CHIEF COMPLAINT: Occassional Chest Pressure

PRESENT ILLNESS: Mr. [**Known lastname **] is a 68-year-old male with worsening symptoms of
dyspnea on exertion and chest tightness, who has been followed
with a known aortic
stenosis. Echocardiogram showed an aortic valve area estimated
at 0.6 square cm.  A cardiac catheterization confirmed critical
aortic stenosis with a high-grade in the normal coronary
arteries.  He is presenting for aortic valve
replacement.

MEDICAL HISTORY: Osteoarthritis
Basal Cell Cancer
Right hip replacement

MEDICATION ON ADMISSION: Advil and tylenol as needed

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: 58 SR    120/77 66" 183 pounds
GEN: well developed well nourished in no distress
SKIN: No lesions or rash
HEENT: Normocephalic/atraumatic, pupils equal, round and
reactive.
NECK: Supple. Transmitted bruit versus radiated murmur
CHEST: Clear
HEART: Regular rate and rhythm, III/VI systolic murmur
ABD: Soft, nontender, nondistended
EXT: Warm well perfused. No edema, 2+ Pulses.
NEURO: Nonfocal

FAMILY HISTORY: Non-Contributory

SOCIAL HISTORY: Lives with wife. Owns a retail store. Smoked for 25 years
quitting 25 years ago.
Aortic valve disorders,Cardiac complications, not elsewhere classified,Atrial fibrillation,Personal history of other malignant neoplasm of skin,Hip joint replacement
Aortic valve disorder,Surg compl-heart,Atrial fibrillation,Hx-skin malignancy NEC,Joint replaced hip
Admission Date:  [**2193-6-17**]              Discharge Date:   [**2193-6-22**]

Date of Birth:  [**2125-5-25**]             Sex:   M

Service: CARDIOTHORACIC

Allergies:
Patient recorded as having No Known Allergies to Drugs

Attending:[**First Name3 (LF) 1505**]
Chief Complaint:
Occassional Chest Pressure

Major Surgical or Invasive Procedure:
[**2193-6-17**] Aortic Valve Replacement (21mm [**Last Name (un) 3843**] [**Doctor Last Name **]
Pericardial)


History of Present Illness:
Mr. [**Known lastname **] is a 68-year-old male with worsening symptoms of
dyspnea on exertion and chest tightness, who has been followed
with a known aortic
stenosis. Echocardiogram showed an aortic valve area estimated
at 0.6 square cm.  A cardiac catheterization confirmed critical
aortic stenosis with a high-grade in the normal coronary
arteries.  He is presenting for aortic valve
replacement.


Past Medical History:
Osteoarthritis
Basal Cell Cancer
Right hip replacement

Social History:
Lives with wife. Owns a retail store. Smoked for 25 years
quitting 25 years ago.

Family History:
Non-Contributory

Physical Exam:
58 SR    120/77 66" 183 pounds
GEN: well developed well nourished in no distress
SKIN: No lesions or rash
HEENT: Normocephalic/atraumatic, pupils equal, round and
reactive.
NECK: Supple. Transmitted bruit versus radiated murmur
CHEST: Clear
HEART: Regular rate and rhythm, III/VI systolic murmur
ABD: Soft, nontender, nondistended
EXT: Warm well perfused. No edema, 2+ Pulses.
NEURO: Nonfocal

Pertinent Results:
[**2193-6-21**] 05:45AM BLOOD WBC-5.0 RBC-3.06* Hgb-9.1* Hct-27.4*
MCV-90 MCH-29.6 MCHC-33.0 RDW-14.3 Plt Ct-103*
[**2193-6-22**] 05:25AM BLOOD PT-12.4 PTT-24.7 INR(PT)-1.0
[**2193-6-22**] 05:25AM BLOOD UreaN-17 Creat-0.9 K-4.3
[**2193-6-22**] 05:25AM BLOOD Mg-2.1
[**2193-6-19**] 04:55AM BLOOD Glucose-160* K-4.1

[**2193-6-22**] CXR
1) Small bilateral pleural effusions.
2) Clear lungs.

[**2193-6-20**] EKG
Sinus rhythm. Extensive ST elevation suggests pericarditis
Since previous tracing of [**2193-6-18**], ST changes seen



Brief Hospital Course:
Mr. [**Known lastname **] was admitted to the [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 1675**] [**Last Name (NamePattern1) **] Medical
Center electively for surgery on [**2193-6-17**]. He was taken directly
to the operating room where he underwent an aortic valve
replacement utilizing a 21mm [**Last Name (un) **] [**Doctor Last Name **] pericardial
bioprosthesis. Postoperatively he was taken to the cardiac
surgical intensive care unit for monitoring. On postoperative
day one, Mr. [**Known lastname **] [**Last Name (Titles) 5058**] neurologically intact and was
extubated. He developed atrial fibrillation which was treated
with beta blockade. He was anticoagulated with coumadin for his
atrial fibrillation. Amiodarone was subsequently started with
conversion to normal sinus rhythm. Two units of packed red blood
cells were transfused for postoperative anemia. On postoperative
day three, Mr. [**Known lastname **] was transferred to the cardiac
surgical step down unit for further recovery. He was gently
diuresed towards his preoperative weight. The physical therapy
service was consulted for assistance with his strength and
postoperative mobility. As Mr. [**Known lastname **] remained in normal
sinus rhythm, his coumadin was discontinued. His drains and
wires were removed per protocol. Mr. [**Known lastname **] continued to
make steady progress and was discharged home on postoperative
day four. He will follow-up with Dr. [**Last Name (STitle) **], his cardiologist
and his primary care physician as an outpatient.

Medications on Admission:
Advil and tylenol as needed

Discharge Medications:
1. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2
times a day).
Disp:*60 Capsule(s)* Refills:*0*
2. Aspirin 81 mg Tablet, Delayed Release (E.C.) Sig: One (1)
Tablet, Delayed Release (E.C.) PO DAILY (Daily).
Disp:*30 Tablet, Delayed Release (E.C.)(s)* Refills:*2*
3. Hydrocodone-Acetaminophen 5-500 mg Tablet Sig: 1-2 Tablets PO
Q4-6H (every 4 to 6 hours) as needed.
Disp:*50 Tablet(s)* Refills:*0*
4. Amiodarone HCl 200 mg Tablet Sig: Two (2) Tablet PO BID (2
times a day): 400mg [**Hospital1 **] x7days then 400mg QD x7 days then 200mg
QD.
Disp:*60 Tablet(s)* Refills:*2*
5. Furosemide 20 mg Tablet Sig: One (1) Tablet PO DAILY (Daily)
for 10 days.
Disp:*10 Tablet(s)* Refills:*0*
6. Potassium Chloride 20 mEq Tab Sust.Rel. Particle/Crystal Sig:
One (1) Tab Sust.Rel. Particle/Crystal PO DAILY (Daily) for 10
days.
Disp:*10 Tab Sust.Rel. Particle/Crystal(s)* Refills:*0*
7. Metoprolol Tartrate 25 mg Tablet Sig: 0.5 Tablet PO BID (2
times a day).
Disp:*30 Tablet(s)* Refills:*2*


Discharge Disposition:
Home With Service

Facility:
[**Location (un) 1110**] VNA

Discharge Diagnosis:
[**2193-6-17**] - Status post Aortic Valve Replacement (#21 [**Last Name (un) 3843**]
[**Doctor Last Name **] pericardial)

Discharge Condition:
good

Discharge Instructions:
keep wounds clean and dry, ok to shower, no bathing or swimming.
Take all medications as prescribed.
Call for any fever, redness or drainage from wounds

Followup Instructions:
wound clinic in 2 weeks
Dr [**Last Name (STitle) 9751**] in [**5-8**] weeks
Dr [**Last Name (STitle) **] in 4 weeks



Completed by:[**2193-7-5**]
{'Aortic valve disorders,Cardiac complications, not elsewhere classified,Atrial fibrillation,Personal history of other malignant neoplasm of skin,Hip joint replacement'}


You are an AI assistant analyzing clinical admission notes from the MIMIC III dataset. Your task is to map symptoms mentioned in the notes to a list of provided ICD-9 LONG_TEXT.



### Clinical text :
CHIEF COMPLAINT: Occassional Chest Pressure

PRESENT ILLNESS: Mr. [**Known lastname **] is a 68-year-old male with worsening symptoms of
dyspnea on exertion and chest tightness, who has been followed
with a known aortic
stenosis. Echocardiogram showed an aortic valve area estimated
at 0.6 square cm.  A cardiac catheterization confirmed critical
aortic stenosis with a high-grade in the normal coronary
arteries.  He is presenting for aortic valve
replacement.

MEDICAL HISTORY: Osteoarthritis
Basal Cell Cancer
Right hip replacement

MEDICATION ON ADMISSION: Advil and tylenol as needed

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: 58 SR    120/77 66" 183 pounds
GEN: well developed well nourished in no distress
SKIN: No lesions or rash
HEENT: Normocephalic/atraumatic, pupils equal, round and
reactive.
NECK: Supple. Transmitted bruit versus radiated murmur
CHEST: Clear
HEART: Regular rate and rhythm, III/VI systolic murmur
ABD: Soft, nontender, nondistended
EXT: Warm well perfused. No edema, 2+ Pulses.
NEURO: Nonfocal

FAMILY HISTORY: Non-Contributory

SOCIAL HISTORY: Lives with wife. Owns a retail store. Smoked for 25 years
quitting 25 years ago. 

### Response:
{'Aortic valve disorders,Cardiac complications, not elsewhere classified,Atrial fibrillation,Personal history of other malignant neoplasm of skin,Hip joint replacement'}
