Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There is extensive changes from chronic obstructive pulmonary disease . There is no pleural effusion or pneumothorax . There is no focal airspace consolidation concerning for pneumonia . Bibasilar patchy opacities likely reflect scarring which also account for blunting of the costophrenic angles on the lateral view . No pleural effusion was evident on the prior CT . Moderate enlargement of the heart and pulmonary vessels is unchanged . The known bulky mediastinal lymphadenopathy is better appreciated on the prior CT . A mitral valve prosthesis is again noted . A compression fracture of the lower thoracic spine is stable . No new compression fractures .
    OUTPUT:
    
No acute cardiopulmonary process .