Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Moderate enlargement of the cardiac silhouette is again noted . Low lung volumes are noted with secondary bronchovascular crowding . There is no overt pulmonary edema or large effusion . Mid thoracic vertebral body height loss seen on prior is less clearly delineated on today 's exam . Hypertrophic changes noted in the spine .
    OUTPUT:
    
Cardiomegaly without superimposed acute cardiopulmonary process .