Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Lower spinal fusion hardware is intact . Metallic densities projecting over the humeral heads likely reflect prior rotator cuff repair . Distension of the azygos vein , borderline cardiomegaly , and pulmonary vascular congestion reflect volume overload . Retrocardiac opacity reflects left lower lobe atelectasis . Gas bubble overlying the left heart is of unclear etiology , and may reflect hiatal hernia , loculated pleural air collection , or air within the lung parenchyma . Recommend obtaining a lateral view when feasible for further evaluation . Small left pleural effusion . Normal hilar contours . No pneumothorax .
    OUTPUT:
    
No pneumothorax . Mild volume overload with a small left pleural effusion . Gas bubble projecting over the left heart warrants further evaluation with a lateral view when feasible .