Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Cardiomegaly is again seen , significantly increased since ___ , and appearing gradually increased since ___ possibly reflecting pericardial effusion . Pulmonary vascular congestion and edema have increased since the ___ , examination . There is an enlarged moderate right pleural effusion . A small left pleural effusion is unchanged . There is no pneumothorax .
    OUTPUT:
    
Worsening pulmonary vascular congestion and interstitial edema , with enlarged moderate right pleural effusion . Possible pericardial effusion .