FINDINGS:
There is severe enlargement of the cardiac silhouette.  The aorta is calcified
 and tortuous.  There is a trace left pleural effusion and possible trace right
 pleural effusion.  No pulmonary edema is seen.  There is no pneumothorax.  No
 focal consolidation to suggest pneumonia is identified.  There is prominence
 of the central pulmonary arteries.

IMPRESSION:
Severe enlargement of the cardiac silhouette.  No priors for comparison. 
 Consider follow-up echocardiogram if this has not been previously assessed.
 
 Mild prominence of the central pulmonary vasculature may be due to underlying
 pulmonary hypertension.
 
 Trace pleural effusions.