Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: AP portable upright view of the chest . Midline sternotomy wires and mediastinal clips are again noted . The heart remains markedly enlarged . The lungs appear clear without focal consolidation , large effusion or pneumothorax . A tiny pleural effusion on the right is suspected . No overt edema . Bony structures are intact .
    OUTPUT:
    
Marked cardiomegaly without overt pneumonia or edema . Probable tiny right pleural effusion .