Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Lungs are hyperinflated and diaphragms are flattened , consistent with COPD . There is probable cardiomegaly . The aorta is calcified and unfolded . No CHF , focal consolidation , pleural effusion or pneumothorax is detected . Minimal atelectasis and possible minimal blunting of left costophrenic angle . There is a moderately large hiatal hernia . Probable diffuse osteopenia . Note , there is a severe compression fracture ( near vertebral plana ) in the low thoracic spine that results in thoracic kyphosis .
    OUTPUT:
    
1 . No evidence of pneumonia . 2 . Background COPD . Probable cardiomegaly . 3 . Moderately large hiatal hernia . 4 . Severe compression fracture in a low thoracic vertebral body , associated with accentuated kyphosis . This is of uncertain acuity . If the patient has new onset focal symptoms in this area , the possibility of a recent thoracic spine fracture would be difficult to exclude and further assessment with MRI or CT would be useful .