Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The lungs are hyperinflated , with flattening of the diaphragms . Blunting of the right costophrenic angle suggests a small pleural effusion . Chronic deformity of multiple right - sided ribs from prior fractures noted , with overall volume loss of the right lung as compared to the left . The cardiac silhouette is enlarged . There is subtle splaying of the carina which can be seen with left atrial enlargement . The aorta is calcified and tortuous . Evidence of a large hiatal hernia is seen .
    OUTPUT:
    
Hyperinflated lungs . Small right pleural effusion . Chronic deformity of the right - sided ribs with overall volume loss of the right lung as compared to the left . No definite focal consolidation is seen although this would be difficult to exclude at the right lung base . Cardiomegaly . Large hiatal hernia .