Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The lungs are clear without focal consolidation , effusion , or edema . Cardiac silhouette is moderately enlarged . Tortuosity of the descending thoracic aorta is noted . Left shoulder arthroplasty changes are noted . No acute osseous abnormalities . Hypertrophic changes are seen in the spine .
    OUTPUT:
    
Cardiomegaly without acute cardiopulmonary process .