Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The heart is moderately increased in size and is larger compared to the prior study . There is a moderate - sized right pleural effusion that has increased compared to the prior . There is no focal infiltrate . The patient is status post sternotomy with sternal wires and mediastinal clips .
    OUTPUT:
    
Increased right effusion and cardiomegaly .