Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Marked cardiomegaly , is unchanged . The hilar and mediastinal contours are stable , with moderate enlargement of both main pulmonary arteries . The lungs are clear , without consolidation , pulmonary edema , pleural effusion or pneumothorax . No displaced rib fractures are evident . However , this study is not optimal for assessment of rib fractures . If there is high concern for the same , a dedicated rib series with marker placed at the site of maximum tenderness is recommended . A left chest wall AICD device is in place , with three leads terminating in the right atrium , right ventricle and left ventricle as before . Multiple intact sternotomy wires are noted .
    OUTPUT:
    
1 . Marked cardiomegaly , unchanged . No acute cardiopulmonary pathology . 2 . If there is high concern for nondisplaced rib fracture , dedicated rib series can be performed with marker placed at the site of maximum tenderness .