Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: PA and lateral views of the chest provided . Midline sternotomy wires and prosthetic cardiac valve again noted . The heart remains markedly enlarged , unchanged in configuration . No large effusion or pneumothorax . No pulmonary edema . No acute osseous abnormality .
    OUTPUT:
    
Cardiomegaly . No signs of pneumonia .