Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Cardiac silhouette size remains moderate to severely enlarged . The aorta is tortuous with atherosclerotic calcifications noted at the aortic knob . Mediastinal and hilar contours are unchanged . Pulmonary vasculature is not engorged . Elevation of the left hemidiaphragm appears chronic . Calcified granulomas are again noted within the left lung base . No focal consolidation , pleural effusion or pneumothorax is present . No acute osseous abnormality is visualized .
    OUTPUT:
    
Moderate to severe enlargement of the cardiac silhouette , as seen previously . No pulmonary edema .