Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Heart size remains mildly enlarged . A large hiatal hernia is again noted . Mediastinal and hilar contours are otherwise unchanged . Pulmonary vasculature is normal . The lungs are hyperinflated compatible mild emphysema . Scarring within the left lower lobe is unchanged . Lungs are otherwise clear without focal consolidation . No pleural effusion or pneumothorax is seen . Left - sided pleural thickening accounts for the mild blunting within the left posterior costophrenic sulcus on the lateral view . No acute osseous abnormalities demonstrated .
    OUTPUT:
    
Mild emphysema . No radiographic evidence for pneumonia . Large hiatal hernia .