Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Portable semi-upright radiograph of the chest demonstrates an enlarged cardiac silhouette , not markedly changed since the prior examination . There is increased atelectasis . Pulmonary edema is worsened since ___ . There is no pneumothorax . Likely pleural effusions are present . No definite consolidation is identified . Midline sternal wires are well aligned and intact .
    OUTPUT:
    
No significant change since the prior . Superimposed pneumonia is not excluded .