Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Lung volumes are low . Enlarged chest AP diameter is similar to ___ , consistent with underlying COPD . Heterogeneous airspace opacities are prominent in both lung bases and the left upper lobe , overlying the spine on lateral view . Reticular interstitial abnormality is more severe than in ___ . Redistribution of the pulmonary vasculature to the upper lobes and a small left pleural effusion are new since ___ . The heavily calcified tortuous aorta , vertebral body wedge deformities , and single lead left chest pacemaker defibrillator are unchanged from ___ .
    OUTPUT:
    
1 . Nonspecific findings could represent asymmetric pulmonary edema with or without superimposed pneumonia . 2 . Interstitial abnormality may represent pulmonary edema in the setting of chronic obstructive pulmonary disease although if the patient is not improving clinically , chest CT may be helpful to evaluate for severe interstitial lung disease . 3 . Small left pleural effusion new since ___ .