Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Heart size remains mildly enlarged . The aorta is slightly tortuous . The mediastinal and hilar contours are similar with enlargement of the left pulmonary artery suggestive of underlying pulmonary arterial hypertension . Emphysematous changes are most pronounced in the upper lobes . Pulmonary vasculature is normal . Small bilateral pleural effusions are present with patchy opacities in the lung bases most likely reflective of atelectasis . No pneumothorax is present . Moderate to severe multilevel degenerative changes are again noted in the thoracic spine .
    OUTPUT:
    
Small bilateral pleural effusions and mild bibasilar atelectasis . No pulmonary edema . Moderate emphysema .