Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: PA and lateral views of the chest provided . Midline sternotomy wires and mediastinal clips are again noted as well as a left chest wall pacer device with pacer lead extending into the right ventricle region . Cardiomegaly and hilar congestion again noted . No frank edema or signs of pneumonia . No large effusion or pneumothorax . Bony structures are intact .
    OUTPUT:
    
Cardiomegaly with hilar congestion similar to prior .