Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: PA and lateral views of the chest provided . Midline sternotomy wires and mediastinal clips are again seen . The lungs appear clear . No pleural effusion or pneumothorax . The cardiomediastinal silhouette is stable with moderate cardiomegaly re - demonstrated . Mediastinal contour appears normal . Bony structures are intact though appears slightly sclerotic which could reflect underlying renal osteodystrophy .
    OUTPUT:
    
Cardiomegaly without superimposed acute process .