Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Massive enlargement of the cardiac silhouette is re - demonstrated , similar compared to the previous exam . The aorta remains unfolded . There is mild pulmonary vascular congestion , but this appears improved compared to the prior study . No definite focal consolidation , large pleural effusion or pneumothorax is seen though assessment lung bases is somewhat limited by underpenetration . There are mild to moderate multilevel degenerative changes in the thoracic spine .
    OUTPUT:
    
Severe cardiomegaly with mild pulmonary vascular congestion .