Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Left - sided pacer is present with leads ending in the expected location of the right atrium and ventricle , unchanged . The lungs are hyperinflated with flattening of the diaphragms consistent with COPD . Lungs are clear . There is no pleural effusion or pneumothorax . Small rounded density at the right lung base posteriorly , best seen on the lateral view , is consistent with a small Bochdalek hernia as seen on the prior cardiac MRI .
    OUTPUT:
    
COPD . No acute intrathoracic process .