Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Lungs are distorted by a marked kyphosis of the thoracic spine and patient rotation . There is mild vascular congestion with tiny bilateral pleural effusions . Heart is moderately enlarged but unchanged . No pneumothorax or focal airspace consolidation . There is a large hiatal hernia . Multilevel degenerative changes of the thoracic spine are unchanged .
    OUTPUT:
    
Mild vascular congestion with tiny bilateral pleural effusions .