Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There is no focal consolidation or pneumothorax . Cardiomegaly is severe , measuring approximately ___ .5 cm in width , compared to approximately ___ .2 cm on prior CT scout image . The mediastinum is not widened . Pulmonary vasculature is not engorged . There is likely a trace right pleural effusion . There may be a trace left pleural effusion . Imaged osseous structures are intact . No free air below the right hemidiaphragm is seen .
    OUTPUT:
    
Severe cardiomegaly is likely partially due to a component of pericardial effusion as seen on prior CT . Although accurate comparison is difficult due to differences in modality , the pericardial effusion may have enlarged since ___ .