CHIEF COMPLAINT: Chest pain.

PRESENT ILLNESS: This is a 42 year old man with
an anterior myocardial infarction on [**4-30**], status post left
anterior descending PCI at [**Hospital6 **], who
presented to his primary care physician's office on the
morning of admission with complaints of left substernal chest
pain.  The symptoms began at 9 a.m. with chest pain,
diaphoresis, nausea and some dizziness.  The pain was slow in
onset.  It radiated to the left shoulder; no shortness of
breath.  Similar in location and character to anginal pain
but less severe, seven out of ten as opposed to ten out of
ten with myocardial infarction, not relieved by sublingual
Nitroglycerin.  The pain was also different in that it was
exacerbated by motion, pleuritic in nature.

MEDICAL HISTORY: 1.  Coronary artery disease.
2.  Hypertension.
3.  Hypercholesterolemia.
4.  Gastroesophageal reflux disease.
5.  History of alcohol.
6.  Status post right knee surgery.
7.  Status post tummy tuck in [**2173**].

MEDICATION ON ADMISSION: 

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: No early coronary disease in the family;
father with alcohol abuse.

SOCIAL HISTORY: Attends [**State 1558**] as a
student.  Works at [**Doctor First Name 47672**] Pantry.  Quit tobacco one week;
prior one pack per day times 35 years.  History of heavy
alcohol use; quit eleven months ago.  No illicit drug use.
No intravenous drug use.
Postmyocardial infarction syndrome,Paroxysmal ventricular tachycardia,Congestive heart failure, unspecified,Acute myocardial infarction of other anterior wall, subsequent episode of care,Coronary atherosclerosis of native coronary artery,Unspecified essential hypertension,Pure hypercholesterolemia,Esophageal reflux,Percutaneous transluminal coronary angioplasty status
Post MI syndrome,Parox ventric tachycard,CHF NOS,AMI anterior wall,subseq,Crnry athrscl natve vssl,Hypertension NOS,Pure hypercholesterolem,Esophageal reflux,Status-post ptca
Admission Date:  [**2177-5-15**]       Discharge Date:  [**2177-5-16**]

Date of Birth:   [**2135-1-14**]       Sex:  M

Service:  .

CHIEF COMPLAINT:   Chest pain.

HISTORY OF PRESENT ILLNESS:    This is a 42 year old man with
an anterior myocardial infarction on [**4-30**], status post left
anterior descending PCI at [**Hospital6 **], who
presented to his primary care physician's office on the
morning of admission with complaints of left substernal chest
pain.  The symptoms began at 9 a.m. with chest pain,
diaphoresis, nausea and some dizziness.  The pain was slow in
onset.  It radiated to the left shoulder; no shortness of
breath.  Similar in location and character to anginal pain
but less severe, seven out of ten as opposed to ten out of
ten with myocardial infarction, not relieved by sublingual
Nitroglycerin.  The pain was also different in that it was
exacerbated by motion, pleuritic in nature.

The patient denies shortness of breath, has two to three
pillow orthopnea which is stable.  No paroxysmal nocturnal
dyspnea.  The patient reports loosing weight since discharge
from hospitalization on [**5-5**].  He has mild intermittent
lower extremity edema but no progressive edema.  The patient
was transferred to [**Hospital1 69**] and
underwent cardiac catheterization.

The cardiac catheterization demonstrated a patent left
anterior descending stent, serial 40% lesions in obtuse
marginal 2, 80% right coronary artery lesion with left to
right collaterals from the left anterior descending, PAP
pressures 43/20.

The patient was transferred to the cardiac care unit for
concerns of elevated pulmonary capillary wedge pressures post
procedure.

PAST MEDICAL HISTORY:
1.  Coronary artery disease.
2.  Hypertension.
3.  Hypercholesterolemia.
4.  Gastroesophageal reflux disease.
5.  History of alcohol.
6.  Status post right knee surgery.
7.  Status post tummy tuck in [**2173**].

MEDICATIONS:
1.  Aspirin.
2.  Plavix.
3.  Lipitor 80.
4.  Warfarin 5.
5.  Lisinopril 10.
6.  Atenolol 50 p.o. q. day.
7.  Mirtazapine 30 p.o. q. day.
8.  Zoloft 100 mg q. day.
9.  Neurontin 1500 mg p.o. q. day.
10. Protonix 40 mg p.o. q. day.
11. Lorazepam 0.5 mg p.o. three times a day.
12. Azolitmin nasal spray.

ALLERGIES:   No known drug allergies.

SOCIAL HISTORY:   Attends [**State 1558**] as a
student.  Works at [**Doctor First Name 47672**] Pantry.  Quit tobacco one week;
prior one pack per day times 35 years.  History of heavy
alcohol use; quit eleven months ago.  No illicit drug use.
No intravenous drug use.

FAMILY HISTORY:   No early coronary disease in the family;
father with alcohol abuse.

PHYSICAL EXAMINATION:   Blood pressure 121/66; pulse 56;
respirations 15, O2 saturation 98%.  PA-pressure 36/16 with
mean of 23.  In general, a middle aged man in no acute
distress.  HEENT:  Extraocular muscles are intact.  Moist
mucous membranes.  Neck supple.  No jugular venous
distention.  Cardiovascular is regular rate and rhythm,
positive S3.  Pulmonary clear to auscultation bilaterally.
Abdomen soft, notable for ecchymosis across the lower
abdomen.  Mildly tender around area surrounding bruise.  No
hematomas, not distended.  Positive obesity.  Extremities
with no edema.  Two plus dorsalis pedis pulses bilaterally.
Neurological:  Alert and oriented, appropriate, non-focal.

LABORATORY:  White blood cell count 10.8, normal
differential.  Hematocrit 40.8, platelets 372.   Sodium 137,
potassium hemolyzed, chloride 100, bicarbonate 25, BUN 21,
creatinine 0.6, glucose 88.  CK 159, troponin less than 0.3,
MB 2.0.

Coagulation studies were INR 2.1.

EKG normal sinus rhythm at 70, normal axis and intervals.  ST
elevation in V1 through V4 with Q waves V1 through V3
consistent with evolving old infarction.

HOSPITAL COURSE:   Mr. [**Known lastname **] was admitted to the Cardiac
Care Unit for monitoring overnight.  His hemodynamics
remained stable.  He was negative approximately two liters
post cardiac catheterization and his wedge pressure returned
to [**Location 213**].  His arterial and Swan-Ganz catheter were removed
by morning.

The patient underwent echocardiogram which demonstrated no
pericardial effusion. Ejection fraction 30 to 35% on early
depressed overall left ventricular systolic function.

The patient was started on aspirin 650 mg four times a day
times seven days for treatment of post myocardial infarction
pericarditis.  The patient's Telemetry monitoring
demonstrated no arrhythmia and the patient will continue to
follow-up for further electrophysiology studies as planned
through [**Hospital6 **].

DISCHARGE MEDICATIONS:
1.  Aspirin 650 mg p.o. four times a day times seven days,
then return to aspirin 325 mg p.o. q. day.
2.  Plavix 75 mg p.o. q. day.
3.  Lipitor 80 mg p.o. q. day.
4.  Warfarin 5 mg p.o. q. h.s.; INR measured at 2.6 on
[**2177-5-16**].
5.  Lisinopril 10 mg p.o. q. day.
6.  Atenolol 50 mg p.o. q. day.
7.  Mirtazapine 30 mg p.o. q. day.
8.  Zoloft 100 mg p.o. q. a.m.
9.  Neurontin 1500 mg p.o. q. day.
10. Protonix 40 mg p.o. q. day.
11. Lorazepam 0.5 mg p.o. three times a day p.r.n.
12. Azolitmin spray 137 micrograms, two sprays q. nostril
h.s.
13. Percocet one to two tablets q. six hours p.r.n., dispense
twenty.
14. Nicotine transdermal 21 patch q. day.

DISCHARGE INSTRUCTIONS:
1.  Follow-up as previously planned with Dr. [**Last Name (STitle) **] and Dr.
[**Last Name (STitle) 1617**].
2.  Follow-up with primary care physician, [**Last Name (NamePattern4) **]. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 3265**].
3.  Appointment with Dr. [**Last Name (STitle) **] on [**6-25**] at 03:00 p.m. with
appointment with Dr. [**Last Name (STitle) 1617**] to follow.

PLEASE SEND CARDIAC CATHETERIZATION REPORT AND ECHOCARDIOGRAM
REPORT WITH CARBON COPIES.

DISCHARGE DIAGNOSES:  Pericarditis.

CONDITION ON DISCHARGE:   Good.


                            [**First Name8 (NamePattern2) **] [**First Name8 (NamePattern2) **] [**Name8 (MD) **], M.D.  [**MD Number(1) 7169**]

Dictated By:[**Last Name (NamePattern1) 7485**]
MEDQUIST36

D:  [**2177-5-16**]  16:27
T:  [**2177-5-16**]  22:20
JOB#:  [**Job Number 47673**]

CC.:  DR. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **], [**Hospital1 **], [**Location **],
TELEPHONE NUMBER [**Telephone/Fax (1) 47674**].

DR. [**Last Name (STitle) **], [**Hospital1 2177**] CARDIOLOGY, TELEPHONE NUMBER [**Telephone/Fax (1) 47675**]


Admission Date:                 Discharge Date:

Date of Birth:                  Sex:

Service:

CHIEF COMPLAINT:  Chest pain.

HISTORY OF PRESENT ILLNESS:  The patient is a 42-year-old man
with anterior MI on [**4-30**].  The patient had been
recovering without incident and on [**5-15**], he presented to his
PCP's office with complaints of left substernal chest pain.
The patient states symptoms began approximately 9 a.m. with
slow onset of chest pain radiating to his left shoulder
associated with diaphoresis, nausea, some dizziness.  The
patient denies shortness of breath.  The patient reports the
pain is similar in location and character to his anginal
pain, but less severe.  The pain was 10 out of 10.  The
patient took two sublingual nitroglycerins without relief.
The patient's pain is exacerbated by motion, cough and
reproducible on palpation.  The patient denies shortness of
breath, he notes two to three pillow orthopnea, which is
stable, no paroxysmal nocturnal dyspnea.  The patient reports
having loss weight since discharge from the hospital,
followed by home VNA and had intermittent, but not
progressive lower extremity edema.

The patient was transferred to [**Hospital1 188**].  The patient underwent cardiac catheterization, which
demonstrated patent stent, serial 40% lesions in OM2 and 80%
RCA lesion with left to right collaterals in the LAD.
Hemodynamics in the catheterization lab were suggestive of
fluid overload.  The patient was transferred to cardiac care
unit for further management.

PAST MEDICAL HISTORY:
1.  Coronary artery disease.
2.  Hypertension.
3.  Hypercholesterolemia.
4.  GERD.
5.  History of alcohol.
6.  Status post right knee surgery.
7.  Status post tummy tuck.

MEDICATIONS:
1.  Aspirin.
2.  Plavix.
3.  Lipitor.
4.  Warfarin.
5.  Lisinopril.
6.  Atenolol 50 mg p.o. q.day.







                          [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **], M.D.

Dictated By:[**Last Name (NamePattern1) 7485**]

MEDQUIST36

D:  [**2177-5-16**]  15:03
T:  [**2177-5-20**]  20:16
JOB#:  [**Job Number 47676**]
{'Postmyocardial infarction syndrome,Paroxysmal ventricular tachycardia,Congestive heart failure, unspecified,Acute myocardial infarction of other anterior wall, subsequent episode of care,Coronary atherosclerosis of native coronary artery,Unspecified essential hypertension,Pure hypercholesterolemia,Esophageal reflux,Percutaneous transluminal coronary angioplasty status'}


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 is a 42 year old man with
an anterior myocardial infarction on [**4-30**], status post left
anterior descending PCI at [**Hospital6 **], who
presented to his primary care physician's office on the
morning of admission with complaints of left substernal chest
pain.  The symptoms began at 9 a.m. with chest pain,
diaphoresis, nausea and some dizziness.  The pain was slow in
onset.  It radiated to the left shoulder; no shortness of
breath.  Similar in location and character to anginal pain
but less severe, seven out of ten as opposed to ten out of
ten with myocardial infarction, not relieved by sublingual
Nitroglycerin.  The pain was also different in that it was
exacerbated by motion, pleuritic in nature.

MEDICAL HISTORY: 1.  Coronary artery disease.
2.  Hypertension.
3.  Hypercholesterolemia.
4.  Gastroesophageal reflux disease.
5.  History of alcohol.
6.  Status post right knee surgery.
7.  Status post tummy tuck in [**2173**].

MEDICATION ON ADMISSION: 

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: No early coronary disease in the family;
father with alcohol abuse.

SOCIAL HISTORY: Attends [**State 1558**] as a
student.  Works at [**Doctor First Name 47672**] Pantry.  Quit tobacco one week;
prior one pack per day times 35 years.  History of heavy
alcohol use; quit eleven months ago.  No illicit drug use.
No intravenous drug use. 

### Response:
{'Postmyocardial infarction syndrome,Paroxysmal ventricular tachycardia,Congestive heart failure, unspecified,Acute myocardial infarction of other anterior wall, subsequent episode of care,Coronary atherosclerosis of native coronary artery,Unspecified essential hypertension,Pure hypercholesterolemia,Esophageal reflux,Percutaneous transluminal coronary angioplasty status'}
