Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Study is slightly limited by patient rotation . Heart size is mildly enlarged , unchanged . Atherosclerotic calcifications are again noted at the aortic knob . Mediastinal and hilar contours are unremarkable . The pulmonary vasculature is not engorged . No focal consolidation , pleural effusion or pneumothorax is noted . Focal bilateral diaphragmatic contour irregularities again likely reflect localized diaphragmatic defects , unchanged . Remote left - sided rib fracture is present . No acute osseous abnormalities seen .
    OUTPUT:
    
No acute cardiopulmonary abnormality .