Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The cardiac silhoutte is moderate to severely enlarged . The mediastinum is normal in width and there is no pulmonary vascular congestion . No right lung opacity is seen . The retrocardiac portion of the left lung may be opacified , however , this area is not well seen due to enlargement of the cardiac silhouette . There are small bilateral pleural effusions . No pneumothorax is identified .
    OUTPUT:
    
Moderate to severe enlargement of the cardiac silhouette in the absence of pulmonary vascular congestion is concerning for cardiomyopathy or a pericardial effusion . The retrocardiac lung parenchyma is poorly seen , and retrocardiac opacity could represent pneumonia in the appropriate clinical .