Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Moderate cardiomegaly is again seen . Lungs are hyperinflated , consistent with COPD . No pleural effusions , focal consolidations , or pneumothorax . Left pectoral pacemaker and leads are unchanged in position . Degenerative changes of thoracic spine are again seen .
    OUTPUT:
    
No evidence of focal consolidation or pulmonary edema .