Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The right cardiomediastinal contour has a pronounced convexity , and extends farther lateral than expected , particularly considering the normal appearance of the left cardiac contour . There is an additional rightward convexity to the left of the spine . It is uncertain whether this represents a markedly enlarged cardiac chamber or a paracardiac mass such as a hiatal hernia . Pulmonary vascularity is normal centrally , but paucity of vessels in upper lobes suggests the possibility of emphysema . With the exception of atelectasis adjacent to the right cardiac border , lungs are otherwise grossly clear .
    OUTPUT:
    
Unusual configuration of right cardiomediastinal contour , which could be due to an enlarged cardiac chamber or paracardiac mass such as a large hiatal hernia . In the absence of older radiographs for comparison , this could initially be further evaluated with dedicated PA and lateral chest radiographs when the patient 's condition permits , as communicated by phone to Dr . ___ on ___ at 8 :45 a .m . at the time of discovery .