Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The cardiac , mediastinal and hilar contours appear unchanged including dextro-positioning positioning and cardiomegaly . The aortic arch is calcified . There is a prominent epicardial fat pad . The chest appears hyperinflated . Coarse lung markings appear unchanged and reflect emphysema . There is no focal opacity . Slight blunting of the right costophrenic sulcus appears unchanged and accordingly most likely reflects minor scarring or atelectasis rather than an effusion .
    OUTPUT:
    
Findings consistent with emphysema but no evidence of acute disease .