Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Lungs : The lungs are well inflated and free of consolidation . The enlarged heart precludes accurate evaluation of a left basilar process . Pleura : There is probably a small right pleural effusion . Mediastinum : Surgical clips are noted in the mediastinum . Heart : The heart is grossly enlarged . . Osseous structures : The patient is status post median sternotomy . Additional findings : Monitor leads overlie the chest .
    OUTPUT:
    
Gross cardiomegaly . Possible small right effusion The left base is difficult to evaluate given the enlarged cardiac silhouette