Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: AP and lateral views of the chest demonstrate moderate - to - severe cardiomegaly , unchanged . Cardiomediastinal contour is stable . Lungs are clear . There is no pleural effusion or pneumothorax . The sternotomy wires , multiple surgical clips and degenerative changes in the spine are noted .
    OUTPUT:
    
No significant change compared to the prior study .