Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The lungs are hyperinflated , compatible with COPD . Mild bibasilar atelectasis is present . Calcified apical pleural thickening and scattered calcified pulmonary nodules are stable consistent with prior granulomatous infection . There is no pleural effusion , pulmonary edema , or focal airspace consolidation . A left chest wall pulse generator device , with pacemaker leads in the right atrium and right ventricle are unchanged . Multiple healed right - sided rib deformities and compression deformities in the thoracic spine are unchanged .
    OUTPUT:
    
Multiple chronic changes , as described above . No pneumonia or acute displaced rib fracture identified .