Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: PA and lateral views of the chest were obtained . Moderate cardiomegaly is again seen . The mediastinal and hilar contours are stable . There is a small right pleural effusion . There is no pneumothorax . Lungs are clear . Cephalization of vessels is compatible with mild fluid overload , similar compared to the prior study . Again noted are tenodesis screws in the right humeral head .
    OUTPUT:
    
Mild vascular congestion with small right pleural effusion and persistent enlargement of the cardiac silhouette .