Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The heart size is normal . The aorta remains tortuous . The mediastinal and hilar contours are otherwise unremarkable , and the pulmonary vasculature is normal . Lungs are clear . No pleural effusion or pneumothorax is seen . There are multilevel degenerative changes noted in the thoracic spine .
    OUTPUT:
    
No acute cardiopulmonary process .