Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A left - sided pacemaker in unchanged position with its leads terminating in the right atrium and right ventricle in expected locations . An aortic valve replacement is noted . Sternal wires are intact . Lungs are hyperexpanded but otherwise are clear . Marked improvement of prior pulmonary congestion . No pulmonary edema . Cardiomediastinal and hilar contours are within normal limits . There is no focal consolidation , pleural effusion or pneumothorax .
    OUTPUT:
    
Hyperexpanded lungs consistent with COPD . Otherwise unremarkable examination .