Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The patient is status post median sternotomy . Left - sided pacer device is seen with leads extending to the expected positions of the right atrium and right ventricle . The cardiac silhouette is mildly enlarged . Mediastinal contours are unremarkable . There may be minimal central vascular engorgement without overt pulmonary edema . No large pleural effusion is seen . There is no evidence of pneumothorax or focal consolidation . The lungs appear relatively hyperinflated .
    OUTPUT:
    
Relatively hyperinflated lungs , suggesting COPD . Possible minimal central pulmonary vascular engorgement without overt pulmonary edema . No focal consolidation . Mild cardiomegaly .