Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There is moderate to severe enlargement of the cardiac silhouette . There is prominence of the interstitial markings without large effusion or confluent consolidation . Median sternotomy wires are intact . There is a left - sided venous catheter identified extending to the midline but the tip is not clearly delineated . No acute osseous abnormalities .
    OUTPUT:
    
Moderate to severe enlargement of the cardiac silhouette , potentially due to cardiomegaly although pericardial effusion would be possible . Vascular congestion without evidence of overt pulmonary edema .