Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Compared to ___ , there is unchanged cardiomegaly . As before , the patient is status post median sternotomy . There is a left chest defibrillator with leads in expected and unchanged positions . Unchanged moderate to severe enlargement of the cardiac silhouette . There is mild pulmonary vascular congestion without overt pulmonary edema , improved since prior . No pleural effusion or pneumothorax . Prominent extrapleural fat is noted bilaterally . No acute osseous abnormalities .
    OUTPUT:
    
Mild pulmonary vascular congestion without overt pulmonary edema . No focal consolidation to suggest pneumonia .