Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Single AP upright portable view of the chest was obtained . Per the radiology technologist , these are the best radiographs obtainable . Patient stated he would pass out if standing and has a sling . Left side of the AICD is again seen with leads in stable position . The cardiac silhouette remains markedly enlarged . There is prominence of the central pulmonary vessels . There is likely a trace left pleural effusion . No definite focal consolidation is seen . Mediastinal and hilar contours are stable .
    OUTPUT:
    
Severe enlargement of the cardiac silhouette again seen . Prominence of the central pulmonary vasculature without overt pulmonary edema . Likely trace left pleural effusion .