Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The heart is moderate to severely enlarged . Aortic knob calcifications are present . Enlargement of the hila bilaterally may suggest pulmonary arterial hypertension . There is mild pulmonary vascular congestion . Small bilateral pleural effusions are noted . No focal consolidation is seen . No pneumothorax is present . Mild multilevel degenerative changes of the thoracic spine are present . Additionally , severe degenerative changes of both glenohumeral and acromioclavicular joints are present with narrowing of the acromiohumeral intervals bilaterally suggestive of underlying rotator cuff disease .
    OUTPUT:
    
Mild pulmonary vascular congestion and small bilateral pleural effusions . Enlargement of the hila bilaterally may suggest underlying pulmonary arterial hypertension .