Patients with CHF are at risk for pulmonary edema, which manifest clinically as a cough, frothy secretions, and dyspnea. The characteristic x-ray findings are obliteration of the costodiaphragmatic recesses due to accumulation of fluid. Although the patient likely has cardiomegaly due to CHF, pulmonary edema is the mostly likely cause of the patient’s symptoms. While coughing and dyspnea (rarely) are associated with pneumonia, frothy secretions are not.