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There is displacement of aortic arch calcification away from the aortic silhouette. This indicates lifting of the initmal calcification.
The heart contour is enlarged, with splaying of the carina to indicate left atrial enlargement. Lung detail has been obscured by the heavy windowing, and while there was no air space opacity a small left pleural effusion is present.
The comparison x-ray from 2 years earlier shows that the displaced calcification is a new finding.