Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The lungs are hyperexpanded with diffuse hyperlucency , flattening of the hemidiaphragms , and widening of the anteroposterior diameter and retrosternal clear space . Moderate enlargements of the cardiac silhouette and pulmonary artery are unchanged over multiple examinations . There are no pleural effusions or pneumothorax . Multilevel degenerative changes in the thoracic spine .
    OUTPUT:
    
COPD . Chronic cardiomegaly and pulmonary hypertension .