plethora vascular blurring and small effusions . This likely represents CHF . The differential diagnosis could include infectious or inflammatory processes in the appropriate clinical setting . This appearance appears significantly more pronounced compared with the outside film from ___ . Underlying collapse and / or consolidation present . 3 . Slightly patulous appearance to the trachea , similar to the prior film . Clinical correlation requested .