CHIEF COMPLAINT: Chest pain

PRESENT ILLNESS: This 47-year-old patient presented with recent onset chest pain
and shortness of breath following a motor vehicle accident. He
had a positive stress
test following which he had a coronary angiogram which revealed
severe triple-vessel disease with preserved left ventricular
function. He was electively admitted for coronary artery bypass
grafting. His medical history was significant for the fact that
he was a Jehovah's Witness, and efforts
were made to minimize blood loss to the least possible.

MEDICAL HISTORY: CAD
HTN
Hyperlipidemia
Diabetes
Glaucoma
Right eye blindness
Eczema

MEDICATION ON ADMISSION: Procrit
Crestor
Imdur
Lopressor
Diclofenac
Fexofenadine
Aspirin
Singulair
Alphagan
Humalog
Lantus

ALLERGIES: Shellfish

PHYSICAL EXAM: 92 SR  111/70   64"  198
GEN: NAD
HEENT: Severe ptosis and cloudiness of OD. Mild left eye ptosis.
NECK: Supple, Minimal range of motion of neck d/t past MVA
LUNGS: Clear
HEART: RRR, Nl S1-S2
ABD: Firm, slightly distended, NABS, NT
EXT: 1+ LE edema, ext warm and perfused. No carotid bruits.
NEURO: Nonfocal other then OD blindness

FAMILY HISTORY: Father with angina and CAD in his 50's.

SOCIAL HISTORY: Lives with wife. [**Name (NI) **] is a jehovah's witness. Never smoked and
rarely drinks alcohol.
Unspecified essential hypertension,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Legal blindness, as defined in U.S.A.,Coronary atherosclerosis of native coronary artery,Pure hypercholesterolemia
Hypertension NOS,DMII wo cmp nt st uncntr,Legal blindness-usa def,Crnry athrscl natve vssl,Pure hypercholesterolem
Admission Date:  [**2106-6-15**]              Discharge Date:   [**2106-6-20**]

Date of Birth:  [**2058-6-12**]             Sex:   M

Service: CARDIOTHORACIC

Allergies:
Shellfish

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

Major Surgical or Invasive Procedure:
[**2106-6-15**] - CABGx4 (Internal mammary to the left anterior
descending artery, vein graft to the diagonal artery, vein to
obtuse marginal artery and vein to right coronary artery)


History of Present Illness:
This 47-year-old patient presented with recent onset chest pain
and shortness of breath following a motor vehicle accident. He
had a positive stress
test following which he had a coronary angiogram which revealed
severe triple-vessel disease with preserved left ventricular
function. He was electively admitted for coronary artery bypass
grafting. His medical history was significant for the fact that
he was a Jehovah's Witness, and efforts
were made to minimize blood loss to the least possible.


Past Medical History:
CAD
HTN
Hyperlipidemia
Diabetes
Glaucoma
Right eye blindness
Eczema

Social History:
Lives with wife. [**Name (NI) **] is a jehovah's witness. Never smoked and
rarely drinks alcohol.

Family History:
Father with angina and CAD in his 50's.

Physical Exam:
92 SR  111/70   64"  198
GEN: NAD
HEENT: Severe ptosis and cloudiness of OD. Mild left eye ptosis.
NECK: Supple, Minimal range of motion of neck d/t past MVA
LUNGS: Clear
HEART: RRR, Nl S1-S2
ABD: Firm, slightly distended, NABS, NT
EXT: 1+ LE edema, ext warm and perfused. No carotid bruits.
NEURO: Nonfocal other then OD blindness

Pertinent Results:
[**2106-6-16**] CXR
Cardiac, mediastinal, and hilar contours are stable status post
median sternotomy and CABG. Bilateral lower lobe linear
atelectasis is noted. There is a stable small left pleural
effusion. Chest and mediastinal tubes and right IJ CVL are in
stable position. Endotracheal and nasogastric tubes have been
removed. Osseous and soft tissue structures are unchanged.

[**2106-6-19**] 06:26AM BLOOD WBC-8.0 RBC-4.63 Hgb-12.7* Hct-38.4*
MCV-83 MCH-27.4 MCHC-33.1 RDW-16.3* Plt Ct-331
[**2106-6-19**] 06:26AM BLOOD Glucose-148* UreaN-24* Creat-1.1 Na-136
K-4.3 Cl-97 HCO3-29 AnGap-14

Brief Hospital Course:
Mr. [**Known lastname **] was admitted to the [**Hospital1 18**] on [**2106-6-15**] for elective
surgical management of his coronary artery disease. He was taken
directly to the operating room where he underwent coronary
artery bypass grafting to four vessels. Postoperatively he was
taken to the intensive care unit for monitoring. By
postoperative day one, Mr. [**Known lastname **] [**Last Name (Titles) 5058**] neurologically intact
and was extubated. Beta blockade, a statin and aspirin were
resumed. He was then transferred to the step down unit for
further recovery. Mr. [**Known lastname **] was gently diuresed towards his
preoperative weight. He had difficulty with urination after
Foley removal.  Flomax was started, and his Foley catheter was
again removed on the morning of discharge.  He did void once
after Foley removal.  He was instructed to report to the
Emergency Department if he was unable to urinate again by 10pm
on the day of discharge.  He progressed well from the physical
therapy standpoint. He has remained stable hemodynamically, and
is ready to be discharged home.

Medications on Admission:
Procrit
Crestor
Imdur
Lopressor
Diclofenac
Fexofenadine
Aspirin
Singulair
Alphagan
Humalog
Lantus

Discharge Medications:
1. Aspirin 81 mg Tablet, Delayed Release (E.C.) Sig: One (1)
Tablet, Delayed Release (E.C.) PO DAILY (Daily).
2. Montelukast 10 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
3. Atropine 1 % Drops Sig: One (1) Drop Ophthalmic TID (3 times
a day).
4. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2
times a day).
Disp:*60 Capsule(s)* Refills:*2*
5. Senna 8.6 mg Tablet Sig: One (1) Tablet PO HS (at bedtime):
hold for loose stools.
Disp:*15 Tablet(s)* Refills:*0*
6. Brimonidine 0.15 % Drops Sig: One (1) drop Ophthalmic [**Hospital1 **] (2
times a day).
7. Crestor 10 mg Tablet Sig: One (1) Tablet PO at bedtime.
8. Metoprolol Tartrate 25 mg Tablet Sig: Three (3) Tablet PO BID
(2 times a day).
Disp:*180 Tablet(s)* Refills:*2*
9. Tamsulosin 0.4 mg Capsule, Sust. Release 24 hr Sig: One (1)
Capsule, Sust. Release 24 hr PO HS (at bedtime).
Disp:*30 Capsule, Sust. Release 24 hr(s)* Refills:*2*
10. Furosemide 20 mg Tablet Sig: One (1) Tablet PO BID (2 times
a day) for 7 days.
Disp:*14 Tablet(s)* Refills:*0*
11. Potassium Chloride 20 mEq Packet Sig: One (1) Packet PO Q12H
(every 12 hours) for 7 days.
Disp:*14 Packet(s)* Refills:*0*
12. Insulin Glargine 100 unit/mL Solution Sig: Seventy (70)
units Subcutaneous once a day: at breakfast.
13. Hydrocodone-Acetaminophen 5-500 mg Tablet Sig: 1-2 Tablets
PO Q4-6H (every 4 to 6 hours) as needed.
Disp:*45 Tablet(s)* Refills:*0*
14. Humalog 100 unit/mL Solution Sig: sliding scale
Subcutaneous four times a day: as directed.


Discharge Disposition:
Home With Service

Facility:
tba

Discharge Diagnosis:
CAD s/p CABG
Hyperlipidemia
HTN
Diabetes
Glaucoma
Right eye blindness


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.
8) If you do not urinate by 10:30p [**6-20**], you need to visit an
emergency room.

Followup Instructions:
Follow-up with Dr. [**Last Name (STitle) 1290**] in 1 month. ([**Telephone/Fax (1) 1504**]
Follow-up with cardiologist Dr. [**Last Name (STitle) 7047**] in 2 weeks.
Follow-up with primary care physician [**Last Name (NamePattern4) **]. [**Last Name (STitle) **] in [**2-13**]
weeks. [**Telephone/Fax (1) 25034**]
Please call all providers for appointments.



Completed by:[**2106-6-21**]
{'Unspecified essential hypertension,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Legal blindness, as defined in U.S.A.,Coronary atherosclerosis of native coronary artery,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: Chest pain

PRESENT ILLNESS: This 47-year-old patient presented with recent onset chest pain
and shortness of breath following a motor vehicle accident. He
had a positive stress
test following which he had a coronary angiogram which revealed
severe triple-vessel disease with preserved left ventricular
function. He was electively admitted for coronary artery bypass
grafting. His medical history was significant for the fact that
he was a Jehovah's Witness, and efforts
were made to minimize blood loss to the least possible.

MEDICAL HISTORY: CAD
HTN
Hyperlipidemia
Diabetes
Glaucoma
Right eye blindness
Eczema

MEDICATION ON ADMISSION: Procrit
Crestor
Imdur
Lopressor
Diclofenac
Fexofenadine
Aspirin
Singulair
Alphagan
Humalog
Lantus

ALLERGIES: Shellfish

PHYSICAL EXAM: 92 SR  111/70   64"  198
GEN: NAD
HEENT: Severe ptosis and cloudiness of OD. Mild left eye ptosis.
NECK: Supple, Minimal range of motion of neck d/t past MVA
LUNGS: Clear
HEART: RRR, Nl S1-S2
ABD: Firm, slightly distended, NABS, NT
EXT: 1+ LE edema, ext warm and perfused. No carotid bruits.
NEURO: Nonfocal other then OD blindness

FAMILY HISTORY: Father with angina and CAD in his 50's.

SOCIAL HISTORY: Lives with wife. [**Name (NI) **] is a jehovah's witness. Never smoked and
rarely drinks alcohol. 

### Response:
{'Unspecified essential hypertension,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Legal blindness, as defined in U.S.A.,Coronary atherosclerosis of native coronary artery,Pure hypercholesterolemia'}
