FINDINGS:
The heart is mildly enlarged.  The aortic arch is calcified.  The
 lungs are hyperinflated.  A rounded contour projecting along the lower central
 mediastinum suggests a substantial hiatal hernia, although not fully
 characterized.  The lungs appear clear.  There are no pleural effusions or
 pneumothorax.  The bones appear demineralized.  Moderate-to-severe rightward
 convex curvature is centered along the upper lumbar spine.

IMPRESSION:
No evidence of acute cardiopulmonary disease.  Rounded contour in
 the lower mediastinum, probably a substantial hiatal hernia.