Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: AP upright and lateral views of the chest provided . Midline sternotomy wires and mediastinal clips again noted . The heart is enlarged , with apparent mild increased from prior exam , please correlate for pericardial effusion . The hila appear slightly congested though there is no frank edema . No large effusion or pneumothorax is seen . Bony structures are intact .
    OUTPUT:
    
Interval cardiac enlargement is concerning for development of a pericardial effusion . Hilar congestion without frank edema .