Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: PA and lateral views of the chest provided . There is large right pleural effusion with compressive atelectasis . The left lung is clear . The heart is again seen to be severely enlarged . On lateral view , there may be a small fluid collection between the epicardial and pericardial fat pads . Pulmonary vasculature is normal . Median sternotomy wires and valvular repairs are seen .
    OUTPUT:
    
1 . New large right pleural effusion . 2 . Massive cardiomegaly without pulmonary edema . Differential includes pericardial effusion versus cardiomyopathy . Echocardiogram is recommended for further assessment .