Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: PA and lateral radiographs were acquired . The lungs are hyperinflated , and there is flattening of the hemidiaphragms as well as enlargement of the retrosternal airspace and attenuation of the upper lobe vascular markings , findings consistent with severe emphysema . The lungs are clear . Surgical clips at the left lung base are again noted . Heart size is normal . The mediastinal contours are unchanged . There are no pleural effusions . No pneumothorax is seen . Aortic arch calcifications are noted .
    OUTPUT:
    
No acute cardiac or pulmonary process . Severe emphysema .