Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Lateral view is suboptimal . A large density projects over the lower mediastinum with splaying of the carina . The visualized aerated portions of lungs demonstrate no consolidation , pleural effusion , pneumothorax , or pulmonary edema . Heart size is difficult to evaluate in the setting of this overlying density .
    OUTPUT:
    
Large density in the mid lower chest , which is nonspecific . This may represent a dilated left atrium or hiatal hernia or mediastinal mass . CT is recommended for further evaluation . Preliminary findings and recommendations discussed with ___ by ___ by phone at 5 :51 p .m . on ___ at time of discovery of these findings .