Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The cardiac silhouette is mildly to severely enlarged , however this is likely accentuated by a large hiatal hernia with air - fluid level seen on the lateral view . The posterior chest is partially obscured by external artifact on the lateral view . Given this , no large pleural effusion is seen . There is no definite focal consolidation or pneumothorax . Mediastinal contours are unremarkable .
    OUTPUT:
    
Large hiatal hernia . Large cardiac silhouette , may be exaggerated by large hiatal hernia .