Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Heart size is normal . Small to moderate - sized hiatal hernia is re - demonstrated . The mediastinal and hilar contours are unchanged . The pulmonary vasculature is not engorged . No focal consolidation , pleural effusion or pneumothorax is present . Remote right - sided rib fractures are again noted . There mild degenerative changes noted in the thoracic spine .
    OUTPUT:
    
No acute cardiopulmonary process . Small to moderate size hiatal hernia .