CHIEF COMPLAINT: Recurrent ventral herniation with omentum up in the anterior
chest

PRESENT ILLNESS: Mr. [**Known lastname 27218**] is a 72 y.o. male with PMH significant for CAD s/p
CABG ([**2131-5-4**]), COPD, HTN who presents with recurrent ventral
hernia.

MEDICAL HISTORY: Coronary artery disease s/p 5 vessel CABG
Bladder cancer
BPH
Anxiety
COPD
History of DVT and PE (in [**2131**] treated with ? 6 months of
coumadin)

MEDICATION ON ADMISSION: Albuterol aerosol 4 puffs daily
Amlodipine 10 mg PO daily
Aspirin 81 mg daily
Atenolol 25 mg PO daily
Atrovent 4 puffs daily
Citalopram 60 mg PO daily
Lisinopril 40 mg PO daily
Folic acid 1 mg PO daily
Iron 65 mg PO daily
Vytorin 10/80 mg PO daily
Omeprazole 40 mg PO daily
Oxycodone 5-10 mg PO BID:PRN
Plavix 75 mg daily
Finasteride 5 mg PO daily

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: GENERAL: Comfortable and in NAD
HEENT: NCAT, sclerae anicteric. MMM.
PULM: CTAB, no rales/rhonchi/wheezes
CVS: RRR with no murmur/gallop/rubs; s/p sternotomy.  Hardware
palpable
ABD: Soft/NT/ND
EXT: No c/c/e

FAMILY HISTORY: Father lung ca
brother throat ca
sister leukemia
brother colon CA
sister pancreatic ca

SOCIAL HISTORY: He smoked one pack per day for over 59 years, active until
[**2134-5-10**], drinks alcohol socially ( 1 drink per month). No
illicits. Retired truck driver. Lives with wife independent in
ADLs.
Incisional hernia without mention of obstruction or gangrene,Iatrogenic pulmonary embolism and infarction,Pneumonia, organism unspecified,Other respiratory complications,Coronary atherosclerosis of unspecified type of vessel, native or graft,Chronic airway obstruction, not elsewhere classified,Unspecified essential hypertension,Hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (LUTS),Anxiety state, unspecified,Personal history of malignant neoplasm of bladder
Incisional hernia,Iatrogen pulm emb/infarc,Pneumonia, organism NOS,Respiratory comp NEC,Cor ath unsp vsl ntv/gft,Chr airway obstruct NEC,Hypertension NOS,BPH w/o urinary obs/LUTS,Anxiety state NOS,Hx of bladder malignancy
Admission Date:  [**2134-5-10**]              Discharge Date:   [**2134-5-20**]

Date of Birth:  [**2061-8-17**]             Sex:   M

Service: PLASTIC

Allergies:
Patient recorded as having No Known Allergies to Drugs

Attending:[**First Name3 (LF) 1430**]
Chief Complaint:
Recurrent ventral herniation with omentum up in the anterior
chest

Major Surgical or Invasive Procedure:
Ventral hernia repair, placement of SurgiMend and omentectomy.
Sternal plate removal.


History of Present Illness:
Mr. [**Known lastname 27218**] is a 72 y.o. male with PMH significant for CAD s/p
CABG ([**2131-5-4**]), COPD, HTN who presents with recurrent ventral
hernia.

Approximately three years ago ([**2131-5-18**]), the patient had a
sternal repair done with plates. He had an omental transfer and
at that time a ventral hernia repair to the anterior fascia at
the bottom of sternotomy lead to a hernia. This was actually
repaired primarily and reinforced with mesh. A separate new hole
was made through the diaphragm for the omental transfer. Over
time omentum and bowel has protruded up through this hole in the
diaphragm, as evidenced on a recent CT. He now comes in for
repair of this defect. In addition was planning on removal of
his plates as he was having some discomfort. He understood we
could not guarantee success and further intervention may be
required.


Past Medical History:
Coronary artery disease s/p 5 vessel CABG
Bladder cancer
BPH
Anxiety
COPD
History of DVT and PE (in [**2131**] treated with ? 6 months of
coumadin)


Social History:
He smoked one pack per day for over 59 years, active until
[**2134-5-10**], drinks alcohol socially ( 1 drink per month). No
illicits. Retired truck driver. Lives with wife independent in
ADLs.

Family History:
Father lung ca
brother throat ca
sister leukemia
brother colon CA
sister pancreatic ca


Physical Exam:
GENERAL: Comfortable and in NAD
HEENT: NCAT, sclerae anicteric. MMM.
PULM: CTAB, no rales/rhonchi/wheezes
CVS: RRR with no murmur/gallop/rubs; s/p sternotomy.  Hardware
palpable
ABD: Soft/NT/ND
EXT: No c/c/e

Pertinent Results:
Initial Labs:
[**2134-5-11**] 06:15AM BLOOD WBC-15.6*# RBC-5.01 Hgb-14.4 Hct-42.2
MCV-84 MCH-28.7 MCHC-34.1 RDW-14.6 Plt Ct-224
[**2134-5-11**] 06:15AM BLOOD Glucose-124* UreaN-19 Creat-1.0 Na-140
K-4.2 Cl-106 HCO3-25 AnGap-13
[**2134-5-11**] 06:15AM BLOOD Calcium-8.0* Phos-3.4 Mg-1.9

Cardiac Enzymes:
[**2134-5-11**] 07:00PM BLOOD CK(CPK)-342* CK-MB-6 cTropnT-0.03*
[**2134-5-12**] 08:33AM BLOOD CK(CPK)-347* CK-MB-6 cTropnT-0.03*

ABG's:
Prior to Intubation - [**2134-5-12**] 03:22PM BLOOD Type-ART pO2-70*
pCO2-75* pH-7.22* calTCO2-32* Base XS-0
After Intubation - [**2134-5-12**] 06:48PM BLOOD Type-ART pO2-84*
pCO2-50* pH-7.36 calTCO2-29 Base XS-1
Prior to ICU Call-Out - [**2134-5-15**] 03:06PM BLOOD Type-ART pO2-64*
pCO2-41 pH-7.53* calTCO2-35* Base XS-10
[**2134-5-12**] 12:35PM BLOOD Lactate-1.0
[**2134-5-15**] 02:50PM BLOOD Lactate-1.7

Blood and sputum cx - No Growth to date.

ECG ([**2134-5-11**]) - Sinus rhythm. Normal tracing. Since the previous
tracing of [**2134-5-4**] sinus bradycardia is absent.

CXR ([**2134-5-11**]) - Mild bibasilar atelectasis documented on the CTA
performed subsequently, 8:00 a.m. on [**5-12**] and available at the
time of this dictation, in combination with pulmonary embolism
demonstrated on that study is sufficient to explain hypoxia.
There is no pulmonary edema. Heart size is probably normal and
unchanged. There is no pulmonary edema. Left pleural thickening
is chronic.

Echo ([**2134-5-12**]) - The left atrium is mildly dilated. The right
atrium is moderately dilated. No atrial septal defect is seen by
2D or color Doppler. There is mild symmetric left ventricular
hypertrophy with normal cavity size and global systolic function
(LVEF>55%). Due to suboptimal technical quality, a focal wall
motion abnormality cannot be fully excluded. There is no
ventricular septal defect. RV appears to have normal free wall
contractility (poor image quality). There is abnormal septal
motion/position. The aortic root is mildly dilated at the sinus
level. The ascending aorta is mildly dilated. The aortic valve
leaflets (3) are mildly thickened but aortic stenosis is not
present. No aortic regurgitation is seen. The mitral valve
leaflets are mildly thickened. There is no mitral valve
prolapse. Mild (1+) mitral regurgitation is seen. Tricuspid
regurgitation is present but cannot be quantified. There is
moderate pulmonary artery systolic hypertension. There is no
pericardial effusion.
Compared with the prior study (images reviewed) of [**2131-5-19**],
the RV funciton has probably improved. If indicated, a cardiac
MRI may better assess RV size and systolic function.

CXR ([**2134-5-12**]) - IMPRESSION: Asymmetric pulmonary edema, new since
one day prior.

CTA Chest ([**2134-5-12**]) - IMPRESSION:
1. Left upper lobe lobar pulmonary embolism.
2. Partial right lower lobe collapse due to a combination of
dependent secretions and bronchial wall thickening, with
associated surrounding peribronchial lymph nodes which are
probably reactive; however, a followup CT is recommended in four
to six weeks to ensure resolution.
3. Diffuse ground-glass opacities superimposed on centrilobular
emphysema are most likely infectious (such as viral in origin);
aspiration and asymetrical edema are less likely.
4. Large fatty lesion posterior to the left scapula contains
internal septations; considering large size and septations, a
dedicated MRI with contrast is recommended for further
evaluation to help distinguish a lipoma from a low grade
liposarcoma.
5. New ventral hernia mesh with postoperative changes in the
soft tissues of the anterior chest and upper abdomen.
6. Diffuse coronary artery calcification with CABG.

Bilateral LENIs ([**2134-5-13**]) - IMPRESSION: No evidence of DVT of
bilateral lower extremities.

Brief Hospital Course:
The patient was taken to the operating room for a joint
procedure between Dr. [**First Name (STitle) **] of plastic surgery and Dr. [**Last Name (STitle) **]
of general surgery.  He [**Last Name (STitle) 1834**] the following procedures:
(1) Repair of chest wall hernia (Dr. [**Last Name (STitle) **]
(2) Ventral hernia repair, placement of SurgiMend and
omentectomy. Sternal plate removal (Dr. [**First Name (STitle) **]
.
The patient tolerated the procedure well and was transferred to
the floor for routine post operate care.  He initially had poor
pain control and his PCA was titrated up.  He was kept strictly
NPO until return of bowel function.  Unfortunately, he developed
acute respiratory distress during the early morning hours of
[**2134-5-12**] that necessitated transfer to the medical intensive care
unit.
.
# Pulmonary: On POD 2, the patient was transferred to the ICU
for ongoing respiratory distress and hypoxia. He had been on 4L
NC since he was in the OR; however, he desaturated to the high
80's. Also, he had had ongoing difficulty with deep breaths
secondary to abdominal pain. CTA during this decompensation
showed pulmonary embolism. Imaging was also concerning for
underlying pneumonia as well as fluid overload. Shortly after
transfer to the ICU, the patient was noted to have worsening
hypercarbic respiratory failure and depressed mental status.
Ultimately, he was intubated on [**2134-5-12**]. The patient was started
on antibiotics to cover for his pneumonia (see below). Diuresis
was intially limited [**2-9**] hypotension; however, his blood
pressures improved and he was ultimately diuresed. After a few
days of antibiotics and diuresis, the patient's respiratory
status improved. His sedating medications were weaned and he was
ultimately extubated on [**2134-5-15**]. He was called out to the floor
on the day following his extubation and remained stable from a
pulmonary standpoint.
.
During the initial workup of his respiratory distress, a left
upper lobe lobar pulmonary embolism was noted on CTA. Of note,
patient does have a history of clots right femoral vein, left
IJ, superficial veins of the left and right cephalic veins,
superficial left basilic vein, and pulmonary embolism in setting
of surgery for cardiac tamponade s/p CABG [**5-14**]. Per Hematology
patient should have a minimum of 6 months of anticoagulation. In
2 months the patient will follow-up with hematology for
additional work-up and determination of total length of
anticoagulation. Mr. [**Known lastname 27218**] was initially on a conservative
heparin drip given he is recently post-operative. He was
continued on heparin until his INR was therapeutic.
.
He continued on oxygen via nasal cannula at a rate of 4 LPM for
the remainder of his admission and was maintaining an oxygen
saturation > 94%.  He continued pulmonary toilet with incentive
spirometry.  He responded well to intermittent doses of lasix
and was started on standing lasix 20mg by mouth daily.
.
Pneumonia - Patient with likely pneumonia based on imaging and
clinical history (reported approximately 1 week of cough during
the week prior to surgery). Large amount of secretions noted
during intubation. Pt started on levofloxacin on admission to
ICU. After intubation, ceftriaxone was added as double-coverage
to treat for severe CAP. Sputum and blood cx were sent but had
no growth to date at the time of transfer out of the ICU. On
transfer out of the ICU, the patient was continued on
levofloxacin / ceftriaxone with an end date of [**2134-5-21**].
.
# Neuro: Post-operatively, the patient received Dilaudid via PCA
initially with poor pain control that was then transitioned to
PO dilaudid with good effect and adequate pain control.
.
# CV: Patient had troponin leak in setting pneumonia and
pulmonary embolism felt to be demand. The patient was evaluated
by the cardiology service during this admission.  They
recommended that the patient should discuss with his outpatient
cardiologist the utility of continuing plavix, given the
anticoagulation that will be started for his PE. Plavix was
restarted towards the end of the [**Hospital 228**] hospital admission.
.
Multiple EKGs were performed throughout this hospitalization
that did not detect any new ST or T wave abnormalities or any
other findings concerning for ischemia.
.
# GI/GU: Post-operatively, the patient was given IV fluids until
tolerating oral intake. His diet was advanced when appropriate,
which was tolerated well. He was also started on a bowel regimen
to encourage bowel movement. Intake and output were
closely monitored, and urine output was noted to be marginal on
several occasions.  The patient initially received boluses of
IVF with improvement in his urine output.  After these boluses,
however, the patient was thought to be in fluid overload and
received lasix.  His urine output increased with lasix, as well.
.
The patient was continued on his home dose of finasteride for
his BPH.
.
ID: The patient was started on antibiotics for hospital acquired
pneumonia as above.
The patient's  temperature was closely watched for signs of
infection.
.
# Hematology: The patient's hematocrit did trend downwards
slightly after his transfer to the ICU. Hematocrit was followed
and remained stable thereafter. Of note, when patient was
intubated, OG tube was placed and moderate amount of brown
guaiac positive liquid was aspirated back; patient was kept on
heparin gtt and started on [**Hospital1 **] IV PPI.  When his plavix was
restarted, his PPI was transitioned to an H2 blocker due to the
interaction between these two medications.
.
# Musculoskeletal: The patient had difficulty ambulating and
getting out of bed.  This was thought to be due to
deconditioning.  A PT consult was requested and the patient
[**Hospital1 1834**] vigorous physical therapy.  He will require continued
physical therapy at rehab.
.
# Prophylaxis: The patient was maintained on subcutaneous
heparin after his operation.  He was transitioned to heparin
drip at the time of his pulmonary embolism, and eventually was
started on coumadin.  At the time of his discharge, his INR was
4.1 ([**2134-5-19**]).  His INR from [**2134-5-20**] was still pending.

Medications on Admission:
Albuterol aerosol 4 puffs daily
Amlodipine 10 mg PO daily
Aspirin 81 mg daily
Atenolol 25 mg PO daily
Atrovent 4 puffs daily
Citalopram 60 mg PO daily
Lisinopril 40 mg PO daily
Folic acid 1 mg PO daily
Iron 65 mg PO daily
Vytorin 10/80 mg PO daily
Omeprazole 40 mg PO daily
Oxycodone 5-10 mg PO BID:PRN
Plavix 75 mg daily
Finasteride 5 mg PO daily


Discharge Medications:
1. Aspirin 81 mg Tablet, Chewable Sig: One (1) Tablet, Chewable
PO DAILY (Daily).
2. Citalopram 20 mg Tablet Sig: Three (3) Tablet PO DAILY
(Daily).
3. Folic Acid 1 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).

4. Ferrous Sulfate 325 mg (65 mg Iron) Tablet Sig: One (1)
Tablet PO once a day.
5. Simvastatin 40 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
6. Acetaminophen 325 mg Tablet Sig: 1-2 Tablets PO Q6H (every 6
hours) as needed for pain, fever: Max 4000 mg Tylenol/day.
7. Ipratropium Bromide 0.02 % Solution Sig: One (1) nebulizer
Inhalation Q6H (every 6 hours).
8. Albuterol Sulfate 2.5 mg /3 mL (0.083 %) Solution for
Nebulization Sig: One (1) nebulizer Inhalation Q2H (every 2
hours) as needed for sob, wheezing.
9. Nicotine 7 mg/24 hr Patch 24 hr Sig: One (1) Patch 24 hr
Transdermal DAILY (Daily).
10. Potassium & Sodium Phosphates 280-160-250 mg Powder in
Packet Sig: Two (2) Powder in Packet PO TID (3 times a day).
11. Albuterol Sulfate 2.5 mg /3 mL (0.083 %) Solution for
Nebulization Sig: One (1) nebulizer Inhalation Q4H (every 4
hours).
12. Ondansetron 4 mg Tablet, Rapid Dissolve Sig: One (1) Tablet,
Rapid Dissolve PO Q8H (every 8 hours) as needed for nausea.
13. Oxycodone 5 mg Tablet Sig: One (1) Tablet PO Q4H (every 4
hours) as needed for pain.
14. Clopidogrel 75 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
15. Famotidine 20 mg Tablet Sig: One (1) Tablet PO BID (2 times
a day).
16. Levofloxacin 750mg PO daily: Last dose Friday [**2134-5-21**].
17. Ceftriaxone in Dextrose,Iso-os 1 gram/50 mL Piggyback Sig:
One (1)  Intravenous Q24H (every 24 hours): Last dose Friday
[**2134-5-21**].
18. Warfarin 1 mg Tablet Sig: dose as necessary for INR [**2-10**]
Tablets PO once a day.


Discharge Disposition:
Extended Care

Facility:
[**Hospital1 700**] - [**Location (un) 701**]

Discharge Diagnosis:
1) Recurrent ventral herniation with omentum up in the anterior
chest
2) Pulmonary embolism
3) hospital acquired pneumonia


Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Out of Bed with assistance to chair or
wheelchair.


Discharge Instructions:
Personal Care:
1. Leave your chest dressing in place until your follow up
appointment with Dr. [**First Name (STitle) **]. If your dressings get wet
underneath, you may remove them.
2. Clean around the drain site(s), where the tubing exits the
skin, with hydrogen peroxide.
3. Strip drain tubing, empty bulb(s), and record output(s) [**2-10**]
times per day.
4. A written record of the daily output from each drain should
be brought to every follow-up appointment. your drains will be
removed as soon as possible when the daily output tapers off to
an acceptable amount.
5. You may shower daily. No baths until instructed to do so by
Dr. [**First Name (STitle) **].
.
Activity:
1. You may resume your regular diet.
2. DO NOT lift anything heavier than 5 pounds or engage in
strenuous activity until instructed by Dr. [**First Name (STitle) **].
.
Medications:
1. Resume your regular medications unless instructed otherwise
and take any new meds as ordered.
2. You may take your prescribed pain medication for moderate to
severe pain. You may switch to Tylenol or Extra Strength Tylenol

for mild pain as directed on the packaging. Please note that
Percocet and Vicodin have Tylenol as an active ingredient so do
not take these meds with additional Tylenol.
4. Take prescription pain medications for pain not relieved by
tylenol.
5. Take your antibiotic as prescribed.
6. Take Colace, 100 mg by mouth 2 times per day, while taking
the prescription pain medication. You may use a different
over-the-counter stool softerner if you wish.
7. Do not drive or operate heavy machinery while taking any
narcotic pain medication. You may have constipation when taking
narcotic pain medications (oxycodone, percocet, vicodin,
hydrocodone, dilaudid, etc.); you should continue drinking
fluids, you may take stool softeners, and should eat foods that
are high in fiber.
.
Call the office IMMEDIATELY if you have any of the following:
1. Signs of infection: fever with chills, increased redness,
swelling, warmth or tenderness at the surgical site, or unusual
drainage from the incision(s).
2. A large amount of bleeding from the incision(s) or drain(s).
3. Separation of the incision.
4. Severe nausea and vomiting and lack of bowel movement or gas
for several days.
5. Fever greater than 101.5 oF
6. Severe pain NOT relieved by your medication.
.
Return to the ER if:
* If you are vomiting and cannot keep in fluids or your
medications.
* If you have shaking chills, fever greater than 101.5 (F)
degrees or 38 (C) degrees, increased redness, swelling or
discharge from incision, chest pain, shortness of breath, or
anything else that is troubling you.
* Any serious change in your symptoms, or any new symptoms that
concern you.
.
DRAIN DISCHARGE INSTRUCTIONS
You are being discharged with drains in place. Drain care is a
clean procedure. Wash your hands thoroughly with soap and warm
water before performing drain care. Perform drainage care twice
a day. Try to empty the drain at the same time each day. Pull
the stopper out of the drainage bottle and empty the drainage
fluid into the measuring cup. Record the amount of drainage
fluid on the record sheet. Reestablish drain suction.


Followup Instructions:
Please follow up with Dr. [**First Name (STitle) **] on Tuesday, [**2134-5-25**] at 9AM
at his office.
.
You are scheduled to see Dr. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **], a hematologist,
on [**2134-7-16**] at 10:30 AM on [**Hospital1 18**] [**Hospital Ward Name 516**], [**Hospital Ward Name 23**]
Clinical Center. Dr. [**Last Name (STitle) 27222**] will determine how long you
should remain on coumdin.  Phone:[**Telephone/Fax (1) 22**]

Please follow-up with your primary care provider [**Last Name (NamePattern4) **]. [**First Name (STitle) **] -
[**Doctor Last Name 15369**] to follow-up on your recent hospitalization and to
monitor your coumadin dose. Your goal INR is [**2-10**]. Your first INR
check out of the hospital will be on [**2134-5-21**].

Please follow-up with your cardiologist Dr. [**Last Name (STitle) **] [**Last Name (STitle) **] discuss your
recent hospitalization and determine if you should re-start
plavix.

You should also call the Pulmonary Clinic as soon as possible
for the next availabe appointment.  Their telephone number is
([**Telephone/Fax (1) 513**].



Completed by:[**2134-5-20**]
{'Incisional hernia without mention of obstruction or gangrene,Iatrogenic pulmonary embolism and infarction,Pneumonia, organism unspecified,Other respiratory complications,Coronary atherosclerosis of unspecified type of vessel, native or graft,Chronic airway obstruction, not elsewhere classified,Unspecified essential hypertension,Hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (LUTS),Anxiety state, unspecified,Personal history of malignant neoplasm of bladder'}


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: Recurrent ventral herniation with omentum up in the anterior
chest

PRESENT ILLNESS: Mr. [**Known lastname 27218**] is a 72 y.o. male with PMH significant for CAD s/p
CABG ([**2131-5-4**]), COPD, HTN who presents with recurrent ventral
hernia.

MEDICAL HISTORY: Coronary artery disease s/p 5 vessel CABG
Bladder cancer
BPH
Anxiety
COPD
History of DVT and PE (in [**2131**] treated with ? 6 months of
coumadin)

MEDICATION ON ADMISSION: Albuterol aerosol 4 puffs daily
Amlodipine 10 mg PO daily
Aspirin 81 mg daily
Atenolol 25 mg PO daily
Atrovent 4 puffs daily
Citalopram 60 mg PO daily
Lisinopril 40 mg PO daily
Folic acid 1 mg PO daily
Iron 65 mg PO daily
Vytorin 10/80 mg PO daily
Omeprazole 40 mg PO daily
Oxycodone 5-10 mg PO BID:PRN
Plavix 75 mg daily
Finasteride 5 mg PO daily

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: GENERAL: Comfortable and in NAD
HEENT: NCAT, sclerae anicteric. MMM.
PULM: CTAB, no rales/rhonchi/wheezes
CVS: RRR with no murmur/gallop/rubs; s/p sternotomy.  Hardware
palpable
ABD: Soft/NT/ND
EXT: No c/c/e

FAMILY HISTORY: Father lung ca
brother throat ca
sister leukemia
brother colon CA
sister pancreatic ca

SOCIAL HISTORY: He smoked one pack per day for over 59 years, active until
[**2134-5-10**], drinks alcohol socially ( 1 drink per month). No
illicits. Retired truck driver. Lives with wife independent in
ADLs. 

### Response:
{'Incisional hernia without mention of obstruction or gangrene,Iatrogenic pulmonary embolism and infarction,Pneumonia, organism unspecified,Other respiratory complications,Coronary atherosclerosis of unspecified type of vessel, native or graft,Chronic airway obstruction, not elsewhere classified,Unspecified essential hypertension,Hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (LUTS),Anxiety state, unspecified,Personal history of malignant neoplasm of bladder'}
