Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: PA and lateral views of the chest provided . Lungs are clear . Pulmonary vasculature is normal . Mild cardiomegaly appears chronic . ICD leads are in appropriate position . Moderate - sized hiatal hernia is larger since prior study from ___ , which may account for patient 's persistent cough .
    OUTPUT:
    
No pneumonia . Larger hiatal hernia , now moderately - sized .