CHIEF COMPLAINT: 

PRESENT ILLNESS: The patient is a 53 year old
male who had a syncopal event in his bathroom on [**2103-2-10**].  He lost consciousness for 20 minutes and was brought
to the Emergency Room and had a seizure.  He was found to
have electrocardiogram changes and the patient was
transferred to Cardiology Service.  Cardiac catheterization
showed severe coronary artery disease.  The patient was
referred to [**Hospital6 256**] for coronary
artery bypass graft.  Right dominant system had critical
disease of the left anterior descending and occlusion of the
right coronary artery, 75% of diagonal, 50 and 70% of the
obtuse marginals, preserved left ventricular function, no
mitral regurgitation or no stenosis.  His ejection fraction
was 35 to 40%.

MEDICAL HISTORY: Past medical history is significant
for a history of gastroesophageal reflux disease,
degenerative disc disease, history of alcohol abuse, right
clubbed foot, borderline hyperlipidemia and depression.  He
is status post tonsillectomy and clubbed foot surgery.

MEDICATION ON ADMISSION: 

ALLERGIES: Penicillin which leads to anaphylactic shock.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: He is unemployed and lives with his wife in
[**Name (NI) 47**] with two children.  He has a history of smoking
for 33 years.  He denied any elicit drug use.  He claimed he
quit ethanol abuse two weeks ago, prior to admission.
Coronary atherosclerosis of native coronary artery,Esophageal reflux
Crnry athrscl natve vssl,Esophageal reflux
Admission Date:  [**2103-2-20**]       Discharge Date:  [**2103-3-1**]

Date of Birth:   [**2049-11-25**]       Sex:  M

Service:  Cardiothoracic Surgery

HISTORY OF PRESENT ILLNESS:  The patient is a 53 year old
male who had a syncopal event in his bathroom on [**2103-2-10**].  He lost consciousness for 20 minutes and was brought
to the Emergency Room and had a seizure.  He was found to
have electrocardiogram changes and the patient was
transferred to Cardiology Service.  Cardiac catheterization
showed severe coronary artery disease.  The patient was
referred to [**Hospital6 256**] for coronary
artery bypass graft.  Right dominant system had critical
disease of the left anterior descending and occlusion of the
right coronary artery, 75% of diagonal, 50 and 70% of the
obtuse marginals, preserved left ventricular function, no
mitral regurgitation or no stenosis.  His ejection fraction
was 35 to 40%.

PAST MEDICAL HISTORY:  Past medical history is significant
for a history of gastroesophageal reflux disease,
degenerative disc disease, history of alcohol abuse, right
clubbed foot, borderline hyperlipidemia and depression.  He
is status post tonsillectomy and clubbed foot surgery.

MEDICATIONS AT HOME:  Benadryl, Aspirin, Thiamine, folic
acid, Zestril, Lipitor, atenolol and librium.

ALLERGIES:  Penicillin which leads to anaphylactic shock.

SOCIAL HISTORY:  He is unemployed and lives with his wife in
[**Name (NI) 47**] with two children.  He has a history of smoking
for 33 years.  He denied any elicit drug use.  He claimed he
quit ethanol abuse two weeks ago, prior to admission.

HOSPITAL COURSE:  The patient was taken to the Operating Room
on [**2103-2-20**] for coronary artery bypass graft times
three with Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 1537**], please see the operative note
for full details.  Postoperatively he was transferred to the
Intensive Care Unit where he was extubated and was on
pressors.  On postoperative day #2 he was showing some
neurological shaking, however, that resolved.  He was stable.
He was transferred to the floor on [**2-22**] and
mediastinal tubes were discontinued.  He then went on to have
an uneventful hospital course whereupon his wires were
discontinued and his pleural tube was discontinued.  He had
some difficulty ambulating initially and a sitter was
required to help watch him.  He was agitated earlier during
his admission and he was on sedatives including
benzodiazepines.  His heartrate was controlled as we
increased his Lopressor.  On [**2-26**], it was noted in the
evening that the patient had some minor sternal drainage and
the decision was made to keep the patient in-house and he was
started on Levofloxacin and continued.  It will be continued
for another ten days past discharge.  His sternal wound looks
clean and had mostly serosanguinous discharge, very minor.
Gram stain of that showed nothing and no microorganisms and
the cultures so far have shown nothing to date as of day #2.
His sternum shows no signs of an active cellulitis and no
signs of an active infection, other than a drop which could
be expressed upon pressing down hard.  The patient has no
click.

DISCHARGE MEDICATIONS:  The patient is being discharged home
on his antibiotic therapy and will also receive prescriptions
for Zestril 5 mg p.o. q.d., Aspirin 325 mg p.o. q.d., Zantac
150 b.i.d., Colace 100 mg p.o. b.i.d., Xanax .25 mg one
tablet p.o. b.i.d. prn for agitation, he is getting folate 1
mg tablets one tablet p.o. q.d., Lipitor 10 mg tablets one
tablet p.o. q.h.s., Imdur 30 mg tablets p.o. q.d. #30 with
two refills, Lopressor 100 mg tablets, one tablet p.o.
b.i.d., now he is getting one refill on that, Levaquin 500 mg
tablets, one tablet p.o. q.d., he is getting ten of those.
Vicodin 5, 500 mg tablets one to two tablets p.o. q. [**4-14**] h.
prn pain.  He is getting 50 of those and Nicotine patch 22 mg
each 24 hours, one patch applied to each arm, he is getting
42 patches prescription.

FOLLOW UP:  The patient will follow up with his primary care
physician and for his medical cardiology issues to follow up
with Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 1537**].

DISCHARGE CONDITION:  On day of discharge the patient is in
good condition with no acute issues.




                            [**First Name11 (Name Pattern1) 275**] [**Last Name (NamePattern4) 1539**], M.D.  [**MD Number(1) 1540**]

Dictated By:[**Name8 (MD) 16758**]
MEDQUIST36

D:  [**2103-3-1**]  11:15
T:  [**2103-3-1**]  11:46
JOB#:  [**Job Number 38709**]
{'Coronary atherosclerosis of native coronary artery,Esophageal reflux'}


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: 

PRESENT ILLNESS: The patient is a 53 year old
male who had a syncopal event in his bathroom on [**2103-2-10**].  He lost consciousness for 20 minutes and was brought
to the Emergency Room and had a seizure.  He was found to
have electrocardiogram changes and the patient was
transferred to Cardiology Service.  Cardiac catheterization
showed severe coronary artery disease.  The patient was
referred to [**Hospital6 256**] for coronary
artery bypass graft.  Right dominant system had critical
disease of the left anterior descending and occlusion of the
right coronary artery, 75% of diagonal, 50 and 70% of the
obtuse marginals, preserved left ventricular function, no
mitral regurgitation or no stenosis.  His ejection fraction
was 35 to 40%.

MEDICAL HISTORY: Past medical history is significant
for a history of gastroesophageal reflux disease,
degenerative disc disease, history of alcohol abuse, right
clubbed foot, borderline hyperlipidemia and depression.  He
is status post tonsillectomy and clubbed foot surgery.

MEDICATION ON ADMISSION: 

ALLERGIES: Penicillin which leads to anaphylactic shock.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: He is unemployed and lives with his wife in
[**Name (NI) 47**] with two children.  He has a history of smoking
for 33 years.  He denied any elicit drug use.  He claimed he
quit ethanol abuse two weeks ago, prior to admission. 

### Response:
{'Coronary atherosclerosis of native coronary artery,Esophageal reflux'}
