Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The lungs are clear without focal consolidation , effusion , or pulmonary edema . There is enlargement of the cardiac silhouette similar to prior . Median sternotomy wires , mediastinal clips , and left chest wall single lead pacing device are noted . Old healed right posterior sixth rib fracture is noted
    OUTPUT:
    
Enlarged cardiac silhouette without acute cardiopulmonary process .