Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There is persistent severe enlargement of the cardiac silhouette . Mediastinal and hilar contours are stable . No focal consolidation is seen . There is no pleural effusion or pneumothorax . Relative splaying of the carina may be due to enlarged left atrium .
    OUTPUT:
    
Persistent severe enlargement of the cardiac silhouette .