Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There is probable background hyperinflation , consistent with COPD . The heart size is at the upper limits of normal . The aorta is calcified minimally unfolded . There is upper zone redistribution , but no overt CHF . There is blunting of the right costophrenic angle , with minimal patchy density there , which appears to represent a long - standing finding and is seen on the radiograph from ___ . There appears to be an adjacent skin fold on today 's examination . There is minimal density overlying the apex of the heart --? confluence of shadows from the bone , heart and vessels . This was not seen on the ___ chest x-ray . There is minimal atelectasis at the left lung base , which is also slightly more pronounced . No focal consolidation or effusion is identified . Clips noted in the right upper quadrant of the abdomen .
    OUTPUT:
    
1 . Probable background COPD . 2 . Doubt acute pulmonary process . 3 . Blunting of the right costophrenic angle again noted . 4 . Focal density at the left heart apex most likely represents confluence of vascular and osseous shadows . Recommend followup radiograph in ___ months to document clearing .