Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Compared to the prior study there has been interval increase in size of the cardiac silhouette . There is a small left pleural effusion . No focal consolidation , pulmonary edema or pneumothorax .
    OUTPUT:
    
Interval increase in size of the cardiac silhouette which may reflect cardiomegaly but a pericardial effusion could have a similar appearance .