Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: AP upright and lateral views of the chest provided . The heart remains markedly enlarged with a prosthetic mitral valve again seen . Mediastinal contour appears normal . Clips project over the right hilum . Bilateral humeral head replacement noted . There is mild blunting of the CP angles bilaterally likely indicative of small pleural effusions . No convincing evidence for edema or pneumonia . No pneumothorax .
    OUTPUT:
    
Marked cardiomegaly with small bilateral pleural effusions .