Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: AP and lateral views of the chest . Low lung volumes are again noted . Dense retrocardiac opacity is likely due in part to known hiatal hernia present on prior CT abdomen from ___ . There is also a small right - sided pleural effusion . Engorged pulmonary vasculature is compatible with vascular congestion . Posterior and posterolateral right rib fractures affecting ribs 7 and 8 appear old . Additional right lateral rib fractures are not well characterized . Deformity of the proximal left humerus is compatible with prior fracture .
    OUTPUT:
    
Pulmonary vascular congestion and small - to - moderate right pleural effusion . Dense retrocardiac opacity is compatible with large hiatal hernia seen on prior exam .