Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Moderate cardiomegaly , increased compared to prior study . Left anterior chest wall ICD with lead positioning now appearing straight compared to the prior exam . Cardiomediastinal silhouette and hilar contours are otherwise unremarkable . Lungs are clear . Pleural surfaces are clear without effusion or pneumothorax .
    OUTPUT:
    
Moderate cardiomegaly , significantly intervally increased . Given interval increase , consider echo for further evaluation and to exclude pericardial effusion . Otherwise no acute cardiopulmonary abnormality .