CHIEF COMPLAINT: 

PRESENT ILLNESS: This is a 45 year old gentleman
who had new onset of angina six days ago, referred for a
stress test which was positive for inferolateral ischemic
changes, referred for cardiac catheterization.  On cardiac
catheterization he was found to have an ejection fraction of
60%, 70% left main lesion, 50% proximal left anterior
descending lesion, 70% diagonal lesion and 95% circumflex
lesion and 90% ramus.  The patient was admitted to [**Hospital6 1760**] for cardiac surgery.

MEDICAL HISTORY: 1.  Hypertension; 2. Peripheral
vascular disease; 3.  Status post bilateral femoral popliteal
bypass; 4.  Hypercholesterolemia; 5.  History of hepatitis C.

MEDICATION ON ADMISSION: 

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: The patient was married with three children.
He smoked cigarettes, one pack per day times 25 years.  He
denies alcohol.  He works for the city of [**Hospital1 **] Fire
Department.
Coronary atherosclerosis of native coronary artery,Intermediate coronary syndrome,Chronic hepatitis C without mention of hepatic coma,Other, mixed, or unspecified drug abuse, unspecified,Peripheral vascular disease, unspecified,Unspecified essential hypertension,Pure hypercholesterolemia
Crnry athrscl natve vssl,Intermed coronary synd,Chrnc hpt C wo hpat coma,Drug abuse NEC-unspec,Periph vascular dis NOS,Hypertension NOS,Pure hypercholesterolem
Admission Date:  [**2178-2-20**]       Discharge Date:  [**2178-2-26**]

Date of Birth:   [**2132-2-26**]       Sex:  M

Service:  Cardiac Surgery

HISTORY OF PRESENT ILLNESS:  This is a 45 year old gentleman
who had new onset of angina six days ago, referred for a
stress test which was positive for inferolateral ischemic
changes, referred for cardiac catheterization.  On cardiac
catheterization he was found to have an ejection fraction of
60%, 70% left main lesion, 50% proximal left anterior
descending lesion, 70% diagonal lesion and 95% circumflex
lesion and 90% ramus.  The patient was admitted to [**Hospital6 1760**] for cardiac surgery.

PAST MEDICAL HISTORY:  1.  Hypertension; 2. Peripheral
vascular disease; 3.  Status post bilateral femoral popliteal
bypass; 4.  Hypercholesterolemia; 5.  History of hepatitis C.

SOCIAL HISTORY:  The patient was married with three children.
He smoked cigarettes, one pack per day times 25 years.  He
denies alcohol.  He works for the city of [**Hospital1 **] Fire
Department.

PREOPERATIVE MEDICATIONS:
1.  Diovan 160 mg p.o. b.i.d.
2.  Lipitor 20 mg p.o. q. day
3.  Alprazolam .25 mg p.o. b.i.d. prn
4.  Ultram 50 mg p.o. q.i.d. prn
5.  Aspirin 325 mg p.o. q. day

ALLERGIES:  No known drug allergies.

HOSPITAL COURSE:  The patient was admitted to [**Hospital6 1760**] on [**2-20**] and on [**2-21**],
he was taken to the Operating Room with Dr. [**Last Name (STitle) 70**] for
coronary artery bypass graft times four, left internal
mammary artery to left anterior descending, right internal
mammary artery to right coronary artery, saphenous vein graft
to ramus and saphenous vein graft to obtuse marginal.
Immediately postoperatively, upon reversal of anesthesia, the
patient was noted to be extremely agitated and combative.
There was some concern that the patient had a history of
substance abuse.  A Pain Service Consult was obtained, the
patient was started on a prosthetic infusion and Valium and
Clonidine for control of blood pressure.  The patient was
subsequently weaned and extubated from mechanical ventilation
and initially required a moderate amount of pulmonary toilet
with significant hypoxia which resolved.  Over the course of
postoperative day #2, the patient was weaned from his
prosthetic infusion, had good pain control with Dilaudid.
The patient continued to have moderate hypertension which was
controlled with the addition of oral medications.  The
patient began ambulating in the Intensive Care Unit and on
postoperative day #4 was transferred from the Intensive Care
Unit to the regular part of the hospital.  On postoperative
day #4, the patient was seen and evaluated by physical
therapy.  At that time he was able to ambulate 500 feet and
climb one flight of stairs without requiring oxygen and
remaining hemodynamically stable, and on postoperative day
#5, the patient was cleared for discharge to home.

Temperature maximum 98.7, pulse 76 in sinus rhythm, blood
pressure 146/67, respiratory rate 16, room air oxygen
saturation 100%.

Laboratory data revealed white blood cell count 11.2,
hematocrit 25.4, platelet count 174.  Sodium 141, potassium
4.3, chloride 103, bicarbonate 28, BUN 16, creatinine 0.8 and
glucose 95.  The patient is awake, alert and oriented times
three and neurologically nonfocal.  Heart:  Regular rate and
rhythm without rub or murmur.  Breath sounds are clear
bilaterally.  Abdomen shows positive bowel sounds, soft,
nontender, nondistended.  Sternal incision is clean, dry and
intact.  Sternum is stable.  Bilateral vein harvest site is
clean and dry.  There is no erythema or drainage.  Distal
extremities have 1 to 2+ pitting edema.

DISCHARGE MEDICATIONS:
1.  Lopressor 75 mg p.o. b.i.d.
2.  Lasix 20 mg p.o. b.i.d. times seven days
3.  Potassium chloride 20 mEq p.o. b.i.d. times seven days.
4.  Zantac 150 mg p.o. b.i.d.
5.  Enteric coated Aspirin 325 mg p.o. q. day
6.  Imdur 60 mg p.o. q. day
7.  Dilaudid 2 to 6 mg p.o. q. 4-6 hours prn
8.  Folate 1 mg p.o. q. day
9.  Thiamine 100 mg p.o. q. day
10. Clonidine 0.1 mg p.o. b.i.d.
11. Valsartan 160 mg p.o. b.i.d.
12. Lipitor 20 mg p.o. q. day
13. Nicotine patch 21 mcg transdermally q. day times one
month.

DISCHARGE DIAGNOSIS:
1.  Coronary artery disease.
2.  Status post coronary artery bypass graft.
3.  Hypertension.

CONDITION ON DISCHARGE:  The patient is to be discharged to
home in stable condition.

FOLLOW UP:  The patient is to follow up with his primary care
physician, [**Last Name (NamePattern4) **]. [**First Name (STitle) **] in one to two weeks.  The patient is to
follow up with Dr. [**Last Name (STitle) 2912**] in one to two weeks.  The patient
is to see Dr. [**Last Name (STitle) 70**] in five to six weeks.



                            [**First Name11 (Name Pattern1) **] [**Initials (NamePattern4) **] [**Last Name (NamePattern4) **], M.D.  [**MD Number(1) 75**]

Dictated By:[**Last Name (NamePattern1) 1541**]
MEDQUIST36

D:  [**2178-2-26**]  12:53
T:  [**2178-2-26**]  13:25
JOB#:  [**Job Number 95917**]
{'Coronary atherosclerosis of native coronary artery,Intermediate coronary syndrome,Chronic hepatitis C without mention of hepatic coma,Other, mixed, or unspecified drug abuse, unspecified,Peripheral vascular disease, unspecified,Unspecified essential hypertension,Pure hypercholesterolemia'}


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: This is a 45 year old gentleman
who had new onset of angina six days ago, referred for a
stress test which was positive for inferolateral ischemic
changes, referred for cardiac catheterization.  On cardiac
catheterization he was found to have an ejection fraction of
60%, 70% left main lesion, 50% proximal left anterior
descending lesion, 70% diagonal lesion and 95% circumflex
lesion and 90% ramus.  The patient was admitted to [**Hospital6 1760**] for cardiac surgery.

MEDICAL HISTORY: 1.  Hypertension; 2. Peripheral
vascular disease; 3.  Status post bilateral femoral popliteal
bypass; 4.  Hypercholesterolemia; 5.  History of hepatitis C.

MEDICATION ON ADMISSION: 

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: The patient was married with three children.
He smoked cigarettes, one pack per day times 25 years.  He
denies alcohol.  He works for the city of [**Hospital1 **] Fire
Department. 

### Response:
{'Coronary atherosclerosis of native coronary artery,Intermediate coronary syndrome,Chronic hepatitis C without mention of hepatic coma,Other, mixed, or unspecified drug abuse, unspecified,Peripheral vascular disease, unspecified,Unspecified essential hypertension,Pure hypercholesterolemia'}
