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There is mild cardiomegaly, primarily due to right-sided chamber enlargement, with straightening of the intraventricular septum and increase in the RV/LV ratio; associated reflux of IV contrast into the infrahepatic IVC and hepatic veins is present. No central or segmental pulmonary embolism is present. There is no thoracic aortic aneurysm or dissection. There is no pericardial effusion.