Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The heart size remains mild to moderately enlarged . A moderate to large hiatal hernia is again noted . Hilar contours are unchanged . Pulmonary vasculature is not engorged . Blunting of the costophrenic angles on the lateral view posteriorly may be due to chronic pleural thickening . No focal consolidation , pleural effusion or pneumothorax is otherwise demonstrated . Multiple remote right - sided rib fractures are again noted . Compression deformity of a low thoracic vertebral body is unchanged along with moderate multilevel degenerative changes .
    OUTPUT:
    
No acute cardiopulmonary abnormality . Moderate to large hiatal hernia .