CHIEF COMPLAINT: Shortness of breath

PRESENT ILLNESS: 49 y/o female with very complex past medical histroy, c/o
shortness of breath, with known CAD with previous PCI to LAD.
She initially presented to OSH with CHF and NSTEMI. Then
transferred to [**Hospital1 18**] for further care.

MEDICAL HISTORY: Type I DM w/ neuropathy, nephropathy (failing transplant),
bilateral retinopathy s/p retinal detachment.
Failing kidney transplant
- most recent creatinine of 5.3
- pt was scheduled for repeat transplant on [**2174-8-23**] but was
cancelled because of her PVD history
HTN
significant PVD history with multiple prior LE bypass surgeries
Prior GI bleeding on ASA and plavix
CAD s/p MI, s/p LAD stents
Meningitis
chronic anemia
- likely multifactorial due to renal failure, hx of antral
erosions and mild esophagitis on EGD
CVA x 2
hyperlipidemia

MEDICATION ON ADMISSION: Lasix 120mg IV every 12 hours, Zaroxylin 2.5mg, asa 81,
catapress patch once a week, Lantus 6 units q am, Humalog
sliding scale, Levaquin (for possible pneumonia), Metoprolol
100mg po bid, cellcept 1000mg po bid, Nifedipine 60 mg PO BID,
Zocor 80mg po bid, Rapamune 4 mg PO QAM

ALLERGIES: Darvon

PHYSICAL EXAM: VS: T 96.0,  BP 154/65,  P98,  RR 20,  SaO2 93%2L
Pt reported weight and height: 152 lbs; 5'5''
Gen: WDWN middle aged woman in NAD. Oriented x3. Mood slightly
depressed, affect appropriate.
HEENT: Sclera anicteric. PERRL, EOMI. Conjunctiva were pink, no
pallor or cyanosis of the oral mucosa. No xanthalesma.
Neck: Supple without JVD
CV: PMI located in 5th intercostal space, midclavicular line.
RR, normal S1, S2. III/VI systolic ejection murmur hear best at
LUSB, No r/g. No thrills, lifts. No S3 or S4.
Chest: No chest wall deformities, scoliosis or kyphosis. Resp
were unlabored, no accessory muscle use. Decreased breath sounds
at the bases bilaterally 1/4th of the way up, with associated
dullness to percussion. No wheezes or rhonchi.
Abd: Soft, NTND. No HSM or tenderness.
Ext: 1+ edema bilaterally half to half way pt from snkle to
knee. No cyanosis.
Skin: No stasis dermatitis, ulcers, scars, or xanthomas.

FAMILY HISTORY: Her mother is alive at age 77 without significant medical
problems.  [**Name (NI) **] father died at age 76 of sepsis.  He also had
type 2 diabetes and prostate cancer.  She has a sister age 51
and another sister age 41 who has type 1 diabetes.  There is no
family history of blood disorders or colon cancer.

SOCIAL HISTORY: Two children in their 20s.  She lives with her boyfriend.  She
formerly worked at the post-office.  She has a 30-pack-year
history of smoking and quit in [**2165**].  She does not drink
alcohol.
Subendocardial infarction, initial episode of care,Other complications due to other cardiac device, implant, and graft,Congestive heart failure, unspecified,End stage renal disease,Diabetes with ophthalmic manifestations, type II or unspecified type, uncontrolled,Acute kidney failure, unspecified,Coronary atherosclerosis of native coronary artery,Cardiac catheterization as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure,Accidents occurring in other specified places,Atherosclerosis of native arteries of the extremities, unspecified,Surgical operation with transplant of whole organ causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation,Background diabetic retinopathy,Polyneuropathy in diabetes,Anemia in chronic kidney disease
Subendo infarct, initial,Comp-oth cardiac device,CHF NOS,End stage renal disease,DMII ophth uncntrld,Acute kidney failure NOS,Crnry athrscl natve vssl,Abn react-cardiac cath,Accident in place NEC,Athscl extrm ntv art NOS,Abn react-org transplant,Diabetic retinopathy NOS,Neuropathy in diabetes,Anemia in chr kidney dis
Admission Date:  [**2174-8-8**]              Discharge Date:   [**2174-8-23**]

Date of Birth:  [**2125-1-14**]             Sex:   F

Service: CARDIOTHORACIC

Allergies:
Darvon

Attending:[**First Name3 (LF) 922**]
Chief Complaint:
Shortness of breath

Major Surgical or Invasive Procedure:
[**2174-8-10**]: TUNNELLED CATH PLACEMENT SC
[**2174-8-17**] CABG x 3 (LIMA to LAD, lesser saph VG to OM, lesser
saph VG to RCA)

History of Present Illness:
49 y/o female with very complex past medical histroy, c/o
shortness of breath, with known CAD with previous PCI to LAD.
She initially presented to OSH with CHF and NSTEMI. Then
transferred to [**Hospital1 18**] for further care.

Past Medical History:
Type I DM w/ neuropathy, nephropathy (failing transplant),
bilateral retinopathy s/p retinal detachment.
Failing kidney transplant
- most recent creatinine of 5.3
- pt was scheduled for repeat transplant on [**2174-8-23**] but was
cancelled because of her PVD history
HTN
significant PVD history with multiple prior LE bypass surgeries
Prior GI bleeding on ASA and plavix
CAD s/p MI, s/p LAD stents
Meningitis
chronic anemia
- likely multifactorial due to renal failure, hx of antral
erosions and mild esophagitis on EGD
CVA x 2
hyperlipidemia

Social History:
Two children in their 20s.  She lives with her boyfriend.  She
formerly worked at the post-office.  She has a 30-pack-year
history of smoking and quit in [**2165**].  She does not drink
alcohol.


Family History:
Her mother is alive at age 77 without significant medical
problems.  [**Name (NI) **] father died at age 76 of sepsis.  He also had
type 2 diabetes and prostate cancer.  She has a sister age 51
and another sister age 41 who has type 1 diabetes.  There is no
family history of blood disorders or colon cancer.

Physical Exam:
VS: T 96.0,  BP 154/65,  P98,  RR 20,  SaO2 93%2L
Pt reported weight and height: 152 lbs; 5'5''
Gen: WDWN middle aged woman in NAD. Oriented x3. Mood slightly
depressed, affect appropriate.
HEENT: Sclera anicteric. PERRL, EOMI. Conjunctiva were pink, no
pallor or cyanosis of the oral mucosa. No xanthalesma.
Neck: Supple without JVD
CV: PMI located in 5th intercostal space, midclavicular line.
RR, normal S1, S2. III/VI systolic ejection murmur hear best at
LUSB, No r/g. No thrills, lifts. No S3 or S4.
Chest: No chest wall deformities, scoliosis or kyphosis. Resp
were unlabored, no accessory muscle use. Decreased breath sounds
at the bases bilaterally 1/4th of the way up, with associated
dullness to percussion. No wheezes or rhonchi.
Abd: Soft, NTND. No HSM or tenderness.
Ext: 1+ edema bilaterally half to half way pt from snkle to
knee. No cyanosis.
Skin: No stasis dermatitis, ulcers, scars, or xanthomas.

Pertinent Results:
[**8-11**] Cardiac Cath: 1. Coronary angiography in this right
dominant system revealed three vessel coronary artery disease.
The LMCA was noted to be a short almost cloacl vessel and was
heavily calcified. The LAD had diffuse disease proximally and a
70& proximal stent edge restenosis in the mid LAD. Septal
collateral were noted to the distal RCA. The LCX had a near
ostial heavily calcified 90% lesion with proximal 40% stenosis
before OM!. Diffuse palquing was noted in OM2 and a 50% stenosis
was noted near the takeoff of AV groove CX from OM2. OM
collaterals to distal RCA were noted as well. The RCA was small
and occluded proximally. 2. Resting hemodynamics revealed mildly
elevated left sided filling pressures with an LVEPD of 16 mmHg.
There was moderate systolic arterial hypertension with an SPB of
176 mmHg. The cardiac index was preserved at 3.94 L/min/m2.o
evidence of aortic stenosis as there was no pressure gradient on
pullback from LV to aorta. There was no evidence of mitral
stenosis upon analysis of PCWP and LVEDP.
[**8-12**] CNIS: There is less than 40% stenosis within bilateral
internal carotid arteries.
[**8-12**] Vein Mapping: Lesser saphenous veins patent bilaterally
with diameters described as above and no visualization of the
greater saphenous veins bilaterally.
[**8-17**] Echo: Pre bypass: The left atrium is moderately dilated.
There is mild symmetric left ventricular hypertrophy. There is
mild regional left ventricular systolic dysfunction with mild
inferior hypokinesis. The remaining left ventricular segments
contract normally. Right ventricular chamber size and free wall
motion are normal. There are multiple severe complex (>4mm)
atheroma in the aortic arch and descending thoracic aorta.
Epiaortic scans of the intended sites of proximal anastamosis,
cannulation, and cross clamp are clear. A long axis epiaortic
pull through from valve up confirms substatial plaque in the
arch, but not at the above mentioned sites..The aortic valve
leaflets (3) appear structurally normal with good leaflet
excursion. There is no aortic valve stenosis. Trace eccentric
aortic regurgitation is seen. The annular portion of the
posterior leaflet of the mitral valve is partialy calcified but
the tip and central portion move and coapt well.. With
provacative manuvers and sbp 150's, Mild to moderate ([**12-14**]+)
mitral regurgitation is seen. Vena contracta meansures 4 mm at
worst. There is a small pericardial effusion. There are
pericardial calcifications. Post Bypass: Patient is A paced, on
epinephreine, phenylepherine infusions. LVEF remains 50% with
mild inferior hypokinesis. Note is made of moderate anteroseptal
hypokinesis which improves with nitroglycerin. MR is now mild.
Aortic contours are intact. Remaining exam is unchanged. All
findings discussed with surgeons at the time of the exam.
[**8-21**] Chest CT: 1. New tiny left anterior pneumothorax. 2. Small
bilateral pleural effusions with associated compressive
atelectasis. 3. Sub 5 mm pulmonary nodules. In the absence of
known malignancy or smoking, no further followup is necessary.
4. No retroperitoneal hematoma. 5. Prominent ovaries.
Questionable soft tissue nodule in the left ovary. Further
evaluation with pelvic ultrasound is recommended.
[**2174-8-9**] 05:50AM BLOOD WBC-9.7 RBC-3.36* Hgb-8.8* Hct-26.9*
MCV-80*# MCH-26.1* MCHC-32.5 RDW-16.6* Plt Ct-373
[**2174-8-15**] 06:00AM BLOOD WBC-12.7* RBC-3.76* Hgb-10.4* Hct-31.5*
MCV-84 MCH-27.7 MCHC-32.9 RDW-16.9* Plt Ct-337
[**2174-8-22**] 05:06AM BLOOD WBC-10.0 RBC-3.31*# Hgb-9.9*# Hct-28.3*
MCV-85 MCH-29.9 MCHC-35.0 RDW-15.9* Plt Ct-268
[**2174-8-9**] 05:50AM BLOOD PT-12.4 PTT-26.4 INR(PT)-1.1
[**2174-8-21**] 05:15AM BLOOD PT-13.6* PTT-32.4 INR(PT)-1.2*
[**2174-8-9**] 05:50AM BLOOD Glucose-91 UreaN-105* Creat-6.3* Na-143
K-3.3 Cl-102 HCO3-22 AnGap-22*
[**2174-8-16**] 05:00AM BLOOD Glucose-260* UreaN-36* Creat-3.4* Na-138
K-4.0 Cl-100 HCO3-28 AnGap-14
[**2174-8-23**] 01:43PM BLOOD Glucose-258* UreaN-27* Creat-3.7*# Na-136
K-4.5 Cl-107 HCO3-19* AnGap-15
[**2174-8-23**] 01:43PM BLOOD Calcium-8.4 Phos-3.2# Mg-2.1

Brief Hospital Course:
Pt was admitted to the [**Hospital1 1516**] service on [**8-8**] )cardiology floor)
at [**Hospital1 18**] for work-up and treatment of CHF exacerbation, NSTEMI,
and her failing renal transplant.
.
Pt was found to be volume overloaded with bilateral pleural
effusions and peripheral edema.  The decision was made to not
continue levofloxacin since it appeared very unlikely to be
infection (afebrile, no cough).  CHF was treated with agressive
diuresis with Furosemide 120 mg IV BID as well as Metolazone 2.5
mg PO BID with the goal of diuresis of at least 1L/day which she
exceeded by about 1L on the first 2 days with decreases in her
weight by about 2kg per day as well (for 2 days). Clinically, pt
improved also coming off oxygen at then end of HOD#2.
.
Pt was admitted with what was thought consistent with NSEMI in
the setting of previously known CAD s/p MI, s/p LAD stents and
acute on chronic renal failure with failing renal transplant.
Pt was monitored on telemetry and cardiac enzymes were followed.
 The enzymes consistently trended downward indicating that pt
had an NSEMI prior to presentation to the OSH.  The initial
approach was medical management as there was an obvious concern
over the patients renal function.  A renal transplant consult
was placed; their recommendation was to initiate HD, as there
was no reason to delay (now that transplant was not going to
happen) and had a fragile volume window. Pt had tunnelled cath
placed on [**8-12**], with HD initiated that same day.
The following day pt had coronary catheterization showing three
vessel coronary artery disease, including a near ostial LCX
lesion not favorable for PCI, as one would have to stent back
into the LMCA jailing the LAD, and "LMCA" supplies the entire
LV. HD was planned post-coronary cath but as pt appeared
depressed about the news that she would have to have a CABG and
tired from a long day. HD was performed early the following
morning and was from thereon continued qd for 2 days before
transitioning to qod HD.  After initiation of HD pt was taken
off standing diuretics and given one-time doses as needed for
diuresis.
.
The night of the coronary cath pt had an episode of nausea and
vomiting associated with some diaphoresis.  EKG with ?ST
elevations in V2, V3.  Heparin was started and pt had not
further episodes.  Cardiac enzymes were still downtrending and
so it likley was not an ACS.  Heparin was stopped after 48 hrs
since there was no active concern over ACS and pt had developed
a small R groin hematoma, and a mild nosebleed with 6pt hct drop
after coronary cath.  2 units of blood was given with good
effect prior to stopping heparin treatment. HCt remined stable
at around 30 from this pt on until surgery.
.
Regarding her failing kidney transplant, pt was continued on
cellcept 1000mg po bid, and Rapamune 4 mg PO QAM despite
initiating HD in the case there was any chance that her kidneys
were going to recover.
.
Pt was also hypertensive throughout much of the hospital stay
despite clonidine patch, 100mg po bid of metoprolol, and 60 mg
po bid of nifedipine.  Her metoprolol was increased to 125 mg po
bid on HOD#6.  On this dose her supine bp was 140s/50-60s and
standing bp 110s/50s.  BP meds were titrated to this standing bp
given her hx of autonomic neuropathy and orhtostatic
hypotension.
.
Regarding her chronic anemia, the etiology was thought to likely
be due to renal failure.  Aside from the transient hct drop as
mentioned above after the cath, her hct remained at about her
baseline of 30.  On HOD#5, epogen 6000 units given at the time
of HD was initiated.

Referred to Dr. [**Last Name (STitle) 914**] for CABG  and vein mapping showed the
presence of bilat. lesser saph, veins.Underwent CABG on [**2174-8-17**].
Transferred to the CVICU in stable condition on nitroglycerin,
propofol and epinephrine drips. Extubated early the next
morning. Renal sevice continued to follow pt.for her dialysis
management. Transferred to the floor on POD #1 to begin
increasing her activity level. Beta blockade titrated and chest
tubes and pacing wires removed without incident.Tranfused 2 u
PRBCs for anemia, but CTA negative for retroperitoneal bleed.A 5
mm pulm. nodule was noted. Mutliple agents titrated for BP
management. Cleared for discharge to home with services on POD
#6. Pt. to make all followup appts. as per discharge
instructions as well as maintaining her outpt. hemodialysis
schedule.

Medications on Admission:
Lasix 120mg IV every 12 hours, Zaroxylin 2.5mg, asa 81,
catapress patch once a week, Lantus 6 units q am, Humalog
sliding scale, Levaquin (for possible pneumonia), Metoprolol
100mg po bid, cellcept 1000mg po bid, Nifedipine 60 mg PO BID,
Zocor 80mg po bid, Rapamune 4 mg PO QAM

Discharge Medications:
1. Metoprolol Tartrate 25 mg Tablet Sig: One (1) Tablet PO BID
(2 times a day).
Disp:*60 Tablet(s)* Refills:*0*
2. Sirolimus 1 mg Tablet Sig: Four (4) Tablet PO DAILY (Daily).
Disp:*120 Tablet(s)* Refills:*0*
3. Sevelamer 800 mg Tablet Sig: One (1) Tablet PO TID W/MEALS (3
TIMES A DAY WITH MEALS).
Disp:*90 Tablet(s)* Refills:*0*
4. Mycophenolate Mofetil 500 mg Tablet Sig: Two (2) Tablet PO
BID (2 times a day).
Disp:*120 Tablet(s)* Refills:*0*
5. Atorvastatin 80 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
Disp:*30 Tablet(s)* Refills:*0*
6. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2
times a day).
Disp:*60 Capsule(s)* Refills:*0*
7. Ranitidine HCl 150 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
Disp:*30 Tablet(s)* Refills:*0*
8. Aspirin 81 mg Tablet, Delayed Release (E.C.) Sig: One (1)
Tablet, Delayed Release (E.C.) PO DAILY (Daily).
Disp:*30 * Refills:*0*
9. Clonidine 0.2 mg Tablet Sig: One (1) Tablet PO TID (3 times a
day) for 1 days.
Disp:*10 Tablet(s)* Refills:*0*
10. Clonidine 0.3 mg/24 hr Patch Weekly Sig: One (1) Patch
Weekly Transdermal QTUES (every Tuesday).
Disp:*QS 1 month* Refills:*0*
11. Insulin Glargine 100 unit/mL Solution Sig: Eight (8) units
Subcutaneous at bedtime.
Disp:*QS 1 month* Refills:*0*
12. Humalog 100 unit/mL Solution Sig: as directed  Subcutaneous
four times a day: per sliding scale.
Disp:*QS 1 month* Refills:*0*
13. Hydromorphone 2 mg Tablet Sig: One (1) Tablet PO Q6H (every
6 hours) as needed.
Disp:*50 Tablet(s)* Refills:*0*

Discharge Disposition:
Home With Service

Facility:
VNA of Greater [**Hospital1 189**]

Discharge Diagnosis:
Coronary Artery Disease s/p Coronary Artery Bypass Graft x 3
pulmonary nodule

PMH: IDDM, ESRD, CHF, ^chol., PVD, s/p CVA x2 [**2165**], anemia, s/p
GI bleed, NSTEMI [**2172**], DES->LAD, retinopathy, neuropathy,
meningitis, s/p ileo bifem, s/p R profunda-> [**Doctor Last Name **], s/p L fem-[**Doctor Last Name **],
s/p renal transplant-failing, s/p cataract surgery, s/p TAH

Discharge Condition:
Good

Discharge Instructions:
Call with fever, redness or drainage from incision or weight
gain more than 2 pounds in one day or five in one week.
Shower, no baths, no lotions, creams or powders to incisions.
No lifting more than 10 pounds or driving until follow up with
surgeon.

Followup Instructions:
Dr. [**Last Name (STitle) **] 2 weeks
Dr. [**Last Name (STitle) 914**] in 4 weeks [**Telephone/Fax (1) 170**]
Dr. [**Last Name (STitle) **] 2 weeks
Hemodialysis monday, wednesday friday@11AM.
Already scheduled appointments:
Provider: [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **], [**Name Initial (NameIs) **].D. Phone:[**Telephone/Fax (1) 5003**]
Date/Time:[**2174-9-30**] 11:20
Provider: [**Name10 (NameIs) **] LAB Phone:[**Telephone/Fax (1) 1237**] Date/Time:[**2175-7-24**]
9:00
Provider: [**First Name11 (Name Pattern1) 1112**] [**Last Name (NamePattern4) 2604**], MD Phone:[**Telephone/Fax (1) 1237**]
Date/Time:[**2175-7-24**] 10:00


Completed by:[**2174-9-12**]
{'Subendocardial infarction, initial episode of care,Other complications due to other cardiac device, implant, and graft,Congestive heart failure, unspecified,End stage renal disease,Diabetes with ophthalmic manifestations, type II or unspecified type, uncontrolled,Acute kidney failure, unspecified,Coronary atherosclerosis of native coronary artery,Cardiac catheterization as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure,Accidents occurring in other specified places,Atherosclerosis of native arteries of the extremities, unspecified,Surgical operation with transplant of whole organ causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation,Background diabetic retinopathy,Polyneuropathy in diabetes,Anemia in chronic kidney disease'}


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: Shortness of breath

PRESENT ILLNESS: 49 y/o female with very complex past medical histroy, c/o
shortness of breath, with known CAD with previous PCI to LAD.
She initially presented to OSH with CHF and NSTEMI. Then
transferred to [**Hospital1 18**] for further care.

MEDICAL HISTORY: Type I DM w/ neuropathy, nephropathy (failing transplant),
bilateral retinopathy s/p retinal detachment.
Failing kidney transplant
- most recent creatinine of 5.3
- pt was scheduled for repeat transplant on [**2174-8-23**] but was
cancelled because of her PVD history
HTN
significant PVD history with multiple prior LE bypass surgeries
Prior GI bleeding on ASA and plavix
CAD s/p MI, s/p LAD stents
Meningitis
chronic anemia
- likely multifactorial due to renal failure, hx of antral
erosions and mild esophagitis on EGD
CVA x 2
hyperlipidemia

MEDICATION ON ADMISSION: Lasix 120mg IV every 12 hours, Zaroxylin 2.5mg, asa 81,
catapress patch once a week, Lantus 6 units q am, Humalog
sliding scale, Levaquin (for possible pneumonia), Metoprolol
100mg po bid, cellcept 1000mg po bid, Nifedipine 60 mg PO BID,
Zocor 80mg po bid, Rapamune 4 mg PO QAM

ALLERGIES: Darvon

PHYSICAL EXAM: VS: T 96.0,  BP 154/65,  P98,  RR 20,  SaO2 93%2L
Pt reported weight and height: 152 lbs; 5'5''
Gen: WDWN middle aged woman in NAD. Oriented x3. Mood slightly
depressed, affect appropriate.
HEENT: Sclera anicteric. PERRL, EOMI. Conjunctiva were pink, no
pallor or cyanosis of the oral mucosa. No xanthalesma.
Neck: Supple without JVD
CV: PMI located in 5th intercostal space, midclavicular line.
RR, normal S1, S2. III/VI systolic ejection murmur hear best at
LUSB, No r/g. No thrills, lifts. No S3 or S4.
Chest: No chest wall deformities, scoliosis or kyphosis. Resp
were unlabored, no accessory muscle use. Decreased breath sounds
at the bases bilaterally 1/4th of the way up, with associated
dullness to percussion. No wheezes or rhonchi.
Abd: Soft, NTND. No HSM or tenderness.
Ext: 1+ edema bilaterally half to half way pt from snkle to
knee. No cyanosis.
Skin: No stasis dermatitis, ulcers, scars, or xanthomas.

FAMILY HISTORY: Her mother is alive at age 77 without significant medical
problems.  [**Name (NI) **] father died at age 76 of sepsis.  He also had
type 2 diabetes and prostate cancer.  She has a sister age 51
and another sister age 41 who has type 1 diabetes.  There is no
family history of blood disorders or colon cancer.

SOCIAL HISTORY: Two children in their 20s.  She lives with her boyfriend.  She
formerly worked at the post-office.  She has a 30-pack-year
history of smoking and quit in [**2165**].  She does not drink
alcohol. 

### Response:
{'Subendocardial infarction, initial episode of care,Other complications due to other cardiac device, implant, and graft,Congestive heart failure, unspecified,End stage renal disease,Diabetes with ophthalmic manifestations, type II or unspecified type, uncontrolled,Acute kidney failure, unspecified,Coronary atherosclerosis of native coronary artery,Cardiac catheterization as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure,Accidents occurring in other specified places,Atherosclerosis of native arteries of the extremities, unspecified,Surgical operation with transplant of whole organ causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation,Background diabetic retinopathy,Polyneuropathy in diabetes,Anemia in chronic kidney disease'}
