Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: PA and lateral views of the chest were provided . A left upper extremity PICC line is seen with its tip residing in the upper SVC region . Midline sternotomy wires and mediastinal clips are again noted . The heart remains markedly enlarged . There is no focal consolidation , or convincing signs of congestive heart failure . There is trace right pleural effusion noted . No pneumothorax is present . The bony structures are intact . An aortic stent is partially imaged in the upper abdomen .
    OUTPUT:
    
Massive cardiomegaly unchanged . Trace right pleural effusion . PICC line unchanged in position .