Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The lungs are poorly inflated , accounting for some vascular crowding , but there are no focal opacities . There is moderate to severe cardiac enlargement which might represent cardiomegaly versus moderate pericardial effusion . Of note , the vascular pedicle is slightly widened , suggesting hemodynamic compromise . There is no pleural effusion or pneumothorax .
    OUTPUT:
    
Enlarged cardiac sillhouete might represent moderate to severe cardiomegaly versus pericardial effusion . The association of these findings with a widened vascular pedicle raises concern for hemodynamic compromise from increased right heart pressure . These findings were communicated by Dr ___ ___ telephone to Dr ___ on ___ at 8 am , immediately after discussion of the findings with Dr ___ .