Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The heart size remains mildly enlarged . A large hiatal hernia is again demonstrated . An aortic valve graft prosthesis is again seen . The mediastinal and hilar contours are unchanged . The lungs are hyperinflated . No pulmonary vascular congestion is noted . Streaky left basilar opacity appears worse compared to the prior exam , and could either reflect atelectasis adjacent to the hiatal hernia or aspiration . No pleural effusion or pneumothorax is clearly evident . There are mild degenerative changes in the thoracic spine .
    OUTPUT:
    
Streaky left basilar opacity could reflect atelectasis or aspiration given the presence of a large hiatal hernia .