Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Moderate enlargement of the cardiac silhouette is demonstrated , slightly more pronounced than on the prior study . The mediastinal and hilar contours are normal . Pulmonary vasculature is not engorged . Streaky atelectasis is noted in the retrocardiac region . Small left pleural effusion is noted . No pneumothorax is identified . There are mild degenerative changes in the thoracic spine .
    OUTPUT:
    
Increased size of the cardiac silhouette suggestive of the presence of a pericardial effusion . Echocardiogram is suggested for further assessment . No pulmonary edema . Small left pleural effusion .