CHIEF COMPLAINT: chest pain

PRESENT ILLNESS: Ms. [**Known lastname **] is a 73 year old woman who has a history of chest
coronary artery disease s/p a myocardial infarction in [**2131**] and
a large abdominal aortic aneurysm.  She recently had an abnormal
dobutamine stress test and then a cardiac catheterization
revealed three vessel coronary artery disease.

MEDICAL HISTORY: Abdominal aortic aneurysm, diabetes mellitus, myocardial
infarction in [**2131**], Diverticulitis, Neuropathy, Sciatica,
Asthmatic, Bronchitis, Bursitis Rt shoulder, Rotator cuff tear,
Dry eyes

MEDICATION ON ADMISSION: Albuterol Sulfate [Proventil HFA] 90 mcg HFA Aerosol Inhaler
     1-2 puffs IH q 4 hrs as needed for prn

ALLERGIES: Sulfa (Sulfonamide Antibiotics) / Flagyl

PHYSICAL EXAM: Pulse:80 Resp:20  O2 sat:
B/P  Right:108/63    Left: 113/63
Height:5'0"     Weight:137 lbs

FAMILY HISTORY: noncontributory

SOCIAL HISTORY: Ms. [**Known lastname **] is a former smoker who quit 17 yrs ago, with an 80
pack/yr history. She denies drinking alcohol or illicits.
Coronary atherosclerosis of native coronary artery,Chronic systolic heart failure,Atherosclerosis of aorta,Surgical or other procedure not carried out because of contraindication,Other chronic pulmonary heart diseases,Old myocardial infarction,Abdominal aneurysm without mention of rupture,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Other and unspecified hyperlipidemia,Asthma, unspecified type, unspecified,Esophageal reflux,Unspecified hereditary and idiopathic peripheral neuropathy
Crnry athrscl natve vssl,Chr systolic hrt failure,Aortic atherosclerosis,No proc/contraindication,Chr pulmon heart dis NEC,Old myocardial infarct,Abdom aortic aneurysm,DMII wo cmp nt st uncntr,Hyperlipidemia NEC/NOS,Asthma NOS,Esophageal reflux,Idio periph neurpthy NOS
Admission Date:  [**2155-7-9**]              Discharge Date:   [**2155-7-13**]

Date of Birth:  [**2081-12-1**]             Sex:   F

Service: CARDIOTHORACIC

Allergies:
Sulfa (Sulfonamide Antibiotics) / Flagyl

Attending:[**First Name3 (LF) 1505**]
Chief Complaint:
chest pain

Major Surgical or Invasive Procedure:
Median sternotomy, coronary artery bypass grafting aborted
secondary to a heavily calcified aorta and inability to tolerate
an off-pump procedure [**2155-7-9**]


History of Present Illness:
Ms. [**Known lastname **] is a 73 year old woman who has a history of chest
coronary artery disease s/p a myocardial infarction in [**2131**] and
a large abdominal aortic aneurysm.  She recently had an abnormal
dobutamine stress test and then a cardiac catheterization
revealed three vessel coronary artery disease.


Past Medical History:
Abdominal aortic aneurysm, diabetes mellitus, myocardial
infarction in [**2131**], Diverticulitis, Neuropathy, Sciatica,
Asthmatic, Bronchitis, Bursitis Rt shoulder, Rotator cuff tear,
Dry eyes


Social History:
Ms. [**Known lastname **] is a former smoker who quit 17 yrs ago, with an 80
pack/yr history. She denies drinking alcohol or illicits.


Family History:
noncontributory

Physical Exam:
Pulse:80 Resp:20  O2 sat:
B/P  Right:108/63    Left: 113/63
Height:5'0"     Weight:137 lbs

General: comfortable
Skin: Dry [] intact [x]
HEENT: PERRLA [x] EOMI [x]
Neck:  Supple [x] Full ROM [x]
Chest: Lungs clear bilaterally [x]
Heart: RRR [x]  Irregular []  Murmur [-]
Abdomen: Soft [x] non-distended [x] non-tender [x]  bowel sounds
+ [x]
Extremities: Warm [x], well-perfused [x]  Edema Varicosities:
mild to moderate / + spider veins
Neuro: Grossly intact/ moves 4 ext
Pulses:
Femoral      Right:drsg c/i/d   Left: +
DP           Right:   Left:
PT           [**Name (NI) 167**]:+   Left:+
Radial       Right:+   Left:+


Brief Hospital Course:
On [**2155-7-9**] Ms. [**Known lastname **] [**Last Name (Titles) 1834**] a median sternotomy.  Upon opening
the chest her aorta was noted to be heavily calcified to an
extent that an off-pump procedure was deemed to have an
unacceptably high stroke risk.  An off-pump bypass was then
attempted, but her blood pressure was unable to tolerate it.
The bypass was aborted and her chest was closed.  Please see the
operative note for details.  She was transferred in critical but
stable condition to the surgical intensive care unit.  Once
there, she was extubated and weaned from pressors.  By the
following day she was transferred to the surgical step down
floor.  Her chest tubes and epicardial wires were removed.  She
was gently diuresed.  A plan was made with her cardiologist to
return home to regain her strength, and then return at a later
date for stenting of her blocked coronary arteries.  By
post-operative day #4 she was discharged to home.

Medications on Admission:
Albuterol Sulfate [Proventil HFA] 90 mcg HFA Aerosol Inhaler
     1-2 puffs IH q 4 hrs as needed for prn

Budesonide [Pulmicort Flexhaler] 180 mcg/Actuation (160 mcg
delivered) Aerosol Powdr Breath Activated 1 puff IH twice a day


Duloxetine [Cymbalta] 30 mg Capsule, Delayed Release(E.C.)
     1 Capsule(s) by mouth once a day

Formoterol Fumarate [Foradil Aerolizer] 12 mcg Capsule,
w/Inhalation Device 1 cap IH twice a day as needed for prn

Gabapentin 300 mg Capsule 1 Capsule(s) by mouth once a day

Nizatidine 150 mg Capsule 1 Capsule(s) by mouth twice a day

Rosiglitazone [Avandia] 4 mg Tablet 1 Tablet(s) by mouth once a
day

Rosuvastatin [Crestor] 20 mg Tablet 1 Tablet(s) by mouth once a
day

Acetaminophen [Tylenol Arthritis] 650 mg Tablet Sustained
Release
2 Tablet(s) by mouth twice a day

Aspirin [Ecotrin] 325 mg Tablet, Delayed Release (E.C.)
1 Tablet(s) by mouth once a day

Calcium Carbonate [Titralac] 420 mg Tablet, Chewable
1 Tablet(s) by mouth once a day
Calcium Carbonate [Tums] 500 mg Tablet, Chewable 1 Tablet(s) by
mouth three times day

Carboxymethylcellulose Sodium [Thera Tears]
0.25 % Drops 2 gtts OD 2-3 times daily as needed for prn

Ferrous Sulfate 325 mg (65 mg Iron) Tablet 1 Tablet(s) by mouth
once a day

Loratadine 10 mg Tablet
1 Tablet(s) by mouth once a day (Prescribed by Other Provider)
[**2155-6-12**]

Multivitamin Tablet 1 Tablet(s) by mouth once a day

Simethicone [Gas Relief] 180 mg Capsule 2 Capsule(s) by mouth
once a day

Discharge Medications:
1. Metoprolol Tartrate 25 mg Tablet Sig: One (1) Tablet PO BID
(2 times a day).
Disp:*60 Tablet(s)* Refills:*2*
2. Aspirin 81 mg Tablet, Delayed Release (E.C.) Sig: One (1)
Tablet, Delayed Release (E.C.) PO DAILY (Daily).
Disp:*30 Tablet, Delayed Release (E.C.)(s)* Refills:*2*
3. Rosuvastatin 20 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
Disp:*30 Tablet(s)* Refills:*2*
4. Gabapentin 300 mg Capsule Sig: One (1) Capsule PO Q12H (every
12 hours).
5. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO
Q4H (every 4 hours) as needed for pain.
Disp:*30 Tablet(s)* Refills:*0*
6. Rosiglitazone 2 mg Tablet Sig: Two (2) Tablet PO DAILY
(Daily).
7. Duloxetine 30 mg Capsule, Delayed Release(E.C.) Sig: One (1)
Capsule, Delayed Release(E.C.) PO DAILY (Daily).
8. Albuterol Sulfate 90 mcg/Actuation HFA Aerosol Inhaler Sig:
Two (2) Puff Inhalation Q4H (every 4 hours) as needed for
wheezing.
9. Nizatidine 150 mg Capsule Sig: One (1) Capsule PO once a day.

10. Budesonide 180 mcg/Inhalation Aerosol Powdr Breath Activated
Sig: 1-2 puffs Inhalation at bedtime.
11. Formoterol Fumarate 12 mcg Capsule, w/Inhalation Device Sig:
One (1) capsule Inhalation twice a day.
12. Loratadine 10 mg Tablet Sig: One (1) Tablet PO once a day.
13. Thera Tears 0.25 % Drops Sig: [**1-31**]  Ophthalmic three times a
day.
14. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID
(2 times a day).


Discharge Disposition:
Home With Service

Facility:
[**Hospital **] Home Health Care

Discharge Diagnosis:
coronary artery disease


Discharge Condition:
good


Discharge Instructions:
Please shower daily including washing incisions, no baths or
swimming
Monitor wounds for infection - redness, drainage, or increased
pain
Report any fever greater than 101
Report any weight gain of greater than 2 pounds in 24 hours or 5
pounds in a week
No creams, lotions, powders, or ointments to incisions
No driving for approximately one month
No lifting more than 10 pounds for 10 weeks
Please call with any questions or concerns [**Telephone/Fax (1) 170**]


Followup Instructions:
Dr [**Last Name (STitle) **] (cardiac surgeon) in 4 weeks ([**Telephone/Fax (1) 170**]) please
call for appointment
Dr [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **] (cardiologist) in 1 week ([**Telephone/Fax (1) 2394**]) please
call for appointment
Dr [**Last Name (STitle) 82226**] [**Name (STitle) **] (PCP) in [**3-4**] weeks  ([**Telephone/Fax (1) 82227**]) please call
for appointment
Wound check appointment [**Hospital Ward Name 121**] 2 as instructed by nurse
([**Telephone/Fax (1) 3071**])



Completed by:[**2155-7-13**]
{'Coronary atherosclerosis of native coronary artery,Chronic systolic heart failure,Atherosclerosis of aorta,Surgical or other procedure not carried out because of contraindication,Other chronic pulmonary heart diseases,Old myocardial infarction,Abdominal aneurysm without mention of rupture,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Other and unspecified hyperlipidemia,Asthma, unspecified type, unspecified,Esophageal reflux,Unspecified hereditary and idiopathic peripheral neuropathy'}


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: Ms. [**Known lastname **] is a 73 year old woman who has a history of chest
coronary artery disease s/p a myocardial infarction in [**2131**] and
a large abdominal aortic aneurysm.  She recently had an abnormal
dobutamine stress test and then a cardiac catheterization
revealed three vessel coronary artery disease.

MEDICAL HISTORY: Abdominal aortic aneurysm, diabetes mellitus, myocardial
infarction in [**2131**], Diverticulitis, Neuropathy, Sciatica,
Asthmatic, Bronchitis, Bursitis Rt shoulder, Rotator cuff tear,
Dry eyes

MEDICATION ON ADMISSION: Albuterol Sulfate [Proventil HFA] 90 mcg HFA Aerosol Inhaler
     1-2 puffs IH q 4 hrs as needed for prn

ALLERGIES: Sulfa (Sulfonamide Antibiotics) / Flagyl

PHYSICAL EXAM: Pulse:80 Resp:20  O2 sat:
B/P  Right:108/63    Left: 113/63
Height:5'0"     Weight:137 lbs

FAMILY HISTORY: noncontributory

SOCIAL HISTORY: Ms. [**Known lastname **] is a former smoker who quit 17 yrs ago, with an 80
pack/yr history. She denies drinking alcohol or illicits. 

### Response:
{'Coronary atherosclerosis of native coronary artery,Chronic systolic heart failure,Atherosclerosis of aorta,Surgical or other procedure not carried out because of contraindication,Other chronic pulmonary heart diseases,Old myocardial infarction,Abdominal aneurysm without mention of rupture,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Other and unspecified hyperlipidemia,Asthma, unspecified type, unspecified,Esophageal reflux,Unspecified hereditary and idiopathic peripheral neuropathy'}
