Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The AP view is lordotic . The patient is status post sternotomy . There are surgical clips along the right mediastinum . The heart appears at the upper limits of normal size . The mediastinal and hilar contours appear unchanged , allowing for differences in technique . The lungs appear clear . Bilateral subpulmonic pleural effusions are moderate and have increased since the prior study , particularly conspicuous on the right . Mild degenerative changes are similar along the thoracic spine .
    OUTPUT:
    
Increasing pleural effusions , but without overt evidence for congestive heart failure or pneumonia .