Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The cardiac silhouette is severely enlarged . The aorta is somewhat tortuous . There may be minimal pulmonary vascular congestion without overt pulmonary edema . Minimal left mid to lower lung linear atelectasis / scarring is seen . No lobar consolidation is seen . No large pleural effusion is seen although a small pleural effusion would be difficult to exclude on the right . There is a dual lead left - sided pacemaker with leads extending the expected positions of the right atrium and right ventricle .
    OUTPUT:
    
Marked enlargement of the cardiac silhouette could be due to cardiomyopathy or pericardial effusion . Possible minimal pulmonary vascular congestion without overt pulmonary edema .