CHIEF COMPLAINT: 

PRESENT ILLNESS: The patient is a 78 year old
male to local Emergency Department [**2169-9-11**], with dyspnea and
was started on steroids.  Two days later, he represented with
acute respiratory failure and was intubated and admitted to
the Intensive Care Unit.  The patient was extubated within 24
hours.  During this stay, the electrocardiogram showed
interim changes.  Cardiac enzyme series were positive for a
myocardial infarction with a peak CPB at 241.  Transthoracic
echocardiogram was performed which showed an ejection
fraction of 30%, mild mitral regurgitation, trace tricuspid
regurgitation and no focal wall motion abnormalities.  The
patient denies prior history of angina, no history of
orthopnea, peripheral vascular disease or lower extremity
edema.  The patient does have chronic dyspnea on exertion
which has become worse over the past year.  No history of
cerebrovascular accident, transient ischemic attack or atrial
fibrillation.

MEDICAL HISTORY: 1.  Coronary artery disease.
2.  Hypertension.
3.  Chronic obstructive pulmonary disease.
4.  Noninsulin dependent diabetes mellitus.
5.  Colon carcinoma resection in [**2163**].
6.  Osteoarthritis.
7.  Peptic ulcer disease.
8.  Anemia.

MEDICATION ON ADMISSION: 1.  Levaquin.
2.  Aspirin.
3.  Nitroglycerin paste.
4.  Synthroid.
5.  Folate.
6.  Colchicine.
7.  Lopressor.
8.  Capoten.

ALLERGIES: Sulfa.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: 
Subendocardial infarction, initial episode of care,Coronary atherosclerosis of native coronary artery,Congestive heart failure, unspecified,Other primary cardiomyopathies,Atrial fibrillation,Chronic airway obstruction, not elsewhere classified,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Unspecified essential hypertension
Subendo infarct, initial,Crnry athrscl natve vssl,CHF NOS,Prim cardiomyopathy NEC,Atrial fibrillation,Chr airway obstruct NEC,DMII wo cmp nt st uncntr,Hypertension NOS
Admission Date:  [**2169-9-15**]       Discharge Date:  [**2169-9-23**]


Service:  CT SURGERY

HISTORY OF PRESENT ILLNESS:  The patient is a 78 year old
male to local Emergency Department [**2169-9-11**], with dyspnea and
was started on steroids.  Two days later, he represented with
acute respiratory failure and was intubated and admitted to
the Intensive Care Unit.  The patient was extubated within 24
hours.  During this stay, the electrocardiogram showed
interim changes.  Cardiac enzyme series were positive for a
myocardial infarction with a peak CPB at 241.  Transthoracic
echocardiogram was performed which showed an ejection
fraction of 30%, mild mitral regurgitation, trace tricuspid
regurgitation and no focal wall motion abnormalities.  The
patient denies prior history of angina, no history of
orthopnea, peripheral vascular disease or lower extremity
edema.  The patient does have chronic dyspnea on exertion
which has become worse over the past year.  No history of
cerebrovascular accident, transient ischemic attack or atrial
fibrillation.

PAST MEDICAL HISTORY:
1.  Coronary artery disease.
2.  Hypertension.
3.  Chronic obstructive pulmonary disease.
4.  Noninsulin dependent diabetes mellitus.
5.  Colon carcinoma resection in [**2163**].
6.  Osteoarthritis.
7.  Peptic ulcer disease.
8.  Anemia.

PAST SURGICAL HISTORY:
1.  Thyroidectomy.
2.  Colectomy.

MEDICATIONS ON ADMISSION:
1.  Levaquin.
2.  Aspirin.
3.  Nitroglycerin paste.
4.  Synthroid.
5.  Folate.
6.  Colchicine.
7.  Lopressor.
8.  Capoten.

ALLERGIES:  Sulfa.

PHYSICAL EXAMINATION:  Head, eyes, ears, nose and throat -
thyroidectomy scar.  Lungs with basilar crackles and a few
wheezes right left lower lobe.  Heart regular rate and
rhythm, II to IV systolic murmur.  The abdomen is soft,
nontender, obese.  Extremities warm, negative edema, negative
varicosities.

LABORATORY DATA:  White blood count 27.0, hematocrit 42.0,
platelet count 389,000.  Potassium 3.8.

Initial catheterization severe three vessel coronary artery
disease, ejection fraction 25%.

HOSPITAL COURSE:  The patient was admitted on [**2169-9-15**].  The
patient was followed by the Internal Medicine and Pulmonary
service for the acute respiratory failure and was started on
Levaquin 500 mg p.o. q.d.  The patient had an uneventful stay
in the hospital preceding his surgery.  On [**2169-9-18**], the
patient was transferred to the operating room with diagnosis
of coronary artery disease and unstable angina.  The
procedure was a coronary artery bypass graft times four with
left internal mammary artery graft to the diagonal and
saphenous vein graft to the left anterior descending, OM and
posterior descending artery.  The patient tolerated the
procedure well and was transferred to the Post Anesthesia
Care Unit in stable condition.

Postoperative day one, the patient did well and was
transferred out of the Cardiothoracic Intensive Care Unit to
the floor.  On postoperative day two, the patient continued
to do well with increasing ambulation and physical therapy.
Postoperative day three, the patient continued to do well and
was assessed for rehabilitation versus home discharge.  On
postoperative day five, the patient continued to do well and
achieved a physical therapy level of five and was discharged
home.

His discharge physical examination, temperature 98, pulse 96,
respiratory rate 20, blood pressure 118/74.  Oxygen
saturation is 94% in room air.  Positive 0.5 kilograms from
preoperative weight.  Cardiovascular regular rate and rhythm.
Respiratory clear to auscultation bilaterally.  The abdomen
is soft, nontender, nondistended.  Incisions intact, dry and
clean for both chest and lower extremity.  Extremities
negative peripheral edema.

COMPLICATIONS:  None.

DISCHARGE MEDICATIONS:
1.  Levofloxacin 500 mg p.o. t.i.d. times seven days.
2.  Colchicine 0.6 mg p.o. q.d.
3.  Synthroid 0.125 mg p.o. q.d.
4.  Combivent MDI two puffs p.o. q.i.d.
5.  Lopressor 50 mg b.i.d.
6.  Aspirin 81 mg p.o. q.d.
7.  Captopril 25/15 one half tablet p.o. b.i.d.
8.  Percocet one to two tablets p.o. q4-6hours.

CONDITION ON DISCHARGE:  Good, stable to home.

FOLLOW-UP:  Dr. [**Last Name (STitle) **] in three to four weeks.  The patient
will also return in two weeks for half his staples removed.

DISCHARGE DIAGNOSIS:  Status post coronary artery bypass
graft times four.

SECONDARY DIAGNOSES:
1.  Hypercholesterolemia.
2.  Status post colon cancer resection.
3.  Chronic obstructive pulmonary disease.
4.  Coronary artery disease.
5.  Diabetes mellitus type 2.
6.  Hypothyroidism.
7.  Osteoarthritis.
8.  Peptic ulcer disease.
9.  Anemia.
10. Gout.




                            [**First Name11 (Name Pattern1) 1112**] [**Last Name (NamePattern1) **], M.D.  [**MD Number(1) 3113**]

Dictated By:[**Last Name (NamePattern4) 959**]
MEDQUIST36

D:  [**2169-9-23**]  13:47
T:  [**2169-9-23**]  15:11
JOB#:  [**Job Number 36583**]
{'Subendocardial infarction, initial episode of care,Coronary atherosclerosis of native coronary artery,Congestive heart failure, unspecified,Other primary cardiomyopathies,Atrial fibrillation,Chronic airway obstruction, not elsewhere classified,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Unspecified essential hypertension'}


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: 

PRESENT ILLNESS: The patient is a 78 year old
male to local Emergency Department [**2169-9-11**], with dyspnea and
was started on steroids.  Two days later, he represented with
acute respiratory failure and was intubated and admitted to
the Intensive Care Unit.  The patient was extubated within 24
hours.  During this stay, the electrocardiogram showed
interim changes.  Cardiac enzyme series were positive for a
myocardial infarction with a peak CPB at 241.  Transthoracic
echocardiogram was performed which showed an ejection
fraction of 30%, mild mitral regurgitation, trace tricuspid
regurgitation and no focal wall motion abnormalities.  The
patient denies prior history of angina, no history of
orthopnea, peripheral vascular disease or lower extremity
edema.  The patient does have chronic dyspnea on exertion
which has become worse over the past year.  No history of
cerebrovascular accident, transient ischemic attack or atrial
fibrillation.

MEDICAL HISTORY: 1.  Coronary artery disease.
2.  Hypertension.
3.  Chronic obstructive pulmonary disease.
4.  Noninsulin dependent diabetes mellitus.
5.  Colon carcinoma resection in [**2163**].
6.  Osteoarthritis.
7.  Peptic ulcer disease.
8.  Anemia.

MEDICATION ON ADMISSION: 1.  Levaquin.
2.  Aspirin.
3.  Nitroglycerin paste.
4.  Synthroid.
5.  Folate.
6.  Colchicine.
7.  Lopressor.
8.  Capoten.

ALLERGIES: Sulfa.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY:  

### Response:
{'Subendocardial infarction, initial episode of care,Coronary atherosclerosis of native coronary artery,Congestive heart failure, unspecified,Other primary cardiomyopathies,Atrial fibrillation,Chronic airway obstruction, not elsewhere classified,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Unspecified essential hypertension'}
