Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Cardiac silhouette size remains mild to moderately enlarged with a large hiatal hernia again noted . The aorta remains tortuous , and mediastinal contours similar . Hilar contours are normal . Pulmonary vasculature is not engorged . Lungs are clear apart from minimal atelectasis at the lung bases . No pleural effusion or pneumothorax is present . Degenerative changes of the imaged thoracolumbar spine are again noted with bridging osteophytes .
    OUTPUT:
    
Large hiatal hernia . No acute cardiopulmonary process .