CHIEF COMPLAINT: Chest pain

PRESENT ILLNESS: 53 year old woman with dyspnea on exertion . She underwent an
ETT on [**2163-6-28**] which was positive for ischemia. She underwent a
cardiac catheterizationon [**2163-7-8**] which revealed a 60% left main
and three vessel coronary artery disease. Given these findings,
she was transferred to the [**Hospital1 18**] for coronary artery bypass
grafting.

MEDICAL HISTORY: Bipolar disorder
Diabetes mellitus type 2
Hyperlipidemia
Obesity
HTN
CAD

MEDICATION ON ADMISSION: Metformin 1000mg [**Hospital1 **]
Motrin 800mg TID
Lisinoprill 40mg QD
Actos 30mg QD
Aspirin 81mg QD
Prilosec 20mg QD
Vytorin 10/80mg QD

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: 98.9  70 SR  18   104/60  64"  198lbs
NEURO: Nonfocal
HEENT: NCAT, PERRL, EOMI, Full dentures
PULM: Clear
HEART: RRR, No R/G/M, Nl S1-S2
ABD: NABS, Soft, NT, ND
EXT: No clubbing, cyanosis or edema. Pulses 2+

FAMILY HISTORY: Noncontributory

SOCIAL HISTORY: Lives with sister. On disability. Does not smoke or drink
alcohol.
Coronary atherosclerosis of native coronary artery,Intermediate coronary syndrome,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Unspecified essential hypertension,Other and unspecified hyperlipidemia,Obesity, unspecified,Bipolar disorder, unspecified
Crnry athrscl natve vssl,Intermed coronary synd,DMII wo cmp nt st uncntr,Hypertension NOS,Hyperlipidemia NEC/NOS,Obesity NOS,Bipolar disorder NOS
Admission Date:  [**2163-7-10**]              Discharge Date:   [**2163-7-17**]

Date of Birth:  [**2109-9-15**]             Sex:   F

Service: CARDIOTHORACIC

Allergies:
Patient recorded as having No Known Allergies to Drugs

Attending:[**First Name3 (LF) 1283**]
Chief Complaint:
Chest pain

Major Surgical or Invasive Procedure:
[**2163-7-12**] - CABGx3 (Left internal mammary->left anterior
descending, vein graft->obtuse marginal, vein graft->right
coronary artery)


History of Present Illness:
53 year old woman with dyspnea on exertion . She underwent an
ETT on [**2163-6-28**] which was positive for ischemia. She underwent a
cardiac catheterizationon [**2163-7-8**] which revealed a 60% left main
and three vessel coronary artery disease. Given these findings,
she was transferred to the [**Hospital1 18**] for coronary artery bypass
grafting.

Past Medical History:
Bipolar disorder
Diabetes mellitus type 2
Hyperlipidemia
Obesity
HTN
CAD


Social History:
Lives with sister. On disability. Does not smoke or drink
alcohol.

Family History:
Noncontributory

Physical Exam:
98.9  70 SR  18   104/60  64"  198lbs
NEURO: Nonfocal
HEENT: NCAT, PERRL, EOMI, Full dentures
PULM: Clear
HEART: RRR, No R/G/M, Nl S1-S2
ABD: NABS, Soft, NT, ND
EXT: No clubbing, cyanosis or edema. Pulses 2+

Pertinent Results:
[**2163-7-12**] ECHO
PRE-BYPASS: The left atrium is normal in size. No spontaneous
echo contrast or thrombus is seen in the body of the left atrium
or left atrial appendage. No atrial septal defect is seen by 2D
or color Doppler. Left ventricular wall thicknesses and cavity
size are normal. Right ventricular chamber size and free wall
motion are normal. There are simple atheroma in the descending
thoracic aorta. There are three aortic valve leaflets. The
aortic valve leaflets are mildly thickened. There is no aortic
valve stenosis. No aortic regurgitation is seen. The mitral
valve leaflets are mildly thickened. Torn mitral chordae are
present. No mitral regurgitation is seen. There is no
pericardial effusion.

POST:
Preserved Biventricular systolic function.
There is chordal [**Male First Name (un) **]. No other change in valve structure or
function

7//29/07 CXR
No evidence of acute cardiopulmonary process.


Brief Hospital Course:
Ms. [**Known lastname 21006**] was admitted to the [**Hospital1 18**] on [**2163-7-10**] for surgical
management of her coronary artery disease. She was worked-up in
the usual preoperative manner. She was originally schedule for
surgery on [**2163-7-11**] however wanted more time to think things
over. As she was having chest discomfort at rest, heparin and
nitroglycerin were started. On [**2163-7-12**], Ms. [**Known lastname 21006**] was taken
to the operating room where she underwent coronary artery bypass
grafting to three vessels. Please see operative note for
details. Postoperatively she was taken to the cardiac surgical
intensive care unit for monitoring. Later that day, she awoke
neurologically intact and was extubated. On postoperative day
one, she was transferred to the step down unit for further
recovery. She was gently diuresed towards her preoperative
weight. The physical therapy service was consulted for
assistance with her postoperative strength and mobility. She was
cleared to go home without physical therapy.  She is still
mildly volume overloaded at the time of discharge.  She will be
sent on Lasix and potassium for one week.  She has a perserved
ejection fraction; she will likely not need agressive diuresis
beyond this.  She will restart lisinopril as an outpatient.

Medications on Admission:
Metformin 1000mg [**Hospital1 **]
Motrin 800mg TID
Lisinoprill 40mg QD
Actos 30mg QD
Aspirin 81mg QD
Prilosec 20mg QD
Vytorin 10/80mg QD

Discharge Medications:
1. Aspirin 81 mg Tablet, Delayed Release (E.C.) Sig: One (1)
Tablet, Delayed Release (E.C.) PO DAILY (Daily).
Disp:*60 Tablet, Delayed Release (E.C.)(s)* Refills:*0*
2. Prilosec 20 mg Capsule, Delayed Release(E.C.) Sig: One (1)
Capsule, Delayed Release(E.C.) PO once a day.
Disp:*30 Capsule, Delayed Release(E.C.)(s)* Refills:*0*
3. Actos 30 mg Tablet Sig: One (1) Tablet PO once a day.
Disp:*30 Tablet(s)* Refills:*0*
4. Vytorin [**9-/2136**] 10-80 mg Tablet Sig: One (1) Tablet PO once a
day.
Disp:*30 Tablet(s)* Refills:*0*
5. Metoprolol Tartrate 25 mg Tablet Sig: One (1) Tablet PO BID
(2 times a day).
Disp:*60 Tablet(s)* Refills:*0*
6. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: One (1) Tablet
PO every six (6) hours as needed for pain.
Disp:*12 Tablet(s)* Refills:*0*
7. Lasix 20 mg Tablet Sig: One (1) Tablet PO once a day for 5
days.
Disp:*5 Tablet(s)* Refills:*0*
8. Potassium Chloride 20 mEq Tab Sust.Rel. Particle/Crystal Sig:
One (1) Tab Sust.Rel. Particle/Crystal PO once a day for 5 days.
Disp:*5 Tab Sust.Rel. Particle/Crystal(s)* Refills:*0*


Discharge Disposition:
Home With Service

Facility:
Multicultural VNA

Discharge Diagnosis:
Hyperlipidemia
Diabetes mellitus type 2
HTN
Obesity
Bipolar disorder
CAD s/p CABGx3


Discharge Condition:
Stable


Discharge Instructions:
1)  Monitor wounds for signs of infection. These include
redness, drainage or increased pain. In the event that you have
drainage from your sternal wound, please contact the [**Name2 (NI) 5059**] at
([**Telephone/Fax (1) 1504**].
2)  Report any fever greater then 100.5.
3)  Report any weight gain of 2 pounds in 24 hours or 5 pounds
in 1 week.
4)  No lotions, creams or powders to incision until it has
healed. You may shower and wash incision. Please shower daily.
No bathing or swimming for 1 month. Use sunscreen on incision if
exposed to sun.
5) No lifting greater then 10 pounds for 10 weeks.
6) No driving for 1 month.
7) Call with any questions or concerns.

Followup Instructions:
Follow-up with Dr. [**Last Name (STitle) 1290**] in 1 month. ([**Telephone/Fax (1) 1504**]
Follow-up with Dr. [**Last Name (STitle) 29070**] in [**12-14**] weeks.
Follow-up with pcp [**Last Name (NamePattern4) **]. [**Last Name (STitle) **] in [**1-15**] weeks. [**Telephone/Fax (1) 59225**]
Provider: [**Name10 (NameIs) **],[**Name11 (NameIs) **] [**Name Initial (NameIs) **].  [**Telephone/Fax (1) 3183**]  Follow-up appointment
should be in 1 week
Please call all providers for appointments.
{'Coronary atherosclerosis of native coronary artery,Intermediate coronary syndrome,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Unspecified essential hypertension,Other and unspecified hyperlipidemia,Obesity, unspecified,Bipolar disorder, unspecified'}


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: Chest pain

PRESENT ILLNESS: 53 year old woman with dyspnea on exertion . She underwent an
ETT on [**2163-6-28**] which was positive for ischemia. She underwent a
cardiac catheterizationon [**2163-7-8**] which revealed a 60% left main
and three vessel coronary artery disease. Given these findings,
she was transferred to the [**Hospital1 18**] for coronary artery bypass
grafting.

MEDICAL HISTORY: Bipolar disorder
Diabetes mellitus type 2
Hyperlipidemia
Obesity
HTN
CAD

MEDICATION ON ADMISSION: Metformin 1000mg [**Hospital1 **]
Motrin 800mg TID
Lisinoprill 40mg QD
Actos 30mg QD
Aspirin 81mg QD
Prilosec 20mg QD
Vytorin 10/80mg QD

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: 98.9  70 SR  18   104/60  64"  198lbs
NEURO: Nonfocal
HEENT: NCAT, PERRL, EOMI, Full dentures
PULM: Clear
HEART: RRR, No R/G/M, Nl S1-S2
ABD: NABS, Soft, NT, ND
EXT: No clubbing, cyanosis or edema. Pulses 2+

FAMILY HISTORY: Noncontributory

SOCIAL HISTORY: Lives with sister. On disability. Does not smoke or drink
alcohol. 

### Response:
{'Coronary atherosclerosis of native coronary artery,Intermediate coronary syndrome,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Unspecified essential hypertension,Other and unspecified hyperlipidemia,Obesity, unspecified,Bipolar disorder, unspecified'}
