Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Severe hyperexpansion is consistent with underlying COPD . There is moderate pulmonary vascular congestion and associated mild to moderate interstitial pulmonary edema . Bilateral pleural effusions are small . A mildly displaced anterior left eighth rib fracture is acute or subacute . Dextroscoliosis of the lower thoracic spine is severe . There is moderate to severe cardiomegaly and tortuosity of the descending aorta . There is focal eventration and elevation of the left hemidiaphragm . Demineralization is moderate to severe . Allowing for scoliosis , the cardiomediastinal silhouette is within normal limits .
    OUTPUT:
    
1 . Moderate pulmonary vascular congestion and mild to moderate interstitial pulmonary edema with moderate to severe cardiomegaly and likely small bilateral pleural effusions . 2 . Severe hyperexpansion consistent with COPD . 3 . Acute to subacute anterior left eighth rib fracture in its lateral aspect without significant displacement . 4 . Elevation of the left hemidiaphragm , projecting over the lower thoracic ribs on the lateral view , better defined on the subsequent CT of the abdomen and pelvis .