Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Moderate to severe enlargement of the cardiac silhouette has increased compared to the prior exam . Mediastinal and hilar contours are normal . Pulmonary vascularity is normal . Lungs are clear . No pleural effusion or pneumothorax is present . No acute osseous abnormalities are visualized . No free air is seen under the diaphragms .
    OUTPUT:
    
Interval increase in size of the cardiac silhouette which is now moderate to severely enlarged , likely due to cardiomyopathy .