Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Tracheostomy tube and sternal wires are noted . The right PICC now terminates in the mid SVC . The cardiac silhouette is enlarged . There is pulmonary vascular congestion . There is right pleural effusion and probable left pleural effusion .
    OUTPUT:
    
1 . Pulmonary vascular congestion and bilateral pleural effusions , similar to prior exam . 2 . Cardiomegaly , similar to prior exam .