Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The heart is moderate - to - severely enlarged with globular configuration . This could relate to cardiomyopathy , but pericardial effusion could yield this appearance as well . There is upper zone redistribution of enlarged indistinct pulmonary vessels , suggesting mild to moderate edema . The retrocardiac space in the left lower lobe is under - penetrated and accordingly difficult to assess , although not necessarily abnormal . There is no definite pleural effusion on the right ; it is difficult to assess for one on the left . There is no free air .
    OUTPUT:
    
1 . Marked enlargement of the cardiac silhouette . Dilated cardiomyopathy or pericardial effusion should be considered as possible etiologies . 2 . Findings suggesting mild - to - moderate pulmonary vascular congestion . 3 . No evidence for free air . 4 . Limited visualization of the left lung base owing to portable technique and underpenetration associated with attenuation of soft tissues . If physical findings or other concern referred to the site , then follow - up radiographs could be considered , preferably with PA and lateral technique , if possible .