Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There is hyperinflation , consistent with COPD . The cardiomediastinal silhouette is unchanged . Heart size is at the upper limits of normal or slightly enlarged . Aorta is unfolded . No CHF , focal consolidation , pleural effusion or pneumothorax is detected . Minimal blunting of the left costophrenic angle posteriorly is unchanged . Bibasilar atelectasis is present . Mild elevation and / or eventration of the right hemidiaphragm is unchanged . Apparent focal synostosis between the right fifth and sixth posterior ribs is unchanged . Degenerative changes about both shoulders noted .
    OUTPUT:
    
No acute pulmonary process detected . Background COPD and borderline cardiomegaly noted .