Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Severe cardiomegaly is noted . Left chest wall dual lead pacing device is identified . There is significant enlargement of the aortic arch , partially visualized on prior CT cervical spine . Rounded opacity in the retrocardiac region potentially in part due to hiatal hernia however given significant aortic abnormality at the arch , it is more likely that this may represent a descending thoracic aortic aneurysm . Compression deformities of several lower thoracic vertebral bodies and likely lumbar vertebral body are age indeterminate .
    OUTPUT:
    
Cardiomegaly . Tortuosity and dilation of the thoracic aorta with a more rounded opacity in the retrocardiac region which is suspicious for a focal descending thoracic aneurysm . Chest CT is suggested .