CHIEF COMPLAINT: 

PRESENT ILLNESS: The patient is a 69 year old
female with past medical history significant for
hypercholesterolemia, hypothyroidism, osteoporosis, who
presented to outside hospital with complaint of one week of
right sided chest pain, burning, for one week.  The pain was
worsened on exertion.  The patient was given Nitroglycerin by
her husband which did not relieve her pain.  The patient
denied shortness of breath, nausea, vomiting, fever and
chills.  At the outside hospital, the patient's troponin was
1.68.  Prevacid did not bring any relief.  On the
electrocardiogram, she had ST depression in leads II, III and
aVF with flipped T waves in lead III.  The patient was given
one dose of Lovenox at the outside hospital and transferred
to [**Hospital1 69**] for further
evaluation and management.

MEDICAL HISTORY: 1.  Hypercholesterolemia.
2.  Hypothyroidism.
3.  Osteoporosis.

MEDICATION ON ADMISSION: 1.  Enteric Coated Aspirin 81 mg once daily.
2.  Lovenox one dose.
3.  Synthroid 0.25 mg once daily.
4.  Pravachol 10 mg p.o. q.h.s.

ALLERGIES: Sulfa.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: 
Subendocardial infarction, initial episode of care,Hematoma complicating a procedure,Coronary atherosclerosis of native coronary artery,Unspecified essential hypertension,Pure hypercholesterolemia,Unspecified acquired hypothyroidism,Osteoporosis, unspecified,Constipation, unspecified
Subendo infarct, initial,Hematoma complic proc,Crnry athrscl natve vssl,Hypertension NOS,Pure hypercholesterolem,Hypothyroidism NOS,Osteoporosis NOS,Constipation NOS
Admission Date:  [**2176-7-8**]       Discharge Date:  [**2176-7-15**]

Date of Birth:   [**2107-8-17**]       Sex:  F

Service:  CARDIOTHORACIC SURGERY

PAST MEDICAL HISTORY:
1.  Hypercholesterolemia.
2.  Hypothyroidism.
3.  Osteoporosis.

ALLERGIES:  Sulfa.

MEDICATIONS ON ADMISSION:
1.  Enteric Coated Aspirin 81 mg once daily.
2.  Lovenox one dose.
3.  Synthroid 0.25 mg once daily.
4.  Pravachol 10 mg p.o. q.h.s.

HISTORY OF PRESENT ILLNESS:  The patient is a 69 year old
female with past medical history significant for
hypercholesterolemia, hypothyroidism, osteoporosis, who
presented to outside hospital with complaint of one week of
right sided chest pain, burning, for one week.  The pain was
worsened on exertion.  The patient was given Nitroglycerin by
her husband which did not relieve her pain.  The patient
denied shortness of breath, nausea, vomiting, fever and
chills.  At the outside hospital, the patient's troponin was
1.68.  Prevacid did not bring any relief.  On the
electrocardiogram, she had ST depression in leads II, III and
aVF with flipped T waves in lead III.  The patient was given
one dose of Lovenox at the outside hospital and transferred
to [**Hospital1 69**] for further
evaluation and management.

PHYSICAL EXAMINATION:  On admission, temperature is 97.8,
pulse 64 and regular, blood pressure 120/80, respiratory rate
18, oxygen saturation 98% in room air.  No carotid bruits, no
jugular venous distention.  Heart - regular rate and rhythm
with normal S1 and S2, I/VI systolic ejection murmur at the
left upper sternal border.  The lungs are clear to
auscultation bilaterally.  The abdomen is soft, nontender,
nondistended.  Extremities are warm and well perfused.  No
edema.

LABORATORY DATA:  On admission, white blood cell count was
7.1, hematocrit 38.0, platelet count 285,000.  INR was 1.2.
Sodium 141, potassium 4.0, blood urea nitrogen 13, creatinine
0.5.

HOSPITAL COURSE:  The patient was admitted to Medicine
service on [**2176-7-8**].  In addition to her own medications, she
was started on a beta blocker and Integrilin.  The patient
underwent cardiac catheterization on [**2176-7-9**], which showed
50% proximal left anterior descending lesion, 60% mid left
anterior descending lesion involving the origin of the major
diagonal, left circumflex distal 95% involving origin of OM3
which is 95% narrowed at origin, 60% OM2 origin, right
coronary artery 70% origin, 95% mid left to right collateral
to posterior descending artery, 1+ mitral regurgitation, left
ventricular ejection fraction 45%, moderate inferior
hypokinesis.

Cardiac surgery was consulted and coronary artery bypass
graft was recommended for this patient.  After appropriate
preoperative workup, the patient went to the operating room
on [**2176-7-10**], where a coronary artery bypass graft times four
was performed (left internal mammary artery to left anterior
descending, saphenous vein graft to diagonal, saphenous vein
graft to OM1, saphenous vein graft to posterior descending
II).  The operation went without complications. Pacing wires,
as well as two mediastinal and one pleural chest tubes, were
placed.  The patient was transferred to Post Anesthesia Care
Unit without complications.

Postoperative day number zero, the patient was extubated
without complications.  Postoperative day number one, the
patient was doing well.  Vital signs were stable.  She was
weaned off drips and started on p.o. Lopressor.  Her chest
tube was removed.

Postoperative day number two, the patient remained afebrile
and vital signs were stable.  Her Foley and wire were
removed.  The patient ambulates and works with physical
therapy without any complications.

Postoperative day number three and four, the patient has no
complaints, afebrile, continued to ambulate.  No complaints
and no active issues.

CONDITION ON DISCHARGE:  Good.

DISCHARGE STATUS:  The patient is discharged home.

FOLLOW-UP:  The patient should follow-up with Dr. [**Last Name (STitle) **] in
four weeks for postoperative check and follow-up.

MEDICATIONS ON DISCHARGE:
1.  Lasix 20 mg p.o. q12hours for fourteen days.
2.  Potassium Chloride 20 meq p.o. twice a day for fourteen
days.
3.  Enteric Coated Aspirin 325 mg p.o. once daily.
4.  Levothyroxine 25 mcg p.o. once daily.
5.  Pravastatin 20 mg p.o. q.h.s.
6.  Metoprolol 25 mg p.o. twice a day.
7.  Percocet one to two tablets p.o. q4-6hours p.r.n. for
pain.
8.  Colace 100 mg p.o. twice a day while taking Percocet.

DISCHARGE DIAGNOSES:
1.  Coronary artery disease, unstable angina, status post
coronary artery bypass graft times four.
2.  Hypercholesterolemia.
3.  Hypothyroidism.
4.  Osteoporosis.




                            [**First Name11 (Name Pattern1) 1112**] [**Last Name (NamePattern1) **], M.D.  [**MD Number(1) 3113**]

Dictated By:[**Last Name (NamePattern4) 15509**]
MEDQUIST36

D:  [**2176-7-14**]  11:23
T:  [**2176-7-14**]  11:58
JOB#:  [**Job Number 44125**]
{'Subendocardial infarction, initial episode of care,Hematoma complicating a procedure,Coronary atherosclerosis of native coronary artery,Unspecified essential hypertension,Pure hypercholesterolemia,Unspecified acquired hypothyroidism,Osteoporosis, unspecified,Constipation, unspecified'}


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: The patient is a 69 year old
female with past medical history significant for
hypercholesterolemia, hypothyroidism, osteoporosis, who
presented to outside hospital with complaint of one week of
right sided chest pain, burning, for one week.  The pain was
worsened on exertion.  The patient was given Nitroglycerin by
her husband which did not relieve her pain.  The patient
denied shortness of breath, nausea, vomiting, fever and
chills.  At the outside hospital, the patient's troponin was
1.68.  Prevacid did not bring any relief.  On the
electrocardiogram, she had ST depression in leads II, III and
aVF with flipped T waves in lead III.  The patient was given
one dose of Lovenox at the outside hospital and transferred
to [**Hospital1 69**] for further
evaluation and management.

MEDICAL HISTORY: 1.  Hypercholesterolemia.
2.  Hypothyroidism.
3.  Osteoporosis.

MEDICATION ON ADMISSION: 1.  Enteric Coated Aspirin 81 mg once daily.
2.  Lovenox one dose.
3.  Synthroid 0.25 mg once daily.
4.  Pravachol 10 mg p.o. q.h.s.

ALLERGIES: Sulfa.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY:  

### Response:
{'Subendocardial infarction, initial episode of care,Hematoma complicating a procedure,Coronary atherosclerosis of native coronary artery,Unspecified essential hypertension,Pure hypercholesterolemia,Unspecified acquired hypothyroidism,Osteoporosis, unspecified,Constipation, unspecified'}
