Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A tracheostomy is in place . There is a left - sided PICC line , with tip at SVC / RA junction . No pneumothorax is detected . There is probable background hyperinflation , consistent with COPD . There is hazy of opacity at the right lung base , essentially unchanged . Deformity of the left upper lateral chest wall and posterior right rib fractures again noted . There is mild vascular plethora , more pronounced than on the prior film . Minimal atelectasis at the left base is slightly more pronounced .
    OUTPUT:
    
1 . Mild CHF , more pronounced than on ___ . Patchy opacity at the left base is also more pronounced , question atelectasis and CHF , but attention this area to exclude an early infiltrate is requested . 3 . Hazy opacity involving the lower third of the right lung is unchanged .