Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Lungs remain hyperinflated . Heart size is moderately enlarged , unchanged . The mediastinal and hilar contours appear similar . Pulmonary vasculature is not engorged . No focal consolidation , pleural effusion or pneumothorax is seen . Blunting of the costophrenic angles posteriorly is chronic , likely reflective of pleural thickening . Degenerative changes of the left glenohumeral joint are noted along with multilevel degenerative changes within the thoracic spine .
    OUTPUT:
    
No acute cardiopulmonary abnormality including no pulmonary edema . Hyperinflated lungs suggestive of COPD .