Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: PA and lateral views of the chest were provided . Midline sternotomy wires and mediastinal clips are again seen . The heart is moderately enlarged which is unchanged , though there is interval increase in pulmonary edema . There are small bilateral pleural effusions which are increased from prior exam . There is no pneumothorax . Clips are seen in the right infraclavicular region . No definite bony abnormalities are seen .
    OUTPUT:
    
Cardiomegaly with increased pulmonary edema , and small bilateral pleural effusions .