Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Severe cardiomegaly with left atrial enlargement has worsened since the prior study . No pleural effusion or pneumothorax is seen . Central pulmonary vascular engorgement is seen . No definite focal consolidation . Median sternotomy is noted .
    OUTPUT:
    
Severe cardiomegaly with left atrial enlargement appears worsened since the prior study . Central pulmonary vascular engorgement without overt pulmonary edema .