CHIEF COMPLAINT: Progressive dyspnea on exertion.

PRESENT ILLNESS: This is a 61 yo male patinet with history od coronary artery
disease and LAD stents x 2 with worsening SOB/DOE/Belching
starting in [**1-20**].  He reports one episode of SOB and pain
radiating to the left arm relieved with two sublingual
nitroglycerine.  He was then referred for cath showing LAD 70%
(in-stent restenosis), [**Location (un) 109**] 1.1 cm2, EF 48%.
He was at that time referred to Dr. [**Last Name (Prefixes) **] for surgery.

MEDICAL HISTORY: Aortic stenosis.
Diabetes-Insulin dependent.
Hypertension.
Hyperlipidimia.
Coronary artery disease s/p LAD stenst [**3-21**].
Obesity.
Benign Prostatic Hypertrophy.

MEDICATION ON ADMISSION: Glyburide 5/500, two tabs [**Hospital1 **].
Zocor 40 daily.
Lisinopril 40 daily.
Toprol 50 daily.
Plavix 75 daily.
Aspirin 325 daily.
Protonix 40 [**Hospital1 **].
Multivitamin daily.
Humalog 10-12 units at dinner.
NPH 56 units q HS.

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: 

FAMILY HISTORY: Mother deceased at age 84 with CAD.

SOCIAL HISTORY: Lives with wife in [**Name (NI) 42513**].  Retired.  Quit smoking 7 years
ago with 76 pack year history.  Reports ETOH consumption rarely.
Aortic valve disorders,Iatrogenic pneumothorax,Other complications due to other cardiac device, implant, and graft,Coronary atherosclerosis of native coronary artery,Percutaneous transluminal coronary angioplasty status,Unspecified essential hypertension,Pure hypercholesterolemia,Hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (LUTS),Obesity, unspecified,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Long-term (current) use of insulin,Osteoarthrosis, unspecified whether generalized or localized, hand
Aortic valve disorder,Iatrogenic pneumothorax,Comp-oth cardiac device,Crnry athrscl natve vssl,Status-post ptca,Hypertension NOS,Pure hypercholesterolem,BPH w/o urinary obs/LUTS,Obesity NOS,DMII wo cmp nt st uncntr,Long-term use of insulin,Osteoarthros NOS-hand
Admission Date:  [**2103-3-19**]              Discharge Date:   [**2103-3-29**]

Date of Birth:  [**2041-3-3**]             Sex:   M

Service: CARDIOTHORACIC

Allergies:
Patient recorded as having No Known Allergies to Drugs

Attending:[**First Name3 (LF) 1283**]
Chief Complaint:
Progressive dyspnea on exertion.

Major Surgical or Invasive Procedure:
Coronary artery bypass graft x 1 and aortic valve replacement
[**2103-3-19**].
Post-op complicated by apical pneumothorax with reinsertion of
chest tube.


[**Last Name (NamePattern4) 15255**] of Present Illness:
This is a 61 yo male patinet with history od coronary artery
disease and LAD stents x 2 with worsening SOB/DOE/Belching
starting in [**1-20**].  He reports one episode of SOB and pain
radiating to the left arm relieved with two sublingual
nitroglycerine.  He was then referred for cath showing LAD 70%
(in-stent restenosis), [**Location (un) 109**] 1.1 cm2, EF 48%.
He was at that time referred to Dr. [**Last Name (Prefixes) **] for surgery.

Past Medical History:
Aortic stenosis.
Diabetes-Insulin dependent.
Hypertension.
Hyperlipidimia.
Coronary artery disease s/p LAD stenst [**3-21**].
Obesity.
Benign Prostatic Hypertrophy.

Social History:
Lives with wife in [**Name (NI) 42513**].  Retired.  Quit smoking 7 years
ago with 76 pack year history.  Reports ETOH consumption rarely.

Family History:
Mother deceased at age 84 with CAD.

Pertinent Results:
[**2103-3-25**] 10:30AM BLOOD WBC-11.8* RBC-2.77* Hgb-8.9* Hct-27.2*
MCV-98 MCH-32.0 MCHC-32.7 RDW-14.1 Plt Ct-250#
[**2103-3-25**] 10:30AM BLOOD Plt Ct-250#
[**2103-3-20**] 04:03AM BLOOD PT-13.9* PTT-26.7 INR(PT)-1.3
[**2103-3-25**] 10:30AM BLOOD Glucose-239* UreaN-23* Creat-0.9 Na-138
K-5.2* Cl-100 HCO3-28 AnGap-15
[**2103-3-25**] 10:30AM BLOOD Calcium-8.7 Phos-3.4 Mg-2.0

Brief Hospital Course:
Mr. [**Name13 (STitle) 22570**] was admitted to the hospital on his operative day.
He underwent a CABG x 1 and aortic valve replacement with Dr. [**Last Name (Prefixes) 42514**].  Please see OP note for full details.  He was
successfully weened and extubated on his operative day.
On POD one he was transferred to the inpatient/telemetry floor
for ongoing management and recovery.
On POD two his medistinal chest tubes were discontinued with one
left pleural chest tube left in place.  On CXR he had a small
left apical PXT.
This PXT was persisent and an POD four, increased slightly in
size with chest tube to water seal.
On POD five a thoracic consult was obtained and a new left sided
chest tube was placed.
On POD six one of the two chest tubes was discontinued with the
other continuing on suction with an ongoing small apical PTX.
On POD seven, CXR on water seal showing marginal improvement in
the PTX however on POD eight, there was slight worsening of the
PTX and the CT was placed back on suction.  On POD nine there
was no change and on POD ten the remaining chest tube was
discontinued with post-pull CXR showing significant improvement
in the PTX.
Throughut his hospital stay, Mr. [**Known lastname 22571**] was followed by the
physical therapy team and was found to be safe for discharge
home.
On [**3-29**], POD ten, Mr. [**Known lastname 22571**] was discharged home with visiting
nurses to follow.

Medications on Admission:
Glyburide 5/500, two tabs [**Hospital1 **].
Zocor 40 daily.
Lisinopril 40 daily.
Toprol 50 daily.
Plavix 75 daily.
Aspirin 325 daily.
Protonix 40 [**Hospital1 **].
Multivitamin daily.
Humalog 10-12 units at dinner.
NPH 56 units q HS.


Discharge Medications:
1. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2
times a day).
Disp:*60 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:*0*
3. Simvastatin 40 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
Disp:*30 Tablet(s)* Refills:*0*
4. 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:*0*
5. Glyburide-Metformin 5-500 mg Tablet Sig: Two (2) Tablet PO
BID (2 times a day).
Disp:*120 Tablet(s)* Refills:*0*
6. Metoprolol Tartrate 25 mg Tablet Sig: Three (3) Tablet PO BID
(2 times a day).
Disp:*180 Tablet(s)* Refills:*0*
7. Ascorbic Acid 500 mg Tablet Sig: One (1) Tablet PO BID (2
times a day).
Disp:*60 Tablet(s)* Refills:*0*
8. Furosemide 40 mg Tablet Sig: One (1) Tablet PO Q12H (every 12
hours) for 10 days.
Disp:*20 Tablet(s)* Refills:*0*
9. Potassium Chloride 20 mEq Tab Sust.Rel. Particle/Crystal Sig:
One (1) Tab Sust.Rel. Particle/Crystal PO Q12H (every 12 hours)
for 10 days.
Disp:*20 Tab Sust.Rel. Particle/Crystal(s)* Refills:*0*
10. Ferrous Gluconate 300 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
Disp:*30 Tablet(s)* Refills:*0*
11. Hydromorphone HCl 2 mg Tablet Sig: 1-2 Tablets PO every four
(4) hours as needed.
Disp:*40 Tablet(s)* Refills:*0*


Discharge Disposition:
Home With Service

Facility:
Ovberlook VNA

Discharge Diagnosis:
Aortic stenosis.
Coronary artery disease.


Discharge Condition:
Stable.

Discharge Instructions:
Shower daily and wash incisions with soap and water.  Rinse
well.  Do not apply nay creams, lotions, powders, or ointments.
You will be able to shower 24 hours after your chest tube has
been removed.
No lifting greater than 10 pounds.
No driving.
Please take all medications as prescribed.
Schedule follow-up appointments as advised.

Followup Instructions:
[**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 1008**], M.D. Where: [**Hospital6 29**] CARDIAC
SERVICES Phone:[**Telephone/Fax (1) 285**] Date/Time:[**2103-6-19**] 12:45
[**Last Name (Prefixes) 413**],[**First Name3 (LF) 412**]  [**Telephone/Fax (1) 170**]  Call to schedule appointment
[**Last Name (LF) **],[**First Name3 (LF) 42515**]  [**Telephone/Fax (1) 42516**]  Call to schedule appointment



Completed by:[**2103-3-29**]
{'Aortic valve disorders,Iatrogenic pneumothorax,Other complications due to other cardiac device, implant, and graft,Coronary atherosclerosis of native coronary artery,Percutaneous transluminal coronary angioplasty status,Unspecified essential hypertension,Pure hypercholesterolemia,Hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (LUTS),Obesity, unspecified,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Long-term (current) use of insulin,Osteoarthrosis, unspecified whether generalized or localized, hand'}


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: Progressive dyspnea on exertion.

PRESENT ILLNESS: This is a 61 yo male patinet with history od coronary artery
disease and LAD stents x 2 with worsening SOB/DOE/Belching
starting in [**1-20**].  He reports one episode of SOB and pain
radiating to the left arm relieved with two sublingual
nitroglycerine.  He was then referred for cath showing LAD 70%
(in-stent restenosis), [**Location (un) 109**] 1.1 cm2, EF 48%.
He was at that time referred to Dr. [**Last Name (Prefixes) **] for surgery.

MEDICAL HISTORY: Aortic stenosis.
Diabetes-Insulin dependent.
Hypertension.
Hyperlipidimia.
Coronary artery disease s/p LAD stenst [**3-21**].
Obesity.
Benign Prostatic Hypertrophy.

MEDICATION ON ADMISSION: Glyburide 5/500, two tabs [**Hospital1 **].
Zocor 40 daily.
Lisinopril 40 daily.
Toprol 50 daily.
Plavix 75 daily.
Aspirin 325 daily.
Protonix 40 [**Hospital1 **].
Multivitamin daily.
Humalog 10-12 units at dinner.
NPH 56 units q HS.

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: 

FAMILY HISTORY: Mother deceased at age 84 with CAD.

SOCIAL HISTORY: Lives with wife in [**Name (NI) 42513**].  Retired.  Quit smoking 7 years
ago with 76 pack year history.  Reports ETOH consumption rarely. 

### Response:
{'Aortic valve disorders,Iatrogenic pneumothorax,Other complications due to other cardiac device, implant, and graft,Coronary atherosclerosis of native coronary artery,Percutaneous transluminal coronary angioplasty status,Unspecified essential hypertension,Pure hypercholesterolemia,Hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (LUTS),Obesity, unspecified,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Long-term (current) use of insulin,Osteoarthrosis, unspecified whether generalized or localized, hand'}
