Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A single semi-upright portable chest radiograph was obtained . There is marked enlargement of the mediastinal contours since the prior exam yesterday at 6 :00 . In particular of the ascending aorta is enlarged . There is also enlargement of the aortic arch to a lesser extent . There are new bilateral pleural effusions and right lower lobe consolidation . There is no pneumothorax . Impression
    OUTPUT:
    
Marked enlargement of the aortic contour , particularly the ascending aorta over the last 24 hours . A CTA of the chest should be considered to exclude acute aortic process . Discussed with Dr ___ ___ phone at approximately ___ on ___ .