Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Moderate - to - severe cardiomegaly is again noted . The lungs however are clear on the current exam . There is no consolidation , effusion or congestion . Median sternotomy wires are again noted . Old posterior left rib fractures identified .
    OUTPUT:
    
Cardiomegaly without superimposed acute cardiopulmonary process .