CHIEF COMPLAINT: 

PRESENT ILLNESS: This is a 57-year-old male who
reports being very physically active (running five miles
regularly) until one year ago, when he began experiencing
episodes of lightheadedness which have led to a loss of
balance when the patient attempts to run.  The patient
visited his primary care physician, [**Name10 (NameIs) 1023**] found a new heart
murmur, for which he was referred for echocardiogram and
subsequent cardiac catheterization.  Cardiac catheterization
data on [**2186-10-10**] showed moderate to severe aortic stenosis,
normal coronary arteries, and preserved left ventricular
function.  Cardiac echocardiogram on [**2186-9-13**],
showed an ejection fraction of 55 to 60%.  On [**2186-9-13**], the
cardiac echocardiogram also showed an aortic stenosis with
peak systolic gradient of 50 mm Hg, and a mean of 37 mm Hg,
and a mild aortic insufficiency and a mild mitral
regurgitation.

MEDICAL HISTORY: Borderline hypertension, borderline
hypercholesterolemia, positive right thigh numbness for two
to three years, dizziness/lightheadedness/loss of balance for
one year.

MEDICATION ON ADMISSION: 

ALLERGIES: 

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: 
Aortic valve disorders,Unspecified essential hypertension,Pure hypercholesterolemia
Aortic valve disorder,Hypertension NOS,Pure hypercholesterolem
Admission Date:  [**2186-12-11**]       Discharge Date:  [**2186-12-17**]

Date of Birth:   [**2128-12-14**]       Sex:  M

Service:  CARDIOTHORACIC SURGERY

HISTORY OF PRESENT ILLNESS:  This is a 57-year-old male who
reports being very physically active (running five miles
regularly) until one year ago, when he began experiencing
episodes of lightheadedness which have led to a loss of
balance when the patient attempts to run.  The patient
visited his primary care physician, [**Name10 (NameIs) 1023**] found a new heart
murmur, for which he was referred for echocardiogram and
subsequent cardiac catheterization.  Cardiac catheterization
data on [**2186-10-10**] showed moderate to severe aortic stenosis,
normal coronary arteries, and preserved left ventricular
function.  Cardiac echocardiogram on [**2186-9-13**],
showed an ejection fraction of 55 to 60%.  On [**2186-9-13**], the
cardiac echocardiogram also showed an aortic stenosis with
peak systolic gradient of 50 mm Hg, and a mean of 37 mm Hg,
and a mild aortic insufficiency and a mild mitral
regurgitation.

PAST MEDICAL HISTORY:  Borderline hypertension, borderline
hypercholesterolemia, positive right thigh numbness for two
to three years, dizziness/lightheadedness/loss of balance for
one year.

PAST SURGICAL HISTORY:  None.

PHYSICAL EXAMINATION:  General:  No acute distress, pleasant,
and appearing stated age.  Skin:  No rashes, well hydrated.
Head, eyes, ears, nose and throat:  Pupils equal, round and
reactive to light and accommodation, extraocular movements
intact, normal buccal mucosa, normal dentition, no dentures.
Neck:  Supple, no jugular venous distention, no thyromegaly,
no lymphadenopathy, no tracheal deviation.  Chest:  Clear to
auscultation bilaterally, slightly decreased breath sounds at
the right base, no wheezing or rhonchi.  Heart:  Tachycardic,
regular rhythm, no rubs, positive III/VI murmur at the left
sternal border.  Abdomen:  Mildly obese, nontender,
nondistended, normal bowel sounds, no guarding, rebound or
rigidity.  Extremities:  Warm, no edema, no cyanosis, no calf
tenderness.  Varicosities:  None.  Neurologic:  Cranial
nerves II through XII intact grossly.  Pulses:  Femoral,
dorsalis pedis and posterior tibial and radial are all 2+,
dorsalis pedis left is 1+.  Carotid bruits:  None.

HOSPITAL COURSE:  On [**2186-12-11**], the patient was taken to the
operating room, and a limited access aortic valve replacement
with a 27 mm Carbomedics mechanical valve was placed under
general endotracheal anesthesia.  At the time, the
pericardium was left open.  An arterial line was placed, as
well as a Swan-Ganz catheter.  Two ventricular and two atrial
wires were placed, and two mediastinal tubes.  The patient
was on cardiopulmonary bypass for 99 minutes, and was
cross-clamped for 76 minutes.

Postoperatively, the patient was extubated and did well.  On
postoperative day one, drips were discontinued, and a beta
blocker was started.  He was transferred to the Surgical
floor in stable condition.  On the floor, he engaged in
physical therapy well, and progressed rapidly.  The only
complication in the patient's postoperative period was in
reaching therapeutic levels with his Warfarin.  Subsequently
he was started on a heparin drip, with a goal PTT of between
40 and 60.  On the day of discharge, the patient's INR
finally reached 2.2, and he was discharged with instructions
to have his PT and INR repeated on Tuesday, and to be
followed up with his cardiologist at [**Hospital3 4527**].

CONDITION AT DISCHARGE:  Good.

DISCHARGE STATUS:  Home.

DISCHARGE DIAGNOSIS:
1.  Severe aortic stenosis
2.  Status post aortic valve replacement with Carbomedics
mechanical valve

FOLLOW-UP PLANS:  The patient is to follow up next week with
his cardiologist, and in four weeks with Dr. [**Last Name (STitle) 1537**].

DISCHARGE MEDICATIONS:
1.  Coumadin 5 mg by mouth once daily
2.  Lasix 20 mg by mouth twice a day for seven days
3.  K-Dur 20 mEq by mouth twice a day for seven days
4.  Colace 100 mg by mouth twice a day
5.  Lopressor 25 mg by mouth twice a day
6.  Simvastatin 10 mg by mouth once daily
7.  Percocet one to two tablets by mouth every four to six
hours as needed for pain
8.  Zantac 150 mg by mouth twice a day




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

Dictated By:[**Last Name (NamePattern1) 17480**]
MEDQUIST36

D:  [**2186-12-17**]  19:12
T:  [**2186-12-18**]  01:24
JOB#:  [**Job Number 45644**]
{'Aortic valve disorders,Unspecified essential hypertension,Pure hypercholesterolemia'}


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: This is a 57-year-old male who
reports being very physically active (running five miles
regularly) until one year ago, when he began experiencing
episodes of lightheadedness which have led to a loss of
balance when the patient attempts to run.  The patient
visited his primary care physician, [**Name10 (NameIs) 1023**] found a new heart
murmur, for which he was referred for echocardiogram and
subsequent cardiac catheterization.  Cardiac catheterization
data on [**2186-10-10**] showed moderate to severe aortic stenosis,
normal coronary arteries, and preserved left ventricular
function.  Cardiac echocardiogram on [**2186-9-13**],
showed an ejection fraction of 55 to 60%.  On [**2186-9-13**], the
cardiac echocardiogram also showed an aortic stenosis with
peak systolic gradient of 50 mm Hg, and a mean of 37 mm Hg,
and a mild aortic insufficiency and a mild mitral
regurgitation.

MEDICAL HISTORY: Borderline hypertension, borderline
hypercholesterolemia, positive right thigh numbness for two
to three years, dizziness/lightheadedness/loss of balance for
one year.

MEDICATION ON ADMISSION: 

ALLERGIES: 

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY:  

### Response:
{'Aortic valve disorders,Unspecified essential hypertension,Pure hypercholesterolemia'}
