Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The patient is status post sternotomy with surgical clips in the mediastinum . The lungs are clear , the cardiomediastinal silhouette and hila are normal . There is no pleural effusion or pneumothorax . Calcification aree seen at the aortic arch . There are moderate to severe degenerative changes at the glenohumeral joints . There is a large hiatal hernia .
    OUTPUT:
    
No acute cardiothoracic process .