Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The cardiac silhouette is moderately to severely enlarged . Mediastinal contours are stable . There is no pulmonary edema . No definite focal consolidation is seen . There is no large pleural effusion although left pleural effusion be difficult to exclude .
    OUTPUT:
    
Moderate to severe enlargement of the cardiac silhouette without pulmonary edema . Findings may be due to underlying cardiomyopathy and / or pericardial effusion . No definite focal consolidation .