Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Again seen are median sternotomy wires and mediastinal clips . The mild cardiomegaly is unchanged . The aorta is tortuous . The overall degree of vascular congestion appears slightly improved in the interim . There are no focal consolidations . There is no pneumothorax . There are no pleural effusions .
    OUTPUT:
    
No acute interval changes to explain patient 's new wheezing and crackles .