Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: One portable AP upright view of the chest . There is severe enlargement of the cardiac silhouette , similar to prior . Sternotomy wires are intact and unchanged in position . Mediastinal clips are seen . There is no evidence of focal consolidation , edema , pleural effusion or pneumothorax . There is no significant change compared the study on ___ .
    OUTPUT:
    
No change compared to ___ . Marked enlargement of the cardiac silhouette . No acute intrathoracic process .