Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The heart size is enlarged , slightly increased from prior exam . Sternotomy wires and mediastinal clips are compatible with prior chest surgery . The lungs are clear of lobar consolidation , and there is no radiographic evidence of large pulmonary metastases . There is no pleural effusion or pneumothorax .
    OUTPUT:
    
No radiographic evidence of pneumonia or for large pulmonary metastases ; chest CT would be more sensitive in detecting small pulmonary nodules .