Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Lungs are now clear . There is no evidence of cardiac decompensation . The aorta is generally large and calcified , little changed since ___ . However the contour of the proximal descending portion , where there may be separation of intimal calcification from the aortic margin could be due to chronic dissection or ulceration with periaortic bleeding , and as such raises concern for acute changes . Heart size is normal .
    OUTPUT:
    
Possible acute activity of chronic thoracic aortic dissection penetrating ulcer and local bleeding .