Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Single portable AP view of the chest demonstrates interval increase in overall cardiac size , with loss of the normal atrioventricular contours . There is no evidence of pleural effusion , pneumothorax or focal air space opacification . No overt pulmonary edema is noted . A left scapular orthopedic screw is again noted .
    OUTPUT:
    
1 . Increased heart size , likely due to pericardial effusion or biventricular heart failure . Chest CT is recommended for further evaluation . 2 . No evidence of pleural effusion or pneumonia .