Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Massive cardiomegaly . Increased pulmonary vasculature with indistinctness of the vessels suggesting cardiac decompensation and interstitial edema . Left - sided pleural effusion . Adjacent left lower lobe atelectasis . Left chest drain in situ . Surgical emphysema in the left chest wall . No right - sided effusion .
    OUTPUT:
    
Massive transverse cardiomegaly . Findings may be in keeping with fluid overload / cardiac decompensation or a pericardial effusion .