Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A hiatal hernia is again noted projecting over the cardiac shadow . Heart appears to be enlarged . Thoracic aorta is tortuous . Cardiomediastinal contours are unchanged compared to the prior study . Lungs are clear with no evidence of focal infiltrates . No pleural effusions and no pneumothorax .
    OUTPUT:
    
No new changes to suggest pneumonia .