Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Marked enlargement of the cardiac silhouette is unchanged . Based on older chest CT of ___ , this may potentially represent a combination of cardiomegaly and pericardial effusion . The mediastinal and hilar contours are normal . The pulmonary vasculature is normal . Lungs are clear except for symmetrical mild biapical scarring . No pleural effusion or pneumothorax is seen . There are no acute osseous abnormalities .
    OUTPUT:
    
No acute cardiopulmonary abnormality . Unchanged enlargement of the cardiac silhouette as described above .