Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The lungs are hyperinflated and the diaphragms are flattened , consistent with COPD . Multiple surgical clips are seen about the mediastinum , consistent with prior surgery . A linear wire - like density is again noted in the retrosternal region , unchanged . Previously seen anterior chest wall drains have been removed . On today 's exam , the heart is not enlarged . The aorta is unfolded . There is prominence of a hila suggesting element of pulmonary hypertension , probably unchanged . There is some linear atelectasis and / or scarring at both lung bases . Ring - like opacity in the left upper zone seen on the prior study has resolved , with only minimal residual scarring . No CHF or new focal infiltrate is detected . No effusions are identified . No pneumothorax is detected . Relative lucency at the right base is thought to represent an artifact due to overlying soft tissues of the chest .
    OUTPUT:
    
1 . Background COPD , with suspected pulmonary hypertension . 2 . Status post sternotomy , with mediastinal clips . No CHF . 3 . No acute infiltrate identified . Residual scarring noted , detailed above . 4 . No pneumothorax detected .