Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There is mild to moderate cardiomegaly , unchanged in appearance from the prior study . There is pulmonary vascular engorgement consistent with chronic anemia . The lungs are clear and there is no evidence of pulmonary edema . The pleural surfaces are normal .
    OUTPUT:
    
1 . No evidence of pneumonia or acute chest syndrome . 2 . Chronic cardiovascular changes of sickle cell disease .