Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There is substantial , but stable enlargement of the cardiac silhouette . A tracheostomy is again demonstrated . There is prominence of the central pulmonary artery as well as evidence of pulmonary vascular congestion and mild edema . Streaky atelectasis is seen at the bases bilaterally . No pneumothorax . No pleural effusion .
    OUTPUT:
    
Persistent cardiomegaly , pulmonary vascular congestion and mild edema . No pleural effusion or pneumothorax .