Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There is moderate enlargement of the cardiac silhouette , increased since ___ . There is pulmonary vascular congestion without overt edema or effusion . No acute osseous abnormalities .
    OUTPUT:
    
Enlarged cardiac silhouette when compared to most recent exam . This could be due cardiomegaly and possible pericardial effusion . Vascular congestion .