CHIEF COMPLAINT: preop w/for knee surgery revealed cardiac dz, asymptomatic

PRESENT ILLNESS: 69yoM with OA having workup for knee replacements found to be in
Afib, had stress test that was positive followed by cardiac
catheterization which revealed severe 3VD. Then referred for
CABG

MEDICAL HISTORY: HTN
^chol
AFib
OA needs bilat arthroplasty
CRI

MEDICATION ON ADMISSION: Atenolol 200'
HCTZ 25'
Lisinopril 20'
Ultram 50'
Prilosec 20'
Zocor 40'
Levitra/prn
Warfarin 4'

ALLERGIES: Penicillins / Norvasc / Verapamil

PHYSICAL EXAM: Admission
VS T 98  HR 74  BP 136/88  RR 18
Gen NAD
Neuro A&Ox3, nonfocal
Chest CTA bilat
CV irreg-irreg, no M/R
Abdn soft, NT/ND/+BS
Ext warm no edema

FAMILY HISTORY: Brother died 64/MI

SOCIAL HISTORY: Lives with wife.
Remote tobacco, quit [**2164**]. + ETOH (1-2 drinks/[**Known lastname **])
Coronary atherosclerosis of native coronary artery,Atrial fibrillation,Chronic kidney disease, unspecified,Hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage I through stage IV, or unspecified,Pure hypercholesterolemia,Osteoarthrosis, localized, not specified whether primary or secondary, lower leg
Crnry athrscl natve vssl,Atrial fibrillation,Chronic kidney dis NOS,Hy kid NOS w cr kid I-IV,Pure hypercholesterolem,Loc osteoarth NOS-l/leg
Admission Date:  [**2181-6-5**]              Discharge Date:   [**2181-6-11**]

Date of Birth:  [**2112-3-30**]             Sex:   M

Service: CARDIOTHORACIC

Allergies:
Penicillins / Norvasc / Verapamil

Attending:[**First Name3 (LF) 1505**]
Chief Complaint:
preop w/for knee surgery revealed cardiac dz, asymptomatic

Major Surgical or Invasive Procedure:
CABGx4([**6-6**])


History of Present Illness:
69yoM with OA having workup for knee replacements found to be in
Afib, had stress test that was positive followed by cardiac
catheterization which revealed severe 3VD. Then referred for
CABG

Past Medical History:
HTN
^chol
AFib
OA needs bilat arthroplasty
CRI

Social History:
Lives with wife.
Remote tobacco, quit [**2164**]. + ETOH (1-2 drinks/[**Known lastname **])

Family History:
Brother died 64/MI

Physical Exam:
Admission
VS T 98  HR 74  BP 136/88  RR 18
Gen NAD
Neuro A&Ox3, nonfocal
Chest CTA bilat
CV irreg-irreg, no M/R
Abdn soft, NT/ND/+BS
Ext warm no edema

Discharge
T99.9  HR 70AF  BP 120/69  RR 20 O2sat 94%RA
Neuro A&Ox3 MAE, non focal exam
Pulm CTAB
CV irreg irreg, sternum stable incision CDI
Abdm soft, NT/ND/+BS
Ext warm 2+ edema

Pertinent Results:
[**2181-6-5**] 04:10PM   GLUCOSE-97 UREA N-44* CREAT-2.0* SODIUM-143
POTASSIUM-4.1 CHLORIDE-107 TOTAL CO2-27 ANION GAP-13
[**2181-6-5**] 04:10PM   ALT(SGPT)-19 AST(SGOT)-19 LD(LDH)-153 ALK
PHOS-58 TOT BILI-0.4
[**2181-6-5**] 04:10PM   ALBUMIN-4.3
[**2181-6-5**] 04:10PM   %HbA1c-5.7
[**2181-6-5**] 04:10PM   TSH-1.2
[**2181-6-5**] 04:10PM   WBC-7.0 RBC-3.92* HGB-12.6* HCT-36.4* MCV-93
MCH-32.1* MCHC-34.6 RDW-13.6
[**2181-6-5**] 04:10PM   PLT COUNT-207
[**2181-6-5**] 04:10PM   PT-11.8 PTT-22.4 INR(PT)-1.0
[**2181-6-11**] 07:30AM BLOOD WBC-8.7 RBC-3.18* Hgb-10.4* Hct-30.4*
MCV-96 MCH-32.7* MCHC-34.3 RDW-13.5 Plt Ct-303
[**2181-6-11**] 07:30AM BLOOD Plt Ct-303
[**2181-6-11**] 07:30AM BLOOD PT-14.4* PTT-24.2 INR(PT)-1.3*
[**2181-6-10**] 06:45AM BLOOD Glucose-99 UreaN-40* Creat-1.9* Na-137
K-4.1 Cl-99 HCO3-28 AnGap-14

CHEST (PORTABLE AP)  [**2181-6-10**] 11:26 AM
CHEST (PORTABLE AP)
Reason: Effusion? Pntx?
[**Hospital 93**] MEDICAL CONDITION:
69 year old man with s/p Off Pump CABG
REASON FOR THIS EXAMINATION:
Effusion? Pntx?
PORTABLE CHEST ON [**2181-6-10**] AT 11:39
INDICATION: CABG with chest tube in place.
COMPARISON: [**2181-6-9**].
FINDINGS: Left chest tube remains in place with some density
adjacent to the tip, but there is no significant interval change
vs. prior. Specifically, there is no pneumothorax and no
interval development of effusion. Cardiac silhouette and
mediastinal contours are stable.
IMPRESSION: No change vs. prior.

DR. [**First Name11 (Name Pattern1) **] [**Initial (NamePattern1) **] [**Last Name (NamePattern4) 4347**]


Brief Hospital Course:
69yoM with known Atrial fibrillation and coronary artery disease
admitted preop for transition fro Coumadin to Heparin. Brought
to the OR on [**6-6**] for CABG, please see OR report for details. In
summary pt had off pump CABGx4 with LIMA-LAD, SVG
OM-Ygraft-Diag,SVG-PDA. Pt tolerated surgery well and was
transferred to CT [**Doctor First Name **] ICU. He did well in immediate post-op
period was extubated and on POD1 he was transferred to the step
down floor. On POD2 his chest tubes and epicardial pacing wires
were removed and his Coumadin was restarted. Over the next
several [**Known lastname **] his activity was advanced on POD5 it was decided he
was stable and ready to be discharged home with visiting nurses.

Medications on Admission:
Atenolol 200'
HCTZ 25'
Lisinopril 20'
Ultram 50'
Prilosec 20'
Zocor 40'
Levitra/prn
Warfarin 4'

Discharge Medications:
1. Metoprolol Tartrate 25 mg Tablet Sig: One (1) Tablet PO BID
(2 times a [**Known lastname **]).
Disp:*60 Tablet(s)* Refills:*2*
2. Furosemide 20 mg Tablet Sig: One (1) Tablet PO once a [**Known lastname **] for
2 weeks.
Disp:*14 Tablet(s)* Refills:*0*
3. Potassium Chloride 10 mEq Tablet Sustained Release Sig: Two
(2) Tablet Sustained Release PO once a [**Known lastname **] for 2 weeks.
Disp:*28 Tablet Sustained Release(s)* Refills:*0*
4. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2
times a [**Known lastname **]).
Disp:*60 Capsule(s)* Refills:*2*
5. 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*
6. Warfarin 2 mg Tablet Sig: Two (2) Tablet PO once a [**Known lastname **]:
target INR 1.5-2.
Disp:*60 Tablet(s)* Refills:*2*
7. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO
every 4-6 hours as needed for pain.
Disp:*50 Tablet(s)* Refills:*0*
8. Simvastatin 40 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
Disp:*30 Tablet(s)* Refills:*2*
9. Prilosec 20 mg Capsule, Delayed Release(E.C.) Sig: One (1)
Capsule, Delayed Release(E.C.) PO once a [**Known lastname **].
10. Ultram 50 mg Tablet Sig: One (1) Tablet PO Q6 hrs/PRN.


Discharge Disposition:
Home With Service

Facility:
[**Hospital1 1474**] vna

Discharge Diagnosis:
s/p off pump CABGx4 LIMA-LAD,Y SVG-OM-Diag, SVG-PDA ([**6-6**])
PMH:HTN,^chol,AF,OA, CRI, s/p bilat knee surgery


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:
[**Hospital 409**] clinic in 2 weeks
Dr [**Last Name (STitle) 7389**] in [**3-17**] weeks
Dr [**Last Name (STitle) **] in 4 weeks



Completed by:[**2181-6-11**]
{'Coronary atherosclerosis of native coronary artery,Atrial fibrillation,Chronic kidney disease, unspecified,Hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage I through stage IV, or unspecified,Pure hypercholesterolemia,Osteoarthrosis, localized, not specified whether primary or secondary, lower leg'}


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: preop w/for knee surgery revealed cardiac dz, asymptomatic

PRESENT ILLNESS: 69yoM with OA having workup for knee replacements found to be in
Afib, had stress test that was positive followed by cardiac
catheterization which revealed severe 3VD. Then referred for
CABG

MEDICAL HISTORY: HTN
^chol
AFib
OA needs bilat arthroplasty
CRI

MEDICATION ON ADMISSION: Atenolol 200'
HCTZ 25'
Lisinopril 20'
Ultram 50'
Prilosec 20'
Zocor 40'
Levitra/prn
Warfarin 4'

ALLERGIES: Penicillins / Norvasc / Verapamil

PHYSICAL EXAM: Admission
VS T 98  HR 74  BP 136/88  RR 18
Gen NAD
Neuro A&Ox3, nonfocal
Chest CTA bilat
CV irreg-irreg, no M/R
Abdn soft, NT/ND/+BS
Ext warm no edema

FAMILY HISTORY: Brother died 64/MI

SOCIAL HISTORY: Lives with wife.
Remote tobacco, quit [**2164**]. + ETOH (1-2 drinks/[**Known lastname **]) 

### Response:
{'Coronary atherosclerosis of native coronary artery,Atrial fibrillation,Chronic kidney disease, unspecified,Hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage I through stage IV, or unspecified,Pure hypercholesterolemia,Osteoarthrosis, localized, not specified whether primary or secondary, lower leg'}
