Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: AP upright and lateral views of the chest provided . Midline sternotomy wires and mediastinal clips are again noted . Cardiomegaly is again noted with small right pleural effusion . Lucency in the upper lungs may reflect emphysema . Patient 's chin obscures the superior mediastinum . Mediastinal contour appears grossly unremarkable allowing for left rightward rotation . Bony structures are diffusely demineralized .
    OUTPUT:
    
Cardiomegaly with small right pleural effusion .