Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The heart size is mildly enlarged but stable . The aorta remains tortuous . A moderate - sized hiatal hernia is unchanged . The pulmonary vascularity is normal , and the lungs are clear . There is hyperinflation of lungs with flattening of diaphragms indicative of underlying COPD . No pleural effusions , pneumothorax , or focal consolidation is present . There are mild degenerative changes in the thoracic spine .
    OUTPUT:
    
No acute cardiopulmonary abnormality . Moderate - sized hiatal hernia .