Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There is moderate to severe enlargement of the cardiac silhouette , new since the prior study , including a prominent left atrium . A wide mediastinum and a prominent right and left main pulmonary arteries are also new since the prior study . No focal opacities concerning for infection . Small bilateral pleural effusions . No pneumothorax .
    OUTPUT:
    
1 . Moderate to severely enlarged cardiac silhouette , new from the prior exam raising the possibility of pericardial effusion . Appropriate correlation with ECHO and or CT should be considered 2 . No evidence of infection