Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There is a large hiatal hernia with an air - fluid level . The heart is mildly enlarged with a left ventricular configuration . The cardiac , mediastinal and hilar contours appear unchanged . The lungs appear clear aside from streaky atelectasis associated with a hiatal hernia in the left lower lung . There is no pleural effusion or pneumothorax . Small anterior osteophytes are noted along the mid - to - lower thoracic spine . There has been no significant change .
    OUTPUT:
    
No evidence of acute disease . Large hiatal hernia .