CHIEF COMPLAINT: Positive ET test followed by cardiac
catheterization with left main and 3-vessel disease.

PRESENT ILLNESS: Mr. [**Known lastname 64138**] is a 37-year-old man
with no previous cardiac history who had chest pressure and
abdominal pain approximately 1 week prior to admission
followed by a positive stress test. He was then referred to
[**Hospital1 **] for cardiac catheterization, which was
done on the day of admission. That catheterization revealed
left main and 3-vessel disease with a normal EF. An
intraaortic balloon pump was placed in the cardiac
catheterization laboratory, and he was referred to
cardiothoracic surgery for an urgent CABG.

MEDICAL HISTORY: Significant for hypercholesterolemia,
hypertension, and seasonal allergies.

MEDICATION ON ADMISSION: Include aspirin 325 daily, Toprol
XL (no dose), Propecia (no dose), Claritin (no dose).

ALLERGIES: The patient states no known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: His married. He lives with his wife. [**Name (NI) **]
works as a mortgage broker. Denies tobacco. Denies alcohol.
Coronary atherosclerosis of native coronary artery,Unspecified essential hypertension,Pure hypercholesterolemia
Crnry athrscl natve vssl,Hypertension NOS,Pure hypercholesterolem
Admission Date: [**2103-7-2**]        Discharge Date: [**2103-7-7**]

Date of Birth:  [**2066-2-13**]        Sex:  M

Service:  CSU


CHIEF COMPLAINT:  Positive ET test followed by cardiac
catheterization with left main and 3-vessel disease.

HISTORY OF PRESENT ILLNESS:  Mr. [**Known lastname 64138**] is a 37-year-old man
with no previous cardiac history who had chest pressure and
abdominal pain approximately 1 week prior to admission
followed by a positive stress test. He was then referred to
[**Hospital1 **] for cardiac catheterization, which was
done on the day of admission. That catheterization revealed
left main and 3-vessel disease with a normal EF. An
intraaortic balloon pump was placed in the cardiac
catheterization laboratory, and he was referred to
cardiothoracic surgery for an urgent CABG.

PAST MEDICAL HISTORY:  Significant for hypercholesterolemia,
hypertension, and seasonal allergies.

MEDICATIONS ON ADMISSION:  Include aspirin 325 daily, Toprol
XL (no dose), Propecia (no dose), Claritin (no dose).

ALLERGIES:  The patient states no known drug allergies.

SOCIAL HISTORY:  His married. He lives with his wife. [**Name (NI) **]
works as a mortgage broker. Denies tobacco. Denies alcohol.

PHYSICAL EXAMINATION ON ADMISSION:  Neurologically, grossly
intact; anxious. No apparent deficits. Pulmonary reveals
clear to auscultation anteriorly. Cardiac reveals a regular
rate and rhythm with no murmur. The abdomen is soft,
nontender, and nondistended with normal active bowel sounds.
The extremities are warm and well perfused with no edema.
Intraaortic balloon pump in the left groin with positive
distal pulses.

LABORATORY DATA ON ADMISSION:  White count of 3.5, hematocrit
of 39.1, and platelets of 120. PT of 12.4, PTT of 27, and INR
of 1.0. Sodium of 135, potassium of 3.6, chloride of 100, CO2
of 25, BUN of 15, creatinine of 0.9, and glucose of 154. ALT
of 62. Other LFTs are within normal range. UA is negative.

RADIOLOGIC AND OTHER STUDIES:  EKG shows a normal sinus
rhythm at 75 beats per minute with normal axis, and no ST
changes, with slight LVH.

As stated previously, the cath showed a 50% left main, 80% to
90% LAD, 80% left circumflex, and 79% RCA, with an EF of 70%.

HOSPITAL COURSE:  The patient was brought emergently to the
operating room where he underwent coronary artery bypass
grafting x 4. Please see the OR report for full details. In
summary, the patient had an emergent CABG x 4 with an
intraaortic balloon pump placed preoperatively. Grafts
included a LIMA to the LAD, RIMA to the RCA, saphenous vein
graft to the diagonal, and saphenous vein graft to OM. His
bypass time was 77 minutes with a cross-clamp time of 47
minutes. He tolerated the operation well and was transferred
from the operating room to the cardiothoracic intensive care
unit. At the time of transfer, the patient was in a sinus
rhythm at 80 beats per minute. His mean arterial pressure was
86 with a CVP of 12. He had propofol at 25 mcg/kg/min and Neo-
Synephrine at 0.5 mcg/kg/min.

The patient did well in the immediate postoperative period.
He remained hemodynamically stable. His anesthesia was
reversed, and he was successfully extubated. He remained
hemodynamically stable throughout the day of surgery.

On postoperative day 1, his intraaortic balloon pump was
weaned and was successfully extubated. The patient remained
hemodynamically stable throughout that period and was
ultimately transferred to the floor on postoperative day 1.
Once on the floor, the patient had an uneventful
postoperative course. His chest tube and temporary pacing
wires were removed on postoperative day 2. His activity level
was increased with the assistance of physical therapy and the
nursing staff. On postoperative day 4, it was decided that
the following day the patient would be stable and ready to be
discharged to home with visiting nurses.

At the time of this dictation, the patient's physical exam is
as follows. Temperature of 99, heart rate of 106 (sinus
tachycardia), blood pressure of 146/68, respiratory rate of
18. Weight preoperatively of 75 kilograms; at discharge is 86
kilograms. Neurologically, alert and oriented x 3. He moves
all extremities. A nonfocal exam. Pulmonary reveals clear to
auscultation, although somewhat diminished in the bases.
Cardiac reveals a regular rate and rhythm, S1 and S2, with no
murmurs. The sternum is stable. Incision with Steri-Strips.
Clean and dry without erythema or drainage. The abdomen is
soft, nontender, and nondistended with normal active bowel
sounds. The extremities are warm and well perfused with trace
edema. Left lower leg incision from endoscopic vein
harvesting with Steri-Strips. Clean and dry.

Lab data reveals a white count of 10, hematocrit of 28, and
platelets of 102. Sodium of 138, potassium of 4.4, chloride
of 104, CO2 of 26, BUN of 19, creatinine of 1.1, and glucose
of 151. Magnesium of 2.0.

DISCHARGE DISPOSITION:  The patient is to be discharged home
with visiting nurses.

DISCHARGE DIAGNOSES:
1. Coronary artery disease; status post coronary artery
   bypass grafting x 4 with a left internal mammary artery to
   the left anterior descending, right internal mammary
   artery to the right coronary artery, saphenous vein graft
   to diagonal, and saphenous vein graft to obtuse marginal.
2. Hypertension.
3. Hypercholesterolemia.


DISCHARGE FOLLOWUP:  The patient is to have followup in the
[**Hospital 409**] Clinic in 2 weeks, followup with Dr. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **] in
3 to 4 weeks, and followup with Dr. [**Last Name (STitle) 70**] in 6 weeks.

MEDICATIONS ON DISCHARGE:  Include Lasix 20 mg b.i.d. x 10
days then 20 mg daily x 10 days; potassium chloride 20 mEq
daily x 20 days; Colace 100 mg b.i.d. (while taking pain
medicine); Percocet 5/325 1 to 2 tablets q.4-6h. p.r.n. (for
pain); aspirin 81 mg daily; atorvastatin 10 mg daily;
metoprolol 75 mg b.i.d.; and ibuprofen 600 mg q.6h. p.r.n.
(for pain).



                        [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 5662**], [**MD Number(1) 5663**]

Dictated By:[**Last Name (NamePattern4) 1718**]
MEDQUIST36
D:  [**2103-7-6**] 15:30:27
T:  [**2103-7-6**] 16:03:53
Job#:  [**Job Number **]
{'Coronary atherosclerosis of native coronary artery,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: Positive ET test followed by cardiac
catheterization with left main and 3-vessel disease.

PRESENT ILLNESS: Mr. [**Known lastname 64138**] is a 37-year-old man
with no previous cardiac history who had chest pressure and
abdominal pain approximately 1 week prior to admission
followed by a positive stress test. He was then referred to
[**Hospital1 **] for cardiac catheterization, which was
done on the day of admission. That catheterization revealed
left main and 3-vessel disease with a normal EF. An
intraaortic balloon pump was placed in the cardiac
catheterization laboratory, and he was referred to
cardiothoracic surgery for an urgent CABG.

MEDICAL HISTORY: Significant for hypercholesterolemia,
hypertension, and seasonal allergies.

MEDICATION ON ADMISSION: Include aspirin 325 daily, Toprol
XL (no dose), Propecia (no dose), Claritin (no dose).

ALLERGIES: The patient states no known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: His married. He lives with his wife. [**Name (NI) **]
works as a mortgage broker. Denies tobacco. Denies alcohol. 

### Response:
{'Coronary atherosclerosis of native coronary artery,Unspecified essential hypertension,Pure hypercholesterolemia'}
