Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The lungs are hyperinflated . There is a focal opacity overlying the right lower lobe , which may be representative of a developing pneumonia in the proper clinical setting . There is also a small right pleural effusion . Otherwise , the remainder of the lungs are clear . The heart is severely enlarged , slightly increased in comparison to prior studies . The aorta appears large and tortuous , with calcifications , not significantly changed in comparison to prior study . Diffuse osteopenia of the thoracic spine is again noted . Decreased loss of height of multiple vertebral bodies as previously , stable .
    OUTPUT:
    
1 . Right lower lobe opacity with a small right pleural effusion . These findings are likely representative of pneumonia in the proper clinical setting . 2 . Severe cardiomegaly , increased in comparison to the prior study .