CHIEF COMPLAINT: CC:[**CC Contact Info 94172**]
Major Surgical or Invasive Procedure:
s/p Left Carotid Stent Placement

PRESENT ILLNESS: 71 y/o male with PMHx mutiple TIAs, CABG Redo, AVR bovine [**1-25**],
multiple PCI, known [**Doctor First Name 3098**] 79% from pre-op CABG US [**11-24**] here s/p
carotid [**Doctor First Name 3098**] stent as part of CREST trial. Pt has hx of multiple
varied neuro symptoms aver past 2 years. Symptoms include
Amaurosis fugax of L eye 2yrs ago, and vertigo 1-2 months ago.
No numbness/weakness, obvious neurologic deficits recently. No
CP, SOB. Pt very active, can do pushups/situps daily. No f/c, no
abd pain,melena, no syncope.
Angiography revealed 99% [**Doctor First Name 3098**] at bifurcation, otherwise [**Country **] is
20%, hypoplastic R vertirbal, normal L vertibral, carebellar,
MCA, ACAs. [**Doctor First Name 3098**] stent with good angiographic results. Pt
comfortable with no complaints s/p stent.

MEDICAL HISTORY: CABG x3 [**2186**], Repeat CABG [**1-25**];
AVR bovine (bicuspid)[**1-25**];
PCI's (11 stents)
TIA - amaurosis, vertigo, speech difficulty; last 4min-2hrs,
Osteo arthhritis knees,
[**Name (NI) 1235**] POA, [**Name (NI) 1235**] [**Name2 (NI) **],
pancreatitis,
cholycystemctomy,
hernia repair,
HTN,
Hyperlipidemia

MEDICATION ON ADMISSION: [**Name (NI) **] 325;
Diltiazem 240mg,
metoprolol 100 [**Hospital1 **],
[**Hospital1 **] 75 [**Hospital1 **],
Zocor 60 qd,
Salsalate 750mg [**Hospital1 **];
fish oil 1g;
Calcium with Vit D 600mg;
Rubeprazole 20,
MVI,
Mg,
Vit E,
Glucosamine

ALLERGIES: Lisinopril

PHYSICAL EXAM: vs: P 53 RR 12 BP 138/65 O2 sat 97% RA Wt 81kg
Gen: NAD
Heent: Perrla, Eomi, oral pharynx clear
Neck: no carotid bruits
Cardio: RRR S1/S2, II/VI SEM in 2 ICS
Lungs: CTA B/L, midline surgical scar
Abd: soft NTND, NABS
Ext: no edema
Neuro: CN II-XII intact

FAMILY HISTORY: non-contributory

SOCIAL HISTORY: Lives in [**Hospital1 789**]
no children
no tobacco use
drinks about 1-2 drinks a day
no drug use
Occlusion and stenosis of carotid artery without mention of cerebral infarction,Heart valve replaced by transplant,Personal history of other diseases of circulatory system,Aortocoronary bypass status,Unspecified essential hypertension,Examination of participant in clinical trial
Ocl crtd art wo infrct,Heart valve transplant,Hx-circulatory dis NEC,Aortocoronary bypass,Hypertension NOS,Exam-clincal trial
Admission Date:  [**2197-7-25**]              Discharge Date:   [**2197-7-26**]

Date of Birth:  [**2125-12-8**]             Sex:   M

Service: [**Hospital Unit Name 196**]

Allergies:
Lisinopril

Attending:[**First Name3 (LF) 2704**]
Chief Complaint:
CC:[**CC Contact Info 94172**]
Major Surgical or Invasive Procedure:
s/p Left Carotid Stent Placement


History of Present Illness:
71 y/o male with PMHx mutiple TIAs, CABG Redo, AVR bovine [**1-25**],
multiple PCI, known [**Doctor First Name 3098**] 79% from pre-op CABG US [**11-24**] here s/p
carotid [**Doctor First Name 3098**] stent as part of CREST trial. Pt has hx of multiple
varied neuro symptoms aver past 2 years. Symptoms include
Amaurosis fugax of L eye 2yrs ago, and vertigo 1-2 months ago.
No numbness/weakness, obvious neurologic deficits recently. No
CP, SOB. Pt very active, can do pushups/situps daily. No f/c, no
abd pain,melena, no syncope.
Angiography revealed 99% [**Doctor First Name 3098**] at bifurcation, otherwise [**Country **] is
20%, hypoplastic R vertirbal, normal L vertibral, carebellar,
MCA, ACAs. [**Doctor First Name 3098**] stent with good angiographic results. Pt
comfortable with no complaints s/p stent.


Past Medical History:
CABG x3 [**2186**], Repeat CABG [**1-25**];
AVR bovine (bicuspid)[**1-25**];
PCI's (11 stents)
TIA - amaurosis, vertigo, speech difficulty; last 4min-2hrs,
Osteo arthhritis knees,
[**Name (NI) 1235**] POA, [**Name (NI) 1235**] [**Name2 (NI) **],
pancreatitis,
cholycystemctomy,
hernia repair,
HTN,
Hyperlipidemia

Social History:
Lives in [**Hospital1 789**]
no children
no tobacco use
drinks about 1-2 drinks a day
no drug use


Family History:
non-contributory

Physical Exam:
vs: P 53 RR 12 BP 138/65 O2 sat 97% RA Wt 81kg
Gen: NAD
Heent: Perrla, Eomi, oral pharynx clear
Neck: no carotid bruits
Cardio: RRR S1/S2, II/VI SEM in 2 ICS
Lungs: CTA B/L, midline surgical scar
Abd: soft NTND, NABS
Ext: no edema
Neuro: CN II-XII intact


Pertinent Results:
[**2197-7-25**] 08:00AM   GLUCOSE-80
[**2197-7-25**] 08:00AM   CK(CPK)-180*
[**2197-7-25**] 08:00AM   CK-MB-4

Brief Hospital Course:
1) s/[**Initials (NamePattern4) **] [**Last Name (NamePattern4) 3098**] stent - kept SBP 140-170 with Neo/Nitro prn.
Continued pt on [**Last Name (LF) **] , [**First Name3 (LF) **], statin. Held all other HTN while
in hospital.  Pt BP remianed stable overnight and pt was off
Neo/Nitro overnight. Pt did not have any neurological deficits
after the procedure and no complaints of HA, change in vision,
weakness/numbness.
2) CAD - Continued [**First Name3 (LF) **], [**First Name3 (LF) 4532**]. Restart outpatient BP meds upon
discharge
3) FEN - card diet
4) PPX - PPI, bowel regimine
5) [**Name (NI) 11053**] Pt sent home the next day after procedure and setup
for blood pressure check outpatient.

Medications on Admission:
[**Name (NI) **] 325;
Diltiazem 240mg,
metoprolol 100 [**Hospital1 **],
[**Hospital1 **] 75 [**Hospital1 **],
Zocor 60 qd,
Salsalate 750mg [**Hospital1 **];
fish oil 1g;
Calcium with Vit D 600mg;
Rubeprazole 20,
MVI,
Mg,
Vit E,
Glucosamine

Discharge Medications:
1. Aspirin 325 mg Tablet, Delayed Release (E.C.) Sig: One (1)
Tablet, Delayed Release (E.C.) PO QD (once a day).
Disp:*30 Tablet, Delayed Release (E.C.)(s)* Refills:*2*
2. Clopidogrel Bisulfate 75 mg Tablet Sig: One (1) Tablet PO QD
(once a day).
Disp:*30 Tablet(s)* Refills:*2*
3. Simvastatin 40 mg Tablet Sig: 1.5 Tablets PO QD (once a day).
Disp:*45 Tablet(s)* Refills:*2*
4. Salsalate 750 mg Tablet Sig: One (1) Tablet PO BID (2 times a
day).
Disp:*60 Tablet(s)* Refills:*2*
5. Vitamin E 400 unit Capsule Sig: One (1) Capsule PO QD (once a
day).
Disp:*30 Capsule(s)* Refills:*2*
6. Omega-3 Fatty Acids 120-180-1.8 mg-mg-unit Capsule Sig: One
(1) Capsule PO BID (2 times a day).
Disp:*60 Capsule(s)* Refills:*2*
7. Calcium Carbonate 500 mg Tablet, Chewable Sig: One (1)
Tablet, Chewable PO TID (3 times a day).
Disp:*90 Tablet, Chewable(s)* Refills:*2*
8. Magnesium Oxide 140 mg Capsule Sig: Two (2) Capsule PO QD
(once a day).
Disp:*60 Capsule(s)* Refills:*2*
9. Multivitamin     Capsule Sig: One (1) Cap PO QD (once a day).
Disp:*30 Cap(s)* Refills:*2*
10. Pantoprazole Sodium 40 mg Tablet, Delayed Release (E.C.)
Sig: One (1) Tablet, Delayed Release (E.C.) PO Q24H (every 24
hours).
Disp:*30 Tablet, Delayed Release (E.C.)(s)* Refills:*2*
11. Cholecalciferol (Vitamin D3) 400 unit Tablet Sig: One (1)
Tablet PO QD (once a day).
Disp:*30 Tablet(s)* Refills:*2*
12. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO
Q4-6H (every 4 to 6 hours) as needed.
Disp:*10 Tablet(s)* Refills:*0*


Discharge Disposition:
Home

Discharge Diagnosis:
Left Carotid stenosis s/p stent placement
TIA
s/p CABG with redo and Bovine AVR in 04


Discharge Condition:
stable

Discharge Instructions:
Please report to your primary care physician with any nausea,
vomiting, palpitations, chest pain, shortness of breath. Please
take all medications as perscribed.

Followup Instructions:
[**First Name8 (NamePattern2) 487**] [**Last Name (NamePattern1) **]- you need to see Dr. [**First Name (STitle) **] on [**2197-7-31**]-
CArdiology- [**Hospital 94173**] clinic has been contact[**Name (NI) **] and they
will call you with the appointment time. Please call the clinic
fi you do not hear from the clinic by [**2197-7-27**].

Please set up follow up with your primary care physician [**Name Initial (PRE) 176**]
2 weeks of discharge.
{'Occlusion and stenosis of carotid artery without mention of cerebral infarction,Heart valve replaced by transplant,Personal history of other diseases of circulatory system,Aortocoronary bypass status,Unspecified essential hypertension,Examination of participant in clinical trial'}


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: CC:[**CC Contact Info 94172**]
Major Surgical or Invasive Procedure:
s/p Left Carotid Stent Placement

PRESENT ILLNESS: 71 y/o male with PMHx mutiple TIAs, CABG Redo, AVR bovine [**1-25**],
multiple PCI, known [**Doctor First Name 3098**] 79% from pre-op CABG US [**11-24**] here s/p
carotid [**Doctor First Name 3098**] stent as part of CREST trial. Pt has hx of multiple
varied neuro symptoms aver past 2 years. Symptoms include
Amaurosis fugax of L eye 2yrs ago, and vertigo 1-2 months ago.
No numbness/weakness, obvious neurologic deficits recently. No
CP, SOB. Pt very active, can do pushups/situps daily. No f/c, no
abd pain,melena, no syncope.
Angiography revealed 99% [**Doctor First Name 3098**] at bifurcation, otherwise [**Country **] is
20%, hypoplastic R vertirbal, normal L vertibral, carebellar,
MCA, ACAs. [**Doctor First Name 3098**] stent with good angiographic results. Pt
comfortable with no complaints s/p stent.

MEDICAL HISTORY: CABG x3 [**2186**], Repeat CABG [**1-25**];
AVR bovine (bicuspid)[**1-25**];
PCI's (11 stents)
TIA - amaurosis, vertigo, speech difficulty; last 4min-2hrs,
Osteo arthhritis knees,
[**Name (NI) 1235**] POA, [**Name (NI) 1235**] [**Name2 (NI) **],
pancreatitis,
cholycystemctomy,
hernia repair,
HTN,
Hyperlipidemia

MEDICATION ON ADMISSION: [**Name (NI) **] 325;
Diltiazem 240mg,
metoprolol 100 [**Hospital1 **],
[**Hospital1 **] 75 [**Hospital1 **],
Zocor 60 qd,
Salsalate 750mg [**Hospital1 **];
fish oil 1g;
Calcium with Vit D 600mg;
Rubeprazole 20,
MVI,
Mg,
Vit E,
Glucosamine

ALLERGIES: Lisinopril

PHYSICAL EXAM: vs: P 53 RR 12 BP 138/65 O2 sat 97% RA Wt 81kg
Gen: NAD
Heent: Perrla, Eomi, oral pharynx clear
Neck: no carotid bruits
Cardio: RRR S1/S2, II/VI SEM in 2 ICS
Lungs: CTA B/L, midline surgical scar
Abd: soft NTND, NABS
Ext: no edema
Neuro: CN II-XII intact

FAMILY HISTORY: non-contributory

SOCIAL HISTORY: Lives in [**Hospital1 789**]
no children
no tobacco use
drinks about 1-2 drinks a day
no drug use 

### Response:
{'Occlusion and stenosis of carotid artery without mention of cerebral infarction,Heart valve replaced by transplant,Personal history of other diseases of circulatory system,Aortocoronary bypass status,Unspecified essential hypertension,Examination of participant in clinical trial'}
