Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The patient is significantly rotated to the left in this study . Within these limitations , there is mild pulmonary vascular congestion without pulmonary edema and moderate to severe cardiomegaly . Lungs are otherwise clear without focal consolidation . A rounded soft tissue density projecting over the heart were may be consistent with a hiatal hernia , or less likely an aortic aneurysm . In addition to thoracolumbar scoliosis , there are marked osteopenic and degenerative changes of the thoracolumbar spine .
    OUTPUT:
    
Mild pulmonary vascular congestion without pulmonary edema . No evidence of pneumonia . Note is made of a retrocardiac soft tissue abnormality possibly a hiatal hernia or less likely a thoracic aorta aneurysm . Recommend follow - up PA and lateral chest radiographs for further evaluation .