Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Moderately enlarged cardiac silhouette has developed , compatible with pericardial effusion . There are numerous metastatic pulmonary nodules in the lower lobes , left greater than right , better evaluated on recent PET - CT . Median sternotomy wires are noted , with fracture of the superior most wire . There are no significant pleural effusions or pneumothorax .
    OUTPUT:
    
1 . Moderate pericardial effusion . 2 . Metastatic pulmonary nodules . 3 . Fractured superior sternal wire .