Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Lung volumes are lower compared to the previous examination . Moderate to severe cardiomegaly is re - demonstrated . The mediastinal and hilar contours are unchanged . Pulmonary vasculature is not engorged . No focal consolidation , pleural effusion or pneumothorax is present . Moderate degenerative changes are noted in the thoracic spine .
    OUTPUT:
    
Moderate to severe cardiomegaly . No focal consolidation to suggest pneumonia .