CHIEF COMPLAINT: +ETT as outpt, s/p cath

PRESENT ILLNESS: 70 year old man with h/o HTN, hyperlipidemia, 6 months of chest
pain and an abnormal ETT referred for cardiac catheterization.
Pt c/o approximately six months of exertional dyspnea and left
sided chest tightness (non-radiating, "not very bad" but could
not put on [**1-15**] scale). He denies symptoms at rest but notes
that he becomes acutely SOB while shoveling/inc exercise which
persistently resolves with rest. + occ diaphoresis. no
nausea/dizziness. no peripheral edema. On [**2131-1-10**] he underwent an
ETT where he exercised 3 minutes on [**Initials (NamePattern4) **] [**Last Name (NamePattern4) **] protocol, stopping
d/t intense fatigue and shortness of breath (no chest pain). EKG
revealed 2-2.[**Street Address(2) 1755**] depression in leads II, III, avF, and
1-1.5mm ST depression in leads  V4-V6. Referred to [**Hospital1 18**] for
cardiac cath which showed: LAD with 95% ostial stenosis, LMCA
with diffuse disease at 30% blockage, LCA/RCA with mild dz.
Given severity of LAD, he is admitted awaiting CABG on Monday.
After cath, pt remained pain free and no complaints.
*

MEDICAL HISTORY: Hyperlipidemia
Mild diverticulosis
Appendectomy
Kidney stones
Gout

MEDICATION ON ADMISSION: lisinopril - 5mg
lipitor - 10mg daily
allopurinol -
asa - 81mg daily
folic acid

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: s/p cath
BP: 153/65  HR: 58  RR: 16 O2: 98%
GEN: Mr [**Known lastname 36444**] is an eldery male, appears younger than
stated age of 70, resting comfortably flat s/p cath, NAD
HEENT: PERRL, EOMI, sclerae anicteric, OP - pink/clear - no
lesions
 neck: supple - could not assess JVD as pt flat
CARDIAC: rrr, nml S1/S2, no m/g/r
LUNGS: ant lung exam - clear, no wheezes/crackles; nml work of
breathing
ABD: obese, soft, nt/nd
EXT: no c/c/e; 2+ DP pulses; warm/dry
Neuro: alert and oriented X3, responding appropriately

FAMILY HISTORY: no family cardiac hx

SOCIAL HISTORY: Lives with his wife in [**Name (NI) 620**]. Hx of smoking but quite 30yrs
ago.
Coronary atherosclerosis of native coronary artery,Other and unspecified angina pectoris,Cardiac complications, not elsewhere classified,Atrial fibrillation,Gout, unspecified,Other and unspecified hyperlipidemia,Personal history of tobacco use,Personal history of urinary calculi,Unspecified essential hypertension
Crnry athrscl natve vssl,Angina pectoris NEC/NOS,Surg compl-heart,Atrial fibrillation,Gout NOS,Hyperlipidemia NEC/NOS,History of tobacco use,Prsnl hst urnr dsrd calc,Hypertension NOS
Admission Date:  [**2131-1-12**]              Discharge Date:   [**2131-1-21**]

Date of Birth:  [**2060-8-14**]             Sex:   M

Service: CARDIOTHORACIC

Allergies:
Patient recorded as having No Known Allergies to Drugs

Attending:[**First Name3 (LF) 14964**]
Chief Complaint:
+ETT as outpt, s/p cath


Major Surgical or Invasive Procedure:
[**1-12**]- cardiac catheterizations, no complications

History of Present Illness:
70 year old man with h/o HTN, hyperlipidemia, 6 months of chest
pain and an abnormal ETT referred for cardiac catheterization.
Pt c/o approximately six months of exertional dyspnea and left
sided chest tightness (non-radiating, "not very bad" but could
not put on [**1-15**] scale). He denies symptoms at rest but notes
that he becomes acutely SOB while shoveling/inc exercise which
persistently resolves with rest. + occ diaphoresis. no
nausea/dizziness. no peripheral edema. On [**2131-1-10**] he underwent an
ETT where he exercised 3 minutes on [**Initials (NamePattern4) **] [**Last Name (NamePattern4) **] protocol, stopping
d/t intense fatigue and shortness of breath (no chest pain). EKG
revealed 2-2.[**Street Address(2) 1755**] depression in leads II, III, avF, and
1-1.5mm ST depression in leads  V4-V6. Referred to [**Hospital1 18**] for
cardiac cath which showed: LAD with 95% ostial stenosis, LMCA
with diffuse disease at 30% blockage, LCA/RCA with mild dz.
Given severity of LAD, he is admitted awaiting CABG on Monday.
After cath, pt remained pain free and no complaints.
*


Past Medical History:
Hyperlipidemia
Mild diverticulosis
Appendectomy
Kidney stones
Gout


Social History:
Lives with his wife in [**Name (NI) 620**]. Hx of smoking but quite 30yrs
ago.


Family History:
no family cardiac hx

Physical Exam:
s/p cath
BP: 153/65  HR: 58  RR: 16 O2: 98%
GEN: Mr [**Known lastname 36444**] is an eldery male, appears younger than
stated age of 70, resting comfortably flat s/p cath, NAD
HEENT: PERRL, EOMI, sclerae anicteric, OP - pink/clear - no
lesions
 neck: supple - could not assess JVD as pt flat
CARDIAC: rrr, nml S1/S2, no m/g/r
LUNGS: ant lung exam - clear, no wheezes/crackles; nml work of
breathing
ABD: obese, soft, nt/nd
EXT: no c/c/e; 2+ DP pulses; warm/dry
Neuro: alert and oriented X3, responding appropriately


Pertinent Results:
[**2131-1-12**] 12:00PM   GLUCOSE-119* UREA N-21* CREAT-1.0 SODIUM-139
POTASSIUM-4.9 CHLORIDE-105 TOTAL CO2-27 ANION GAP-12
[**2131-1-12**] 12:00PM   ALT(SGPT)-31 AST(SGOT)-20 ALK PHOS-66
AMYLASE-46 TOT BILI-0.5
[**2131-1-12**] 12:00PM   ALBUMIN-4.2
[**2131-1-12**] 12:00PM   WBC-9.2 RBC-4.30* HGB-12.1* HCT-36.4* MCV-85
MCH-28.1 MCHC-33.2 RDW-14.0
[**2131-1-12**] 12:00PM   NEUTS-68.4 LYMPHS-25.3 MONOS-3.2 EOS-2.4
BASOS-0.6
[**2131-1-12**] 12:00PM   PLT COUNT-204
[**2131-1-12**] 12:00PM   PT-13.6 PTT-28.6 INR(PT)-1.2

Brief Hospital Course:
Mr. [**Known lastname 36444**] is a 70 yo male with h/o HTN, hyperlipidemia with
+ETT, s/p cath showing which demonstrated critical stenosis of
the LAD.  He has initially admitted to the medical service, and
subsequently underwent OP CAGBx1 on [**2131-1-15**].  His postoperative
course was fairly routine.  He was transferred from the CSRU to
the cardiac floor on POD#1.  He did develop post-op atrial
fibrilation requiring amiodarone, which chemically cardioverted
him to NSR.  He recovered from that point on and his chest tubes
were d/c'd on POD#2.  He ambulated with physical therapy and was
deemed ready to be discharged home on POD#6.

Medications on Admission:
lisinopril - 5mg
lipitor - 10mg daily
allopurinol -
asa - 81mg daily
folic acid


Discharge Medications:
1. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2
times a day) as needed for constipation.
Disp:*30 Capsule(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. Atorvastatin Calcium 10 mg Tablet Sig: One (1) Tablet PO
DAILY (Daily).
Disp:*30 Tablet(s)* Refills:*2*
4. Acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO Q4H (every
4 hours) as needed.
Disp:*30 Tablet(s)* Refills:*0*
5. Clopidogrel Bisulfate 75 mg Tablet Sig: One (1) Tablet PO
DAILY (Daily): Take for three months post surgery.
Disp:*30 Tablet(s)* Refills:*2*
6. Folic Acid 1 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).
Disp:*30 Tablet(s)* Refills:*2*
7. Allopurinol 100 mg Tablet Sig: Three (3) Tablet PO DAILY
(Daily).
Disp:*90 Tablet(s)* Refills:*2*
8. Metoprolol Tartrate 50 mg Tablet Sig: One (1) Tablet PO BID
(2 times a day).
Disp:*60 Tablet(s)* Refills:*2*
9. Tamsulosin HCl 0.4 mg Capsule, Sust. Release 24HR Sig: One
(1) Capsule, Sust. Release 24HR PO HS (at bedtime).
Disp:*30 Capsule, Sust. Release 24HR(s)* Refills:*2*
10. Pantoprazole Sodium 40 mg Tablet, Delayed Release (E.C.)
Sig: One (1) Tablet, Delayed Release (E.C.) PO Q24H (every 24
hours).
Disp:*30 Tablet, Delayed Release (E.C.)(s)* Refills:*2*
11. Amiodarone HCl 200 mg Tablet Sig: Two (2) Tablet PO TID (3
times a day): Take 400mg po TID for 3 weeks
After 3 weeks take 400 po BID.
Disp:*180 Tablet(s)* Refills:*0*
12. Tylenol-Codeine #3 300-30 mg Tablet Sig: 1-2 Tablets PO
every 4-6 hours as needed for pain.
Disp:*40 Tablet(s)* Refills:*0*


Discharge Disposition:
Home With Service

Facility:
[**Company 1519**]

Discharge Diagnosis:
CAD s/p Off Pump Coronary Artery Bypass Graft x1
Post-Op Atrial Fibrilation
Hyperglcemia Peri-op
Hyperlipidemia
Diverticulosis
s/p Appendectomy
H/O Nephrolithiasis


Discharge Condition:
Excellent

Discharge Instructions:
Call Dr.[**Name (NI) 27686**] office if you develop fever, chills,
recurrent chest pain, increased drainage from your incision, or
if your incision appears red around the edges.

Followup Instructions:
Call Dr.[**Name (NI) 27686**] office for an appointment in 2 weeks
Follow-up with your cardiologist
Folow-up with Dr. [**First Name (STitle) 24344**]
[**Name (STitle) **] with Dr. [**Last Name (STitle) **]
{'Coronary atherosclerosis of native coronary artery,Other and unspecified angina pectoris,Cardiac complications, not elsewhere classified,Atrial fibrillation,Gout, unspecified,Other and unspecified hyperlipidemia,Personal history of tobacco use,Personal history of urinary calculi,Unspecified essential hypertension'}


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: +ETT as outpt, s/p cath

PRESENT ILLNESS: 70 year old man with h/o HTN, hyperlipidemia, 6 months of chest
pain and an abnormal ETT referred for cardiac catheterization.
Pt c/o approximately six months of exertional dyspnea and left
sided chest tightness (non-radiating, "not very bad" but could
not put on [**1-15**] scale). He denies symptoms at rest but notes
that he becomes acutely SOB while shoveling/inc exercise which
persistently resolves with rest. + occ diaphoresis. no
nausea/dizziness. no peripheral edema. On [**2131-1-10**] he underwent an
ETT where he exercised 3 minutes on [**Initials (NamePattern4) **] [**Last Name (NamePattern4) **] protocol, stopping
d/t intense fatigue and shortness of breath (no chest pain). EKG
revealed 2-2.[**Street Address(2) 1755**] depression in leads II, III, avF, and
1-1.5mm ST depression in leads  V4-V6. Referred to [**Hospital1 18**] for
cardiac cath which showed: LAD with 95% ostial stenosis, LMCA
with diffuse disease at 30% blockage, LCA/RCA with mild dz.
Given severity of LAD, he is admitted awaiting CABG on Monday.
After cath, pt remained pain free and no complaints.
*

MEDICAL HISTORY: Hyperlipidemia
Mild diverticulosis
Appendectomy
Kidney stones
Gout

MEDICATION ON ADMISSION: lisinopril - 5mg
lipitor - 10mg daily
allopurinol -
asa - 81mg daily
folic acid

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: s/p cath
BP: 153/65  HR: 58  RR: 16 O2: 98%
GEN: Mr [**Known lastname 36444**] is an eldery male, appears younger than
stated age of 70, resting comfortably flat s/p cath, NAD
HEENT: PERRL, EOMI, sclerae anicteric, OP - pink/clear - no
lesions
 neck: supple - could not assess JVD as pt flat
CARDIAC: rrr, nml S1/S2, no m/g/r
LUNGS: ant lung exam - clear, no wheezes/crackles; nml work of
breathing
ABD: obese, soft, nt/nd
EXT: no c/c/e; 2+ DP pulses; warm/dry
Neuro: alert and oriented X3, responding appropriately

FAMILY HISTORY: no family cardiac hx

SOCIAL HISTORY: Lives with his wife in [**Name (NI) 620**]. Hx of smoking but quite 30yrs
ago. 

### Response:
{'Coronary atherosclerosis of native coronary artery,Other and unspecified angina pectoris,Cardiac complications, not elsewhere classified,Atrial fibrillation,Gout, unspecified,Other and unspecified hyperlipidemia,Personal history of tobacco use,Personal history of urinary calculi,Unspecified essential hypertension'}
