Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: AP upright portable chest radiograph obtained . Lung volumes are low . Fusion hardware is noted in the lower cervical spine . The heart is mildly enlarged . The mediastinal contour appears somewhat prominent , though borders appear sharp . No large effusion or pneumothorax seen . Retrocardiac space is poorly assessed . Bony structures are intact .
    OUTPUT:
    
Limited exam with cardiomegaly and mediastinal prominence , which in part could reflect technique . Recommend repeat with dedicated PA and laterals with improved / optimized inspiratory effort .