Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The lungs are well expanded and clear . There is no pleural effusion or pneumothorax . The cardiac silhouette remains moderately enlarged . There is an unchanged appearance of a biventricular AICD as well as mitral and tricuspid valvuloplasties . Median sternotomy wires remain intact . The aortic knob is markedly calcified . The pulmonary vasculature is normal .
    OUTPUT:
    
No acute chest abnormality , with unchanged moderate cardiomegaly .