Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Moderate to severe cardiomegaly persists . The mediastinal contour is stable . Indistinctness of the pulmonary vasculature indicating moderate pulmonary vascular congestion . The left hemidiaphragm is obscured likely secondary to a small left pleural effusion . No pneumothorax is seen .
    OUTPUT:
    
Moderate to severe cardiomegaly is stable . Moderate pulmonary vascular congestion , increased compared to the prior study . Small left pleural effusion .