Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There is new enlargement of the cardiac silhouette compared to prior exam . There is also pulmonary vascular congestion without overt edema , consolidation or effusion . No acute osseous abnormalities .
    OUTPUT:
    
New enlargement of the cardiac silhouette . Given change since prior this raises the possibility of underlying pericardial effusion versus interval development of cardiomegaly . Pulmonary vascular congestion .