Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Moderate to severe cardiomegaly has increased since ___ , mediastinal venous and pulmonary vascular engorgement ( with cephalization ) have worsened , and small bilateral pleural effusion is present once again . There is no pulmonary edema or consolidation . Persistent leftward displacement of the cervical trachea suggests right thyroid enlargement or mass .
    OUTPUT:
    
Acute decompensation of chronically enlarged heart , could be due volume overload or worsened biventricular heart failure . Possible right goiter or thyroid mass .