Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The cardiomediastinal silhouette and pulmonary vasculature are unremarkable . The ascending aorta is mildly tortuous . There is no pleural effusion or pneumothorax . The lungs are clear .
    OUTPUT:
    
1 . No acute intrathoracic process . 2 . Mildly tortuous ascending aorta may be related to hypertension or aortic stenosis . Further evaluation with echocardiogram is recommended .