Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The cardiac silhouette size is top normal . The aorta remains tortuous . Calcifications of the aortic knob are unchanged . Pulmonary vascularity is normal . Lungs are clear . No pleural effusion or pneumothorax is identified . Multilevel degenerative changes are again demonstrated within the thoracic spine with anterior bridging osteophytes .
    OUTPUT:
    
No acute cardiopulmonary process .