CHIEF COMPLAINT: syncope

PRESENT ILLNESS: 80M HTN, h/o CVA, h/o presyncope with known conduction system
disease, h/o SVT, recent admission in [**2159-1-15**] for afib and CHF
exacerbation. Was discharged on Toprol XL for rate control and
on coumadin with plan for 3 weeks of anticoagulation prior to
elective DCCV. Last seen in cardiology clinic on [**2-21**] and had
been doing well. Scheduled for elective DCCV this week.
.
On day of presentation, was walking to refrigerator. Syncope
witnessed by wife. [**Name (NI) **] that he knew he was going to faint [**2-17**]
seconds prior to losing consciousness and was able to brace fall
with arm, landing on his rear. Wife did not note any tonic
clonic movements. No bowel/bladder incontinence. No preceding
CP, SOB, n/v, diaphoresis, palps, or aura. Was out for several
seconds, followed by 15 seconds of filling "dizzy".
.
States symptoms are similar to prior episodes of presyncope,
except that this episode actually led to LOC, whereas prior
episodes had resolved without intervention.
.
In ED, non-contrast head CT negative for acute bleed.

MEDICAL HISTORY: BPH
Incidental R liver cyst
- stable since [**4-19**]
Diverticulosis
Basal cell CA of the nose
- removed [**2157-2-15**]
CVA [**2150**]
- resulting in dysesthesias R hand
- imaging consistent with lacunar hypodensity c/w lacunar
infarct, L cerebellar hypodensity c/w chronic infarct
Cervical spondylosis
Hypertension
varicose veins
Sleep apnea
Colon CA
- s/p chemo/xrt, resection [**9-19**]
Hx of presyncope
- CardioNet monitor in [**4-20**]: episodes of SVT in 130s with
termination after 5-10 beats, no bradyarrythmias
- Conduction system disease: right bundle branch block, left
anterior fascicular block, borderline PR interval

MEDICATION ON ADMISSION: 1. Aspirin 325 mg PO DAILY
2. Toprol XL 200 mg PO once a day
3. Lisinopril 5 mg PO DAILY
4. Warfarin PO DAILY (2.5 M/W/F [**1-16**] tab all other days)
5. Lasix 80 mg [**Hospital1 **]
6. Amitriptyline 50 mg PO HS
7. Docusate Sodium 100 mg PO BID
8. Senna 2 Tablet PO BID
9. MVI
10. Flomax 0.4 daily
11. kdur 20 tid
.
Medications on transfer:
potassium chloride 40 meq po x1 0900
aspirin 325mg po qd
metoprolol 37.5mg po q6
coumadin 2.5mg po q M/W/F, 1.25mg po q T/T
multivitamins
tamsulosin 0.4mg po qd
amitriptyline 50mg po qhs
docusate [**Hospital1 **]
dofetilide 250mcg po q12 hours, last dose 2200
senna prn

ALLERGIES: Penicillins / Erythromycin Base / Streptomycin / Citric Acid /
Atenolol

PHYSICAL EXAM: VS - T 97.8, BP 120/66, HR 66, RR 18, O2 sat 99% RA, wt 78 kg
Gen - comfortable, NAD, speaking full sentences
HEENT - NCAT, PERRL, EOMI, OP clr, MMM, no LAD, JVP ~ 9-10cm
Chest - CTAB
CV - irreg, irreg, nl s1 s2, no m/r/g
Abd - NABS, soft, NT/ND, no g/r, no CVA tenderness
Back - nontender to palpation
Ext - chronic venous stasis, 1+ bilat edema

FAMILY HISTORY: Father died MI in 80s, Mother died PE in 80s, twin sister died
of colitis age 30s, no family h/o colon, breast, uterine, or
ovarian ca

SOCIAL HISTORY: lives in [**Location 745**] with wife [**Name (NI) **], one son, one daughter, 6
grandchildren, retired computer science professor, former heavy
cigar smoker, quit in [**2150**], [**2-17**] drinks per week
Atrial fibrillation,Congestive heart failure, unspecified,Acute kidney failure, unspecified,Chronic kidney disease, unspecified,Mitral valve disorders,Hematoma complicating a procedure,Pneumonitis due to inhalation of food or vomitus,Long-term (current) use of anticoagulants,Hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage I through stage IV, or unspecified,Coronary atherosclerosis of native coronary artery,Atrioventricular block, complete,Personal history of malignant neoplasm of large intestine,Hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (LUTS)
Atrial fibrillation,CHF NOS,Acute kidney failure NOS,Chronic kidney dis NOS,Mitral valve disorder,Hematoma complic proc,Food/vomit pneumonitis,Long-term use anticoagul,Hy kid NOS w cr kid I-IV,Crnry athrscl natve vssl,Atriovent block complete,Hx of colonic malignancy,BPH w/o urinary obs/LUTS
Admission Date:  [**2159-2-28**]              Discharge Date:   [**2159-3-14**]

Date of Birth:  [**2079-1-17**]             Sex:   M

Service: MEDICINE

Allergies:
Penicillins / Erythromycin Base / Streptomycin / Citric Acid /
Atenolol

Attending:[**First Name3 (LF) 425**]
Chief Complaint:
syncope

Major Surgical or Invasive Procedure:
1. Cardioversion
2. Intubation
3. Catheterization
4. [**Company 1543**] virtuoso dual chamber ICD placement
5. CPR
6. Blood transfusion


History of Present Illness:
80M HTN, h/o CVA, h/o presyncope with known conduction system
disease, h/o SVT, recent admission in [**2159-1-15**] for afib and CHF
exacerbation. Was discharged on Toprol XL for rate control and
on coumadin with plan for 3 weeks of anticoagulation prior to
elective DCCV. Last seen in cardiology clinic on [**2-21**] and had
been doing well. Scheduled for elective DCCV this week.
.
On day of presentation, was walking to refrigerator. Syncope
witnessed by wife. [**Name (NI) **] that he knew he was going to faint [**2-17**]
seconds prior to losing consciousness and was able to brace fall
with arm, landing on his rear. Wife did not note any tonic
clonic movements. No bowel/bladder incontinence. No preceding
CP, SOB, n/v, diaphoresis, palps, or aura. Was out for several
seconds, followed by 15 seconds of filling "dizzy".
.
States symptoms are similar to prior episodes of presyncope,
except that this episode actually led to LOC, whereas prior
episodes had resolved without intervention.
.
In ED, non-contrast head CT negative for acute bleed.


Past Medical History:
BPH
Incidental R liver cyst
- stable since [**4-19**]
Diverticulosis
Basal cell CA of the nose
- removed [**2157-2-15**]
CVA [**2150**]
- resulting in dysesthesias R hand
- imaging consistent with lacunar hypodensity c/w lacunar
infarct, L cerebellar hypodensity c/w chronic infarct
Cervical spondylosis
Hypertension
varicose veins
Sleep apnea
Colon CA
- s/p chemo/xrt, resection [**9-19**]
Hx of presyncope
- CardioNet monitor in [**4-20**]: episodes of SVT in 130s with
termination after 5-10 beats, no bradyarrythmias
- Conduction system disease: right bundle branch block, left
anterior fascicular block, borderline PR interval


Social History:
lives in [**Location 745**] with wife [**Name (NI) **], one son, one daughter, 6
grandchildren, retired computer science professor, former heavy
cigar smoker, quit in [**2150**], [**2-17**] drinks per week


Family History:
Father died MI in 80s, Mother died PE in 80s, twin sister died
of colitis age 30s, no family h/o colon, breast, uterine, or
ovarian ca

Physical Exam:
VS - T 97.8, BP 120/66, HR 66, RR 18, O2 sat 99% RA, wt 78 kg
Gen - comfortable, NAD, speaking full sentences
HEENT - NCAT, PERRL, EOMI, OP clr, MMM, no LAD, JVP ~ 9-10cm
Chest - CTAB
CV - irreg, irreg, nl s1 s2, no m/r/g
Abd - NABS, soft, NT/ND, no g/r, no CVA tenderness
Back - nontender to palpation
Ext - chronic venous stasis, 1+ bilat edema


Pertinent Results:
studies:
[**2-27**] head ct:
NON-CONTRAST HEAD CT SCAN: There is no evidence of acute
intracranial hemorrhage or shift of the normally midline
structures. The ventricles and sulci are prominent, consistent
with involutional change. There is hypodensity of the cerebral
periventricular white matter, consistent with chronic
microvascular infarction. There are unchanged rounded
infarctions of the right thalamus and a small lacunar infarction
of the posterolateral left thalamus. Hypodensity of the left
cerebellar hemisphere is unchanged, consistent with prior
infarction. There are no CT findings to suggest acute
territorial infarction on today's exam. There are mucus
retention cysts in the floors of the maxillary antrum
bilaterally. Other visualized paranasal sinuses and mastoid air
cells are clear. Osseous and soft tissue structures are
unremarkable.

IMPRESSION: No evidence of acute intracranial hemorrhage.
Unchanged appearance of the brain compared to [**2158-2-15**]
.
cxr [**2-27**]: IMPRESSION: Stable radiographic examination with right
pleural effusion, cardiomegaly, and pulmonary arterial
hypertension, without acute superimposed consolidation.
.
carotid us [**2-28**]: IMPRESSION: Widely patent common and internal
carotid arteries bilaterally.
.
ruq us [**3-2**] IMPRESSION:
1. No apparent biliary or hepatic parenchymal abnormality to
explain hyperbilirubinemia.
2. Cholelithiasis without cholecystitis.
3. Unchanged subcentimeter right hepatic simple cyst.
.
[**2159-3-7**] cath:
COMMENTS:
1. Selective coronary angiography of this right dominant system
revealed
single vessel disease. The LMCA, LAD, and RCA had no obstructive

lesions. The LCX gave off a large OM1 with a hazy 90% lesion.
2. Left ventriculography revealed an ejection fraction of 30%
with
global hypokinesis and no mitral regurgitation.
3. LVEDP was elevated at 20mmHg.
4. During angiography of the left system, the patient had a
asystolic
arrest. As pacer pads were being placed, he transitioned to
complete
heart block with a ventricular escape in the 40s. He was
hypotensive
with SBP in the 40s to 60s. Venous access was obtained and a
transvenous
pacer was successfully placed.
5. Succesful PCI of CX using overlapping bare metal stents
(3.0x12mm
proximal to a 2.5x12mm).

FINAL DIAGNOSIS:
1. One vessel coronary artery disease.
2. Systolic and diastolic dysfunction.
3. Successful bare metal stenting of the circumflex system
.
[**2159-3-8**] echo:
Conclusions:
The left and right atria are markedly dilated. There is mild
symmetric left ventricular hypertrophy with normal cavity size.
Overall left ventricular systolic function is moderately
depressed, with moderate global hypokinesis (EF 35%). The right
ventricular cavity is mildly dilated. There is mild global right
ventricular free wall hypokinesis. The aortic root is mildly
dilated at the sinus level. The aortic valve leaflets (3) are
mildly thickened but aortic stenosis is not present. Trace
aortic regurgitation is seen. The mitral valve leaflets are
mildly thickened. There is no mitral valve prolapse. An
eccentric jet of moderate (2+) mitral regurgitation is seen.
There is mild pulmonary
artery systolic hypertension. There is no pericardial effusion.
A pacemaker lead is seen entering the right atrium, then
traversing the interatrial septum and the mitral valve, with the
lead tip positioned in the trabeculations of the left
ventricular apex.
IMPRESSION: Pacemaker lead at the left ventricular apex.
Moderate global left ventricular systolic dysfunction. Mild
right ventricular systolic dysfunction. Moderate mitral
regurgitation. Mild pulmonary hypertension.
Compared with the prior study (images reviewed) of [**2159-1-23**],
pacemaker lead is new. The other findings appear similar


Brief Hospital Course:
Brief CCU course: The patient is a 80 year old man with h/o
atrial fibrillation, HTN, h/o CVA, h/o SVT, admitted with
presyncope, who had DCCV on [**2159-2-28**]. This lead to sinus
bradycardia and then Atrial tachycardia with 2:1 block. He was
started on dofetilide that night. He underwent DCCV on [**2159-3-1**].
At 2:55 am on [**2159-3-2**] noted to be in NSVT with long interval
pauses (WT 480 with long RR and PVC on tele). Pt found pulseless
and a code blue was called.  The patient was shocked x 3 with
360 J for vtach. Given CPR and went in to PEA arrest. CPR
resumed, got a pulse at 3:08 am per CCU notes (epi x 3, atropine
x 2, bicarb x 2) He was intubated.
.
In the CCU, pt was extubated successfully. There was question of
anoxic brain injury as the patient was not responding when taken
off of propofol. However, he has continued to progress
neurologically. Neurology team did evaluate him on [**2159-3-2**].
Given his rapid improvement thought to be encourarging. However,
could not rule out milder hypoxic-ischemic injury. Noted to have
fevers with CXR consistent with a PNA. Started on vancomycin and
levaquin on [**2159-3-2**] in the am.  The patient was stable and
tranferred to the floor.  On the floor his SVT was treated with
a beta-blocker and his abx were stopped as he had no signs of
infection.  He remained stable on the floor and then went to
cardiac catheterization which was interrupted by CHB and
ventricular asystole, revived with atropine and pacer wire
placement.  He had 90% OM1 lesion stented with little other
disease. He was in the unit and remained stable and on [**3-8**] had
a virtuoso icd placed, he was stable only with a small chest
wall hematoma and was then transferred back to the medicine
floor.
.
Floor course:
1. CAD: The patient's cardiac cath on [**3-7**] demonstrated 90% L Cx
that occluded in cath lab, the lesion was stented with BMS x2,
with good post-stent result.  He remained chest pain free and
was treated with aspirin, plavix, lisinopril and bb.  His statin
was held given his hyperbilirubinemia, and should be restarted
at a later date.
.
2. Arrythmia (Atrial fibrillation/ventricular fibrillation and
CHB): The patient had initially been admitted with atrial
fibrillation.  He was DCCV and doing well but with dofetilide
developed VT/VFib.  He then went to cath and was noted to have
complete heart block.  Given his VT/VFib/CHB he had [**Company **]
(virtuoso) dual chamber ICD placed. He had no further events
during his course and was treated post-ICD with prophylactic
vancomycin and close monitoring by EP.  He had no complications
and will need close follow-up with the device clinic as an
outpatient.  Given his underlying Atrial fibrillation, he will
need his coumadin restarted once cleared by EP.  With the pacer
and beta-blocker he had no further telemetry events and was
stable for discharge.
.
3. CHF: The patient was overloaded on CXR and exam and his Vgram
was consistent with heart failure as well.  He was aggressively
diuresed and was maintained on a beta-blocker and ace.  As an
outpatient he will continue lasix, bb and ace and will need
close monitoring by his doctor for his fluid status.
.
4. Cough: The patient had a minimal cough throughout his course
and did not have CXR findings or fever, so antibiotics were not
used.  His cough was likely due to CHF and he was treated with
nebs, cough syrup and lasix.
.
5. Hyperbilirubinemia since [**2159-1-29**]: Unclear etiology, his US
was negative and he remained asymptomatic.  This was closely
followed and his statin was held.  His Tbili gradually
downtrended and should continue to be followed as an outpatient.
The feeling is that this could have been secondary to shock
liver/stress.
.
5. anemia: The patient had a hematoma after icd placement, and
he was given a total of 3 units prbc.  After this is hct was
stable and he required no further intervention.
.


Medications on Admission:
1. Aspirin 325 mg PO DAILY
2. Toprol XL 200 mg PO once a day
3. Lisinopril 5 mg PO DAILY
4. Warfarin PO DAILY (2.5 M/W/F [**1-16**] tab all other days)
5. Lasix 80 mg [**Hospital1 **]
6. Amitriptyline 50 mg PO HS
7. Docusate Sodium 100 mg PO BID
8. Senna 2 Tablet PO BID
9. MVI
10. Flomax 0.4 daily
11. kdur 20 tid
.
Medications on transfer:
potassium chloride 40 meq po x1 0900
aspirin 325mg po qd
metoprolol 37.5mg po q6
coumadin 2.5mg po q M/W/F, 1.25mg po q T/T
multivitamins
tamsulosin 0.4mg po qd
amitriptyline 50mg po qhs
docusate [**Hospital1 **]
dofetilide 250mcg po q12 hours, last dose 2200
senna prn


Discharge Medications:
1. Aspirin 325 mg Tablet, Delayed Release (E.C.) Sig: One (1)
Tablet, Delayed Release (E.C.) PO DAILY (Daily).
2. Lisinopril 5 mg Tablet Sig: One (1) Tablet PO once a day.
3. Amitriptyline 50 mg Tablet Sig: One (1) Tablet PO HS (at
bedtime).
4. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2
times a day).
5. Tamsulosin 0.4 mg Capsule, Sust. Release 24HR Sig: One (1)
Capsule, Sust. Release 24HR PO HS (at bedtime): flomax.
6. K-Dur 20 mEq Tab Sust.Rel. Particle/Crystal Sig: One (1) Tab
Sust.Rel. Particle/Crystal PO three times a day.
7. Hexavitamin     Tablet Sig: One (1) Cap PO DAILY (Daily).
8. Clopidogrel 75 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
Disp:*30 Tablet(s)* Refills:*2*
9. Metoprolol Tartrate 25 mg Tablet Sig: 0.5 Tablet PO BID (2
times a day).
Disp:*30 Tablet(s)* Refills:*2*
10. Senna 8.6 mg Tablet Sig: Three (3) Tablet PO DAILY (Daily).

11. Warfarin 2.5 mg Tablet Sig: Three (3) Tablet PO HS (at
bedtime): Please have your INR checked in 2 days from discharge.
Goal is [**2-17**].
Disp:*90 Tablet(s)* Refills:*2*
12. Lasix 80 mg Tablet Sig: One (1) Tablet PO twice a day.
Disp:*60 Tablet(s)* Refills:*2*
13. Ambien 5 mg Tablet Sig: One (1) Tablet PO at bedtime for 14
days.
Disp:*14 Tablet(s)* Refills:*0*
14. Percocet 5-325 mg Tablet Sig: One (1) Tablet PO at bedtime
for 10 days: for pain.
Disp:*10 Tablet(s)* Refills:*0*


Discharge Disposition:
Home With Service

Facility:
[**Hospital 119**] Homecare

Discharge Diagnosis:
1. Atrial fibrillation
2. CHF
3. Acute on chronic renal failure
4. Complete heart block
5. Ventricular tachycardia
6. Ventricular fibrillation
7. Hyperbilirubinemia
8. Anemia


Discharge Condition:
stable, tolerating medications


Discharge Instructions:
1. You were admitted with syncope and based on your abnormal
rhythm you were cardioverted and started on medication.  You
also had an ICD placed for your arrythmia, and a catheterization
performed for your heart disease.  Avoid lifting your left arm
more than 90 degrees for 6 weeks, or until advised by device
clinic.
.
2. Weigh yourself every morning, [**Name8 (MD) 138**] MD if weight > 3 lbs.
Adhere to 2 gm sodium diet
.
3. Please attend all follow-up appointments
.
4. Return for fevers, chills, loss of consciousness, shortness
of breath and chest pain.
.
5. Please follow the new medication list we gave you

Followup Instructions:
1. Please make a follow-up appointment with Dr.
[**Last Name (STitle) **],[**First Name3 (LF) **] D. in 1 week.  Call [**Telephone/Fax (1) 3329**] for an
appointment.
2. Please follow-up in device clinic in 1 week as advised.  Call
([**Telephone/Fax (1) 8793**] or ([**Telephone/Fax (1) 5862**] for more information.
3. Please have your INR checked within 2 days from discharge.
Your goal INR is [**2-17**].
{'Atrial fibrillation,Congestive heart failure, unspecified,Acute kidney failure, unspecified,Chronic kidney disease, unspecified,Mitral valve disorders,Hematoma complicating a procedure,Pneumonitis due to inhalation of food or vomitus,Long-term (current) use of anticoagulants,Hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage I through stage IV, or unspecified,Coronary atherosclerosis of native coronary artery,Atrioventricular block, complete,Personal history of malignant neoplasm of large intestine,Hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (LUTS)'}


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: syncope

PRESENT ILLNESS: 80M HTN, h/o CVA, h/o presyncope with known conduction system
disease, h/o SVT, recent admission in [**2159-1-15**] for afib and CHF
exacerbation. Was discharged on Toprol XL for rate control and
on coumadin with plan for 3 weeks of anticoagulation prior to
elective DCCV. Last seen in cardiology clinic on [**2-21**] and had
been doing well. Scheduled for elective DCCV this week.
.
On day of presentation, was walking to refrigerator. Syncope
witnessed by wife. [**Name (NI) **] that he knew he was going to faint [**2-17**]
seconds prior to losing consciousness and was able to brace fall
with arm, landing on his rear. Wife did not note any tonic
clonic movements. No bowel/bladder incontinence. No preceding
CP, SOB, n/v, diaphoresis, palps, or aura. Was out for several
seconds, followed by 15 seconds of filling "dizzy".
.
States symptoms are similar to prior episodes of presyncope,
except that this episode actually led to LOC, whereas prior
episodes had resolved without intervention.
.
In ED, non-contrast head CT negative for acute bleed.

MEDICAL HISTORY: BPH
Incidental R liver cyst
- stable since [**4-19**]
Diverticulosis
Basal cell CA of the nose
- removed [**2157-2-15**]
CVA [**2150**]
- resulting in dysesthesias R hand
- imaging consistent with lacunar hypodensity c/w lacunar
infarct, L cerebellar hypodensity c/w chronic infarct
Cervical spondylosis
Hypertension
varicose veins
Sleep apnea
Colon CA
- s/p chemo/xrt, resection [**9-19**]
Hx of presyncope
- CardioNet monitor in [**4-20**]: episodes of SVT in 130s with
termination after 5-10 beats, no bradyarrythmias
- Conduction system disease: right bundle branch block, left
anterior fascicular block, borderline PR interval

MEDICATION ON ADMISSION: 1. Aspirin 325 mg PO DAILY
2. Toprol XL 200 mg PO once a day
3. Lisinopril 5 mg PO DAILY
4. Warfarin PO DAILY (2.5 M/W/F [**1-16**] tab all other days)
5. Lasix 80 mg [**Hospital1 **]
6. Amitriptyline 50 mg PO HS
7. Docusate Sodium 100 mg PO BID
8. Senna 2 Tablet PO BID
9. MVI
10. Flomax 0.4 daily
11. kdur 20 tid
.
Medications on transfer:
potassium chloride 40 meq po x1 0900
aspirin 325mg po qd
metoprolol 37.5mg po q6
coumadin 2.5mg po q M/W/F, 1.25mg po q T/T
multivitamins
tamsulosin 0.4mg po qd
amitriptyline 50mg po qhs
docusate [**Hospital1 **]
dofetilide 250mcg po q12 hours, last dose 2200
senna prn

ALLERGIES: Penicillins / Erythromycin Base / Streptomycin / Citric Acid /
Atenolol

PHYSICAL EXAM: VS - T 97.8, BP 120/66, HR 66, RR 18, O2 sat 99% RA, wt 78 kg
Gen - comfortable, NAD, speaking full sentences
HEENT - NCAT, PERRL, EOMI, OP clr, MMM, no LAD, JVP ~ 9-10cm
Chest - CTAB
CV - irreg, irreg, nl s1 s2, no m/r/g
Abd - NABS, soft, NT/ND, no g/r, no CVA tenderness
Back - nontender to palpation
Ext - chronic venous stasis, 1+ bilat edema

FAMILY HISTORY: Father died MI in 80s, Mother died PE in 80s, twin sister died
of colitis age 30s, no family h/o colon, breast, uterine, or
ovarian ca

SOCIAL HISTORY: lives in [**Location 745**] with wife [**Name (NI) **], one son, one daughter, 6
grandchildren, retired computer science professor, former heavy
cigar smoker, quit in [**2150**], [**2-17**] drinks per week 

### Response:
{'Atrial fibrillation,Congestive heart failure, unspecified,Acute kidney failure, unspecified,Chronic kidney disease, unspecified,Mitral valve disorders,Hematoma complicating a procedure,Pneumonitis due to inhalation of food or vomitus,Long-term (current) use of anticoagulants,Hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage I through stage IV, or unspecified,Coronary atherosclerosis of native coronary artery,Atrioventricular block, complete,Personal history of malignant neoplasm of large intestine,Hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (LUTS)'}
