CHIEF COMPLAINT: 

PRESENT ILLNESS: This is a 53-year-old male who
presented to the [**Hospital6 256**]
Emergency Department on [**2115-5-20**] with a chief complaint
of angina.  The patient has multiple risk factors for
coronary artery disease including a family history,
hyperlipidemia and past smoking history.  Patient reported
experiencing approximately one year of dyspnea on exertion
accompanied by mild tightening in the center of his chest
several weeks prior to admission.  Patient reports he
presented to his primary care physician the week prior to
admission with these complaints for which the primary care
physician recommended [**Name Initial (PRE) **] stress test which reportedly
demonstrated inferior reversible ischemia.  The patient
subsequently presented to [**Hospital6 2018**] on [**2115-5-20**] for cardiac catheterization, which
demonstrated three vessel disease requiring placement of a
intraaortic balloon pump.  The patient was subsequently
recommended for admission for further evaluation and
management.

MEDICAL HISTORY: 1.  Hyperlipidemia.
2.  Albuminuria.
3.  History of transient ischemic attacks, status post right
knee arthroscopy.

MEDICATION ON ADMISSION: 

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: Lives in [**Hospital1 1474**] with his wife and
step-son.  [**Name (NI) **] is a semi-retired truck driver who works
at Lowe's Hardware Store.  Patient has a 100 pack year
history of smoking, quit approximately 13 years ago.
Consumes a 12 pack of beer on weekends, no prior drug
history.
Coronary atherosclerosis of native coronary artery,Intermediate coronary syndrome,Unspecified essential hypertension,Other nonspecific abnormal results of function study of cardiovascular system,Other and unspecified hyperlipidemia,Personal history of tobacco use,Family history of ischemic heart disease
Crnry athrscl natve vssl,Intermed coronary synd,Hypertension NOS,Abn cardiovasc study NEC,Hyperlipidemia NEC/NOS,History of tobacco use,Fam hx-ischem heart dis
Admission Date:  [**2115-5-20**]       Discharge Date:  [**2115-5-27**]

Date of Birth:   [**2062-10-8**]       Sex:  M

Service:  CARDIOTHOR

HISTORY OF PRESENT ILLNESS:  This is a 53-year-old male who
presented to the [**Hospital6 256**]
Emergency Department on [**2115-5-20**] with a chief complaint
of angina.  The patient has multiple risk factors for
coronary artery disease including a family history,
hyperlipidemia and past smoking history.  Patient reported
experiencing approximately one year of dyspnea on exertion
accompanied by mild tightening in the center of his chest
several weeks prior to admission.  Patient reports he
presented to his primary care physician the week prior to
admission with these complaints for which the primary care
physician recommended [**Name Initial (PRE) **] stress test which reportedly
demonstrated inferior reversible ischemia.  The patient
subsequently presented to [**Hospital6 2018**] on [**2115-5-20**] for cardiac catheterization, which
demonstrated three vessel disease requiring placement of a
intraaortic balloon pump.  The patient was subsequently
recommended for admission for further evaluation and
management.

PAST MEDICAL HISTORY:
1.  Hyperlipidemia.
2.  Albuminuria.
3.  History of transient ischemic attacks, status post right
knee arthroscopy.

HOME MEDICATIONS:
1.  Aspirin.
2.  Lipitor.
3.  Multivitamin.
4.  Toprol.
5.  Plavix.

ALLERGIES:  No known drug allergies.

SOCIAL HISTORY:  Lives in [**Hospital1 1474**] with his wife and
step-son.  [**Name (NI) **] is a semi-retired truck driver who works
at Lowe's Hardware Store.  Patient has a 100 pack year
history of smoking, quit approximately 13 years ago.
Consumes a 12 pack of beer on weekends, no prior drug
history.

HOSPITAL COURSE:  The patient was admitted to the Coronary
Care Unit on [**2115-5-20**] under the direction of Dr. [**First Name4 (NamePattern1) 47897**]
[**Last Name (NamePattern1) 911**].  As referenced previously, the patient's cardiac
catheterization demonstrated three vessel coronary artery
disease, notable for 70% mid vessel stenosis of the left
anterior descending, a long total occlusion of the proximal
and mid vessel left circumflex, and a 50% stenosis of the
right coronary artery.  The patient had an estimated ejection
fraction of 50%.  An intraaortic balloon pump was
successfully placed through the course of this procedure.
The patient was subsequently evaluated by the Cardiac Surgery
Team, and following a discussion of pros and cons of surgical
intervention, the patient was scheduled for elective coronary
artery bypass graft on [**2115-5-22**].

On [**2115-5-24**], the patient therefore underwent a quadruple
coronary artery bypass grafting procedure.  Anastomosis
included connection from the left internal mammary artery to
the left anterior descending coronary artery, saphenous vein
graft from the aorta to the left anterior descending diagonal
coronary artery, saphenous vein graft from the aorta to the
obtuse marginal coronary artery, the saphenous vein graft
from the aorta to the right posterior descending coronary
artery.  The patient tolerated the procedure well and was
subsequently transferred to the Cardiac Surgery Recovery Room
for further evaluation and management.

Following arrival in the CSRU, the patient was successfully
weaned and extubated without complication.  The patient was
subsequently noted to be tolerant of oral intake and was
gradually transitioned to full regular diet without
complication.  The patient was subsequently cleared for
transfer to the floor on postoperative day number two and was
subsequently admitted to the Cardiac Thoracic Surgery Service
under the direction of Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 70**].

On the floor, the patient progressed well clinically through
to the time of discharge.  On postoperative day number two,
the patient's pacing wires were removed without complication.
The patient was evaluated by Physical Therapy, who deemed an
appropriate candidate for discharge to home following
resolution of his acute medical issues.

On postoperative day number three, the patient's chest tubes
were removed without complication and he was noted to have
adequate pain control provided via oral pain medications.
The patient's Foley catheter was removed and he was
subsequently noted to be independently productive with
adequate amounts of urine for the duration of his stay.  The
patient progressed well clinically through postoperative day
number five, at which point he was cleared for full
independent ambulation by Physical Therapy and was
subsequently cleared for discharge to home with instructions
for follow-up.

The patient was subsequently discharged on postoperative day
number five, [**2115-5-27**], with instructions for follow-up.

CONDITION OF DISCHARGE:  The patient is to be discharged to
home with instructions for follow-up.

STATUS OF DISCHARGE:  Stable.

DISCHARGE MEDICATIONS:
1.  Lopressor 25 mg po b.i.d.
2.  Lasix 20 mg po b.i.d. times ten days.
3.  Potassium chloride 20 mEq po q.d. times ten days.
4.  Colace 100 mg po b.i.d.
5.  Enteric coated aspirin 325 mg po q.d.
6.  Dilaudid 2 mg 1-2 tablets po q. 4 hours prn for pain.
7.  Atorvastatin 20 mg po q.d.
8.  Ibuprofen 400 mg po q. 6 hours prn.

DISCHARGE INSTRUCTIONS:  The patient is to maintain his
incisions clean and dry at all times.  The patient may
shower, but should pat his incisions afterwards; no bathing
or swimming until further notice.  Patient has been
instructed to limit physical activity; no heavy exertion.
Patient has been instructed to resume a cardiac diet.  No
driving while taking prescription pain medications.  Patient
is to follow-up with his primary care physician within one to
two weeks.  The patient is to follow-up with Dr. [**First Name8 (NamePattern2) **]
[**Last Name (NamePattern1) 70**] in six weeks.  Patient is to call to schedule all
appointments.







                            [**First Name11 (Name Pattern1) **] [**Initials (NamePattern4) **] [**Last Name (NamePattern4) **], M.D.  [**MD Number(1) 75**]

Dictated By:[**First Name3 (LF) 47277**]
MEDQUIST36

D:  [**2115-5-28**]  06:23
T:  [**2115-5-28**]  18:26
JOB#:  [**Job Number 47898**]
{'Coronary atherosclerosis of native coronary artery,Intermediate coronary syndrome,Unspecified essential hypertension,Other nonspecific abnormal results of function study of cardiovascular system,Other and unspecified hyperlipidemia,Personal history of tobacco use,Family history of ischemic heart disease'}


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 53-year-old male who
presented to the [**Hospital6 256**]
Emergency Department on [**2115-5-20**] with a chief complaint
of angina.  The patient has multiple risk factors for
coronary artery disease including a family history,
hyperlipidemia and past smoking history.  Patient reported
experiencing approximately one year of dyspnea on exertion
accompanied by mild tightening in the center of his chest
several weeks prior to admission.  Patient reports he
presented to his primary care physician the week prior to
admission with these complaints for which the primary care
physician recommended [**Name Initial (PRE) **] stress test which reportedly
demonstrated inferior reversible ischemia.  The patient
subsequently presented to [**Hospital6 2018**] on [**2115-5-20**] for cardiac catheterization, which
demonstrated three vessel disease requiring placement of a
intraaortic balloon pump.  The patient was subsequently
recommended for admission for further evaluation and
management.

MEDICAL HISTORY: 1.  Hyperlipidemia.
2.  Albuminuria.
3.  History of transient ischemic attacks, status post right
knee arthroscopy.

MEDICATION ON ADMISSION: 

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: Lives in [**Hospital1 1474**] with his wife and
step-son.  [**Name (NI) **] is a semi-retired truck driver who works
at Lowe's Hardware Store.  Patient has a 100 pack year
history of smoking, quit approximately 13 years ago.
Consumes a 12 pack of beer on weekends, no prior drug
history. 

### Response:
{'Coronary atherosclerosis of native coronary artery,Intermediate coronary syndrome,Unspecified essential hypertension,Other nonspecific abnormal results of function study of cardiovascular system,Other and unspecified hyperlipidemia,Personal history of tobacco use,Family history of ischemic heart disease'}
