Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Heart size is mildly enlarged . Mediastinal and hilar contours are unchanged . Pulmonary vasculature is not engorged . Severe upper lobe predominant emphysema is again noted along with lung hyperinflation . No focal consolidation , pleural effusion or pneumothorax is present . Remote right - sided rib fractures are again seen along with a chronic fracture of the right proximal humerus .
    OUTPUT:
    
Severe emphysema . No acute cardiopulmonary abnormality .