Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: AP upright and lateral views of the chest provided . The heart is markedly enlarged as on prior . The aorta is unfolded . Lung volumes are low limiting assessment . There is no focal consolidation , large effusion or pneumothorax . No convincing signs of congestion or edema . Imaged bony structures are intact . Degenerative changes are severe both shoulders . No free air seen below the right hemidiaphragm .
    OUTPUT:
    
Severe cardiomegaly unchanged .