Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: No significant interval change . The lungs are well - expanded and clear . No focal consolidation , pleural effusion , pulmonary edema , or pneumothorax . Flattening of the diaphragms , best appreciated on the lateral view , is overall unchanged and suggests chronic pulmonary disease . The heart is normal in size . The mediastinum is not widened . The hila are within normal limits . Calcifications of the aortic knob are unchanged . Median sternotomy wires are also grossly unchanged . Increased interval aortic valve calcifications . Bilateral coronary stents are intact . Moderate multi - level degenerative changes with anterior osteophytes are not overall similar if not slightly progressed in the thoracic spine .
    OUTPUT:
    
1 . No acute intrathoracic process . Probable chronic pulmonary disease . 2 . Increased aortic valve calcifications . 3 . Note that conventional chest radiograph is suboptimal for detection of rib fractures . If clinical concern is high , return for dedicated rib films with ___ in region of interest is recommended .