Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Chronic enlargement of the cardiac silhouette is moderate to severe , but there is no pulmonary vascular congestion , edema , or pleural effusion . . There is hyperinflation of the lungs , without focal consolidation . A compression deformity of an upper thoracic vertebral body is unchanged .
    OUTPUT:
    
Emphysema . No pneumonia . Chronic moderate to severe cardiomegaly , but no evidence of acute decompensation .