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 noted . The heart remains markedly enlarged . The overall cardiomediastinal silhouette is unchanged . There is a small to moderate left pleural effusion with associated consolidation in the left lower lobe which may represent atelectasis and / or pneumonia . The right lung is clear . Bony structures appear intact . No convincing evidence for edema . There may be mild cephalization and congestion .
    OUTPUT:
    
1 . Cardiomegaly , small to moderate left effusion with left lower lobe consolidation likely atelectasis and / or pneumonia . 2 . Probable mild pulmonary vascular congestion .