Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: PA and lateral chest views were obtained with patient in upright position . There is moderate cardiac enlargement . The enlargement involves mostly the left ventricle which is prominent to the left and posteriorly . The thoracic aorta is generally widened and elongated most prominently in the mid portion of the descending aorta which bulges towards the left . There exists a few calcifications in the wall of the aorta at the level of the arch but no other local contour abnormalities are identified . The pulmonary vasculature is not congested . No signs of acute or chronic pulmonary abnormalities are seen , and the lateral and posterior pleural sinuses are free . No pneumothorax is present in the apical area . Rather advanced degenerative changes are seen in the mid portion of the thoracic spine with multiple disc degenerations and prominent osteophytic reactions which at times are bridging . There is no evidence of vertebral body compression fracture or marked scoliosis . Our records do not include a previous chest examination available for comparison .
    OUTPUT:
    
Moderate cardiac enlargement mostly involving the left ventricle . This exists together with a generally widened and elongated thoracic aorta . The rather isolated left ventricular enlargement is suggestive of volume overload possibly related to aortic valve incompetence , as there is no evidence of pulmonary congestion or acute infiltrates . Referral to cardiologist to evaluate described radiographic cardiac abnormalities is recommended .