Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The heart is again markedly enlarged , probably unchanged , however , allowing for differences in technique ( lung volumes are lower on this study . There is also an indication of a large coinciding hiatal hernia . There is no pleural effusion or pneumothorax . There is mild upper zone prominence of pulmonary vasculature but without explicit pulmonary edema .
    OUTPUT:
    
Marked cardiomegaly . Large hiatal hernia . Findings suggesting pulmonary venous hypertension .