Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The heart size is normal . The mediastinal contour is unchanged with a small to moderate size hiatal hernia again noted . The aorta remains tortuous and diffusely calcified . Hilar contours are normal . There is no pulmonary vascular congestion . Lungs are clear without focal consolidation . No pleural effusion or pneumothorax is present . Multiple old left - sided rib fractures are again demonstrated .
    OUTPUT:
    
No acute cardiopulmonary process .