Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Severe enlargement of the cardiac silhouette with a globular configuration is not substantially changed from the prior radiograph and likely reflects the presence of a moderate size pericardial effusion , as was previously demonstrated on the prior CT . Aortic knob calcifications are again noted . Pulmonary vascular congestion is again present . No pleural effusion or pneumothorax is seen . There is minimal streaky atelectasis at the lung bases . No acute osseous abnormality is identified .
    OUTPUT:
    
Relatively similar appearance of enlarged globular configuration of the cardiac silhouette likely reflective of a moderate size pericardial effusion . Mild pulmonary vascular congestion .