Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: PA and lateral views of the chest were obtained . Midline sternotomy wires and mediastinal clips are again noted . There is a background of emphysema better appreciated on the prior radiographs . There has been interval development of pulmonary vascular congestion and mild pulmonary edema . Trace bilateral pleural effusions are present . No pneumothorax . Cardiomediastinal silhouette is stable . Bony structures are intact .
    OUTPUT:
    
Emphysema with superimposed pulmonary edema . Trace bilateral pleural effusions .