Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Single AP upright portable view of the chest was obtained . The lungs are hyperinflated , suggesting chronic obstructive pulmonary disease . Retrocardiac opacity with air - fluid levels consistent with a large hiatal hernia . The cardiac silhouette is mildly enlarged . The aorta is calcified . No focal consolidation , large pleural effusion , or evidence of pneumothorax is seen . There may be some biapical scarring . No overt pulmonary edema is seen .
    OUTPUT:
    
Hyperinflated lungs with evidence of biapical scarring , which most likely relate to COPD . Large hiatal hernia . No focal consolidation .