CHIEF COMPLAINT: 

PRESENT ILLNESS: This is a 68-year-old
gentleman status post coronary artery bypass graft with
coronary artery disease, who approximately a month prior to
admission noticed chest discomfort while walking quickly up a
[**Doctor Last Name **], which resolved spontaneously.  He had a similar
episode, while playing tennis prior to admission.  The
patient states that the symptoms are very similar to the
symptoms of the previous myocardial infarctions.

MEDICAL HISTORY: History revealed the following:
Coronary artery disease status post prior MI, status post
PTCA, status post CABG, mild AS; spinal meningitis at the age
of 2; mild hypertension; and hyperlipidemia.

MEDICATION ON ADMISSION: 

ALLERGIES: The patient is allergic to PENICILLIN (unknown).
CODEINE (nausea).  The patient reports getting VERY SICK WITH
GENERAL ANESTHESIA.  SHELLFISH.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: 
Coronary atherosclerosis of native coronary artery,Intermediate coronary syndrome,Aortic valve disorders,Unspecified essential hypertension,Pure hypercholesterolemia,Heart disease, unspecified,Old myocardial infarction
Crnry athrscl natve vssl,Intermed coronary synd,Aortic valve disorder,Hypertension NOS,Pure hypercholesterolem,Heart disease NOS,Old myocardial infarct
Admission Date:  [**2105-9-11**]       Discharge Date:  [**2105-9-19**]

Date of Birth:   [**2037-7-18**]       Sex:  M

Service:

HISTORY OF THE PRESENT ILLNESS:  This is a 68-year-old
gentleman status post coronary artery bypass graft with
coronary artery disease, who approximately a month prior to
admission noticed chest discomfort while walking quickly up a
[**Doctor Last Name **], which resolved spontaneously.  He had a similar
episode, while playing tennis prior to admission.  The
patient states that the symptoms are very similar to the
symptoms of the previous myocardial infarctions.

The patient had the onset of angina in [**2088**].  Catheterization
revealed high grade circumflex and LAD disease.  He underwent
CABG at [**Hospital1 2025**] with LIMA to diagonal, SVG to LAD, SVG to IM.
The patient had a heart attack in [**2105-2-3**] while in
[**State 108**] with cardiac catheterization revealing 60% distal LM
stenosis, LAD subtotally occluded left diagonal, RCA with
mild disease, SVG to OM, totally occluded with large amount
of thrombus and SVG to LAD with 95% stenosis; LIMA to
diagonal totally occluded.  The patient underwent AngioJet
stenting of OM vein graft along with stenting of SVG-LAD.

Echocardiography in [**2105-3-6**] showed EF of 55% and mild
aortic stenosis.

PAST MEDICAL HISTORY:  History revealed the following:
Coronary artery disease status post prior MI, status post
PTCA, status post CABG, mild AS; spinal meningitis at the age
of 2; mild hypertension; and hyperlipidemia.

PAST SURGICAL HISTORY:
1.  Coronary artery bypass graft in [**2088**].
2.  Precancerous lesion removed from the lip.
3.  Removal of lipoma from the neck.

ALLERGIES:  The patient is allergic to PENICILLIN (unknown).
CODEINE (nausea).  The patient reports getting VERY SICK WITH
GENERAL ANESTHESIA.  SHELLFISH.

MEDICATIONS:
1.  Enteric coated aspirin 325 mg q.d.
2.  Plavix 75 mg q.h.s.
3.  Lisinopril 5 mg q.a.m.
4.  Lipitor 80 mg q.h.s.
5.  Atenolol 50 mg q.h.s.
6.  Folic acid 400 mcg q.d.
7.  Multivitamins.

LABORATORY DATA:  Labs on admission revealed the following:
White blood cells 8.0; hematocrit 45.6; platelet count
208,000; potassium 4.5; BUN 16; creatinine 1.0; INR 1.1.

HOSPITAL COURSE:  The patient was admitted to the hospital on
[**2105-9-11**].  The patient underwent cardiac
catheterization, which showed 90% LAD stenosis, 100%
circumflex stenosis with 50% RCA stenosis, SVG to OM 50%
stenosis, SVG to LAD 100% stenosis; normal ejection fraction.

The patient remained asymptomatic with stable vital signs in
the hospital.  Cardiac surgery was consulted and CABG was
recommended.  The patient was taken to the operating room on
[**Month (only) 216**] 12t, [**2105**], where redo CABG times three was performed
with LIMA to LAD, SVG to RCA, SVG to OM.  Pacing wires, as
well as mediastinal pleural tubes were placed.  The operation
was without complications.  The patient was transferred to
the PACU in a stable condition.

On postoperative day #1, the patient was extubated without
complications.  The patient remained afebrile with stable
vital signs.  He was started on beta blocker on postoperative
day #2.  The patient continues intermittent pressor support
for mild hypertension.  The patient was transferred to the
floor in stable condition.

On postoperative day #3, the patient was afebrile.  Vital
signs were stable.  The chest tube was removed.  The Foley
was removed.  The patient was ambulating and working with
physical therapy.

On postoperative day #4, the patient remained afebrile. Vital
signs were stable.  The patient was working with physical
therapy.  The pacing wires were removed without
complications.

By the time of discharge, the patient has no complaints.
There were active issues.

DISCHARGE MEDICATIONS:
1.  Lopressor ...................PO b.i.d.
2.  Docusate 100 mg PO b.i.d.
3.  Aspirin 325 mg PO q.d.
4.  Tylenol 625 PO q.4h.to 6h.p.r.n.
5.  Hydromorphone 2 mg PO q.4h.to 6h.p.r.n.
6.  Ibuprofen 100 mg PO q.6h.p.r.n.
7.  Ambien 5 mg PO q.h.s.p.r.n.
8.  Bisacodyl 10 mg PO q.d.p.r.n.

CONDITION ON DISCHARGE:  Good.

DISCHARGE STATUS:  The patient is discharged home.

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

DISCHARGE DIAGNOSES:
1.  Coronary artery disease status post redo CABG.
2.  AS stable.
3.  Hypertension.




                            [**Doctor Last Name 412**] [**Last Name (Prefixes) 413**], M.D.  [**MD Number(1) 414**]

Dictated By:[**Last Name (NamePattern4) 28894**]
MEDQUIST36

D:  [**2105-9-18**]  11:14
T:  [**2105-9-18**]  11:24
JOB#:  [**Job Number **]
{'Coronary atherosclerosis of native coronary artery,Intermediate coronary syndrome,Aortic valve disorders,Unspecified essential hypertension,Pure hypercholesterolemia,Heart disease, unspecified,Old myocardial infarction'}


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: This is a 68-year-old
gentleman status post coronary artery bypass graft with
coronary artery disease, who approximately a month prior to
admission noticed chest discomfort while walking quickly up a
[**Doctor Last Name **], which resolved spontaneously.  He had a similar
episode, while playing tennis prior to admission.  The
patient states that the symptoms are very similar to the
symptoms of the previous myocardial infarctions.

MEDICAL HISTORY: History revealed the following:
Coronary artery disease status post prior MI, status post
PTCA, status post CABG, mild AS; spinal meningitis at the age
of 2; mild hypertension; and hyperlipidemia.

MEDICATION ON ADMISSION: 

ALLERGIES: The patient is allergic to PENICILLIN (unknown).
CODEINE (nausea).  The patient reports getting VERY SICK WITH
GENERAL ANESTHESIA.  SHELLFISH.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY:  

### Response:
{'Coronary atherosclerosis of native coronary artery,Intermediate coronary syndrome,Aortic valve disorders,Unspecified essential hypertension,Pure hypercholesterolemia,Heart disease, unspecified,Old myocardial infarction'}
