Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The heart is mildly enlarged . There is unfolding of the thoracic aorta . The right central and upper mediastinal contours appears widened , suspected to reflect perhaps distention of the superior vena cava , but not entirely specific . The lungs appear clear . There is new mild elevation of the left hemidiaphragm compared to the prior study . Posterior costophrenic sulci appear blunted , so small effusions could be considered , particularly on the left , but not definitive . There is no pneumothorax . Mild loss among mid thoracic vertebral body heights appears stable .
    OUTPUT:
    
Suspected subpulmonic effusion on the left . New apparent widening of the right mediastinum , possibly distention of the superior vena cava and perhaps primarily related to AP technique . When clinically appropriate , evaluation with standard PA and lateral radiographs is recommended to see whether widening may persist and need further evaluation . Recommendation discussed with Dr . ___ at 10 :30 pm on the same day by telephone .