Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Massive enlargement of the cardiac silhouette is again noted . On prior this had been due to a pericardial effusion . There are increased interstitial markings due to a combination of overlying soft tissues and superimposed pulmonary edema . There is no large confluent consolidation or large effusion .
    OUTPUT:
    
Enlargement of the cardiac silhouette as on prior , which could be due to a pericardial effusion and possible underlying cardiomegaly as well . Mild pulmonary edema .