Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: PA and lateral views of the chest provided . Retrocardiac opacity contain containing an air - fluid level is compatible with hiatal hernia . There is a small right pleural effusion . Lungs are hyperinflated with biapical pleural parenchymal scarring . Retrosternal clear space is noted in this patient with underlying presumed emphysema . The heart is top normal in size . Mediastinal contour is unremarkable . No convincing signs of pneumonia or CHF . Bony structures are demineralized though appear intact .
    OUTPUT:
    
Emphysema , small right pleural effusion , hiatal hernia , top - normal heart size .