Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The cardiomediastinal silhouette is grossly stable with the cardiac silhouette enlarged and the aorta is calcified . Evidence of large hiatal hernia is again seen , with adjacent atelectasis . Subtle right paratracheal opacity is stable since a least CT from ___ scout images and likely relates to vasculature . The patient is status post median sternotomy . There has been interval removal of a right internal jugular central venous catheter . There is slight blunting of the right costophrenic angle which could be due to a trace pleural effusion . Chronic deformities of the shoulder joints / proximal humeri all are again noted .
    OUTPUT:
    
Slight blunting of the right costophrenic angle may be due to trace pleural effusion . Enlarged cardiac silhouette . Retrocardiac opacity likely due to known hiatal hernia . No definite focal consolidation .