Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Marked transverse cardiomegaly . Unfolding of the thoracic aorta . Mild cephalization of pulmonary blood flow but no overt pulmonary edema . No pleural effusions . Pulmonary overinflation . No suspicious pulmonary nodules or masses . Spondylotic changes of the thoracic spine .
    OUTPUT:
    
Marked transverse cardiomegaly with mild cephalization of pulmonary blood flow suggesting cardiac decompensation . In the differential diagnosis consider a pericardial effusion . No pneumonia .