Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There is stable widening of the mediastinal structures , likely secondary to pulmonary vascular engorgement . The heart size is stably enlarged . Lung volumes are low . The lungs are otherwise clear . There is no pneumothorax or pleural effusion . The positioning of the left PICC , endotracheal tube , and feeding tube is unchanged .
    OUTPUT:
    
No marked change from prior study .