Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There are median sternotomy wires which appear intact . There are surgical clips projecting over the mediastinum . Lung volumes are somewhat low , and there is prominence of the pulmonary vasculature without frank pulmonary edema . There is no focal airspace opacity . There is no pleural effusion or pneumothorax . Given AP technique , the heart size is likely normal . There are significant degenerative changes at the AC and glenohumeral joints bilaterally .
    OUTPUT:
    
1 . Persistent pulmonary vascular congestion without frank pulmonary edema . 2 . No focal airspace opacity to suggest pneumonia .