Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Heart size is normal . A large hiatal hernia is re - demonstrated . Remainder the mediastinal and hilar contours are unremarkable . Pulmonary vasculature is normal . Lungs are clear . No pleural effusion or pneumothorax is seen . Hypertrophic changes are re - demonstrated within the imaged thoracolumbar spine .
    OUTPUT:
    
No acute cardiopulmonary abnormality . Unchanged large hiatal hernia .