Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: AP semi-upright portable chest radiograph obtained . Midline sternotomy wires and mediastinal clips are again noted . The heart is markedly enlarged , though this is unchanged . There is mild pulmonary edema which is perhaps slightly increased from prior exam . There are likely tiny bilateral pleural effusions . No pneumothorax . No definite signs of pneumonia . Mediastinal contour appears stable . Bony structures are grossly unchanged .
    OUTPUT:
    
Marked cardiomegaly , mild pulmonary edema , tiny bilateral pleural effusions .