Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The cardiomediastinal shadow is normal . Unfolding of the thoracic aorta with associated calcific atherosclerotic changes . Small to moderate size left - sided pleural effusion with adjacent atelectatic changes of the left lower lobe . No pneumothorax . No subdiaphragmatic free air .
    OUTPUT:
    
No free subdiaphragmatic air . Please note that the sensitivity of radiographs for a small amount of free subdiaphragmatic air is lower and if the clinical suspicion is high a CT should be performed . Small to moderate sized left - sided pleural effusion .