Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: PA and lateral views of the chest . The lungs are clear of focal consolidation . There are small bilateral effusions . The degree of cardiomegaly has not changed . Tortuous descending thoracic aorta again noted . No acute osseous abnormality .
    OUTPUT:
    
Persistent moderate cardiomegaly and small effusions without superimposed acute process .