Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The heart is mildly enlarged , and emphysema and left upper lobe fibrosis is again seen . The lungs are otherwise clear of focal consolidation , pleural effusion or pneumothorax . There are left axillary surgical clips . The mediastinal contours are normal .
    OUTPUT:
    
No acute cardiopulmonary process .