Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: AP and lateral views of the chest . Severe cardiomegaly is unchanged . Moderate left pleural effusion is unchanged . No focal consolidations are seen . Again seen are persistent left upper lobe changes consistent with radiation changes . Surgical clips are again seen at the GE junction .
    OUTPUT:
    
Unchanged severe cardiomegaly and moderate left pleural effusion .