CHIEF COMPLAINT: 

PRESENT ILLNESS: The patient is a 65 year-old
male who was admitted for atypical chest pain.  The patient
has a history of hypertension, hypercholesterolemia,
noninsulin dependent diabetes mellitus.  The patient
experienced a bloated feeling after eating and the pain
dissipated with rest.  He had a Myoview scan on [**2200-10-1**],
which showed dilated left ventricle at stress and exercise
associated with left ventricular dysfunction.  EF of 65%.
The patient underwent cardiac catheterization on [**2200-10-6**],
which showed an EF of 65%, patent left main, 50% proximal
obstruction and 80% mid distal obstruction of the left
anterior descending, 90% proximal obstruction of D1, 50%
proximal obstruction of the left circumflex.  For more
detailed account please see catheterization report from
[**2200-10-6**].  The patient now presenting for elective coronary
artery bypass graft surgery.

MEDICAL HISTORY: 1.  Hypertension.
2.  Hypercholesterolemia.
3.  Noninsulin dependent diabetes mellitus.
4.  Nephrolithiasis.
5.  History of cerebrovascular accident.

MEDICATION ON ADMISSION: 1.  Hydrochlorothiazide 75 mg po q day.
2.  Atenolol 25 mg po q day.
3.  Actos 45 mg po q.d.
4.  Captopril 75 mg po b.i.d.
5.  Glyburide 10 mg po b.i.d.
6.  Glucophage 500 mg po b.i.d.
7.  Aspirin 325 mg po q.d.

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: Noncontributory.

SOCIAL HISTORY: The patient lives alone.  Has a 60 year pack
history.  The patient quit in [**2188**].  The patient does not
drink alcohol.
Coronary atherosclerosis of native coronary artery,Cardiac complications, not elsewhere classified,Atrial fibrillation,Anemia, unspecified,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Unspecified essential hypertension,Pure hypercholesterolemia,Personal history of tobacco use
Crnry athrscl natve vssl,Surg compl-heart,Atrial fibrillation,Anemia NOS,DMII wo cmp nt st uncntr,Hypertension NOS,Pure hypercholesterolem,History of tobacco use
Admission Date:  [**2201-1-30**]       Discharge Date:  [**2201-2-9**]

Date of Birth:   [**2135-3-17**]       Sex:  M

Service:  CARDIAC SURGERY

HISTORY OF PRESENT ILLNESS:  The patient is a 65 year-old
male who was admitted for atypical chest pain.  The patient
has a history of hypertension, hypercholesterolemia,
noninsulin dependent diabetes mellitus.  The patient
experienced a bloated feeling after eating and the pain
dissipated with rest.  He had a Myoview scan on [**2200-10-1**],
which showed dilated left ventricle at stress and exercise
associated with left ventricular dysfunction.  EF of 65%.
The patient underwent cardiac catheterization on [**2200-10-6**],
which showed an EF of 65%, patent left main, 50% proximal
obstruction and 80% mid distal obstruction of the left
anterior descending, 90% proximal obstruction of D1, 50%
proximal obstruction of the left circumflex.  For more
detailed account please see catheterization report from
[**2200-10-6**].  The patient now presenting for elective coronary
artery bypass graft surgery.

PAST MEDICAL HISTORY:
1.  Hypertension.
2.  Hypercholesterolemia.
3.  Noninsulin dependent diabetes mellitus.
4.  Nephrolithiasis.
5.  History of cerebrovascular accident.

PAST SURGICAL HISTORY:
1.  Kidney stone removal.
2.  Parotid gland surgery.
3.  Laryngeal polyp resection.

MEDICATIONS ON ADMISSION:
1.  Hydrochlorothiazide 75 mg po q day.
2.  Atenolol 25 mg po q day.
3.  Actos 45 mg po q.d.
4.  Captopril 75 mg po b.i.d.
5.  Glyburide 10 mg po b.i.d.
6.  Glucophage 500 mg po b.i.d.
7.  Aspirin 325 mg po q.d.

ALLERGIES:  No known drug allergies.

SOCIAL HISTORY:  The patient lives alone.  Has a 60 year pack
history.  The patient quit in [**2188**].  The patient does not
drink alcohol.

FAMILY HISTORY:  Noncontributory.

PHYSICAL EXAMINATION:  The patient was in no acute distress,
alert and oriented times three, afebrile.  Vital signs
stable.  99% on room air.  Head was normocephalic,
atraumatic.  No scleral icterus noted.  Neck was soft and
supple.  No masses.  Chest was clear to auscultation
bilaterally.  No rales, wheezes or rhonchi.  Heart was
regular rate and rhythm with no murmurs.  Abdomen obese,
soft, nontender, nondistended.  Positive bowel sounds.
Extremities were without clubbing, cyanosis or edema.
Neurologically the patient was grossly intact.

PERTINENT IMAGING AND CARDIAC EVALUATION:  As noted in the
history of present illness.

HOSPITAL COURSE:  The patient is a 65 year-old male with
coronary artery disease who presents for elective coronary
artery bypass graft procedure to the Cardiac Surgery Service
in [**2201-1-30**].  The patient was taken to the Operating Room on
[**2201-1-30**] for the aforementioned coronary artery bypass graft
times two.  For more detailed account please see operative
report.  Surgeon was Dr. [**Last Name (STitle) 70**] assisted by Dr.
[**Last Name (STitle) 92328**].  Postoperatively, the patient was transferred to
the CSRU.  The patient was extubated on postoperative day
number one and had a small neo-synephrine requirement of 0.4
to maintain a blood pressure in the systolic of 120s.  In
addition, on postoperative day number one the patient was
transfused one unit of packed red blood cells for a
hematocrit of 25.0.  Later on in the day the neo was weaned
off.  On postoperative day number four the patient's chest
tube was discontinued.  The patient was again transfused one
unit of blood for a hematocrit of 24.0.  On postoperative day
number four later on the patient went into a rapid atrial
fibrillation arrhythmia with a heart rate in the 140 to 160
range.  The patient was treated with Lopressor 5 mg
intravenously times four in addition to an Amiodarone bolus.
The patient's heart pattern went into a 2 to 1 atrial flutter
with a rate in the 130s to 140s.  On postoperative day number
five electrophysiology/cardiology was consulted who
recommended an increase in beta blockade and maintaining
Amiodarone intravenously for patient's continued arrhythmia
and tachycardia.  The patient remained hemodynamically stable
despite the heart rate throughout this episode.  The patient
was also started on heparin intravenously for
anticoagulation.

Later on postoperative day number five the
electrophysiologist used the pericardial wires in order to
electrocardioverted the patient to normal sinus rhythm.  The
patient tolerated this very well.  Later on postoperative day
number six the patient was transferred to the floor.  The
patient was stable in normal sinus rhythm on Amiodarone po as
well as high dose beta blockade.  Postoperative day number
eight the patient was started on Coumadin in order to
anticoagulate for postoperative arrhythmia.  The patient was
maintained on heparin intravenously until INR was at suitably
therapeutic level.  On postoperative day number nine the
patient was transfused one unit of packed red blood cells for
a hematocrit of 25.7.  On postoperative day number nine the
patient was started on iron supplementation for persistent
anemia.  On postoperative day number ten the patient was
doing well.  INR was 2.1.  On postoperative day number ten
the patient's INR went down from 2.1 to 1.6 and Coumadin dose
will be adjusted expectedly.  The patient was deemed well
enough to go home at this time.  The patient was cleared by
physical therapy.  The patient is to go home with visiting
nurse assistance.

DISCHARGE CONDITION:  Good.

DISCHARGE DIAGNOSES:
1.  Coronary artery disease.
2.  Status post coronary artery bypass graft.
3.  Postoperative atrial flutter.
4.  Status post electrocardioversion.
5.  Insulin dependent diabetes mellitus.
6.  Hypertension.
7.  Anemia.

FOLLOW UP:  The patient is to follow up with Dr. [**Last Name (STitle) **] in
two to three weeks for a postoperative appointment as well as
periodically for INR checks.  The patient is also to follow
up with the [**Hospital 409**] Clinic in one to two weeks.  The patient is
also to follow up with his cardiologist in two to four weeks.
The patient is to follow up with Dr. [**Last Name (STitle) 70**] in six weeks.

DISCHARGE MEDICATIONS:
1.  Metoprolol 100 mg po b.i.d.
2.  Potassium chloride 20 milliequivalents po q 12 hours
times ten days.
3.  Colace 100 mg po b.i.d.
4.  Aspirin 325 mg po q day.
5.  Percocet one to two tabs po q 4 to 6 hours prn for pain.
6.  Magnesium hydroxide 2400 mg po q.h.s. prn for
constipation.
7.  Metformin 500 mg po b.i.d.
8.  Pioglitazone 45 mg po q day.
9.  Glyburide 10 mg po b.i.d.
10.  Plavix 75 mg po q day.
11.  Amiodarone 400 mg po b.i.d. times one week and then 400
mg po q day.
12.  Coumadin 2 mg po q day with a therapeutic INR between 2
and 2.5.
13.  Norvasc 5 mg po q day.
14.  Protonix 40 mg po q day.
15.  Ascorbic acid 500 mg po b.i.d.
16.  Ferrous sulfate 325 mg po q day.
17.  Lasix 20 mg po b.i.d. times ten days.






                            [**Known firstname **] [**Initials (NamePattern4) **] [**Last Name (NamePattern4) **], M.D.  [**MD Number(1) 75**]

Dictated By:[**Name8 (MD) 7190**]
MEDQUIST36

D:  [**2201-2-9**]  10:25
T:  [**2201-2-9**]  10:28
JOB#:  [**Job Number 92329**]
{'Coronary atherosclerosis of native coronary artery,Cardiac complications, not elsewhere classified,Atrial fibrillation,Anemia, unspecified,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Unspecified essential hypertension,Pure hypercholesterolemia,Personal history of tobacco use'}


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 65 year-old
male who was admitted for atypical chest pain.  The patient
has a history of hypertension, hypercholesterolemia,
noninsulin dependent diabetes mellitus.  The patient
experienced a bloated feeling after eating and the pain
dissipated with rest.  He had a Myoview scan on [**2200-10-1**],
which showed dilated left ventricle at stress and exercise
associated with left ventricular dysfunction.  EF of 65%.
The patient underwent cardiac catheterization on [**2200-10-6**],
which showed an EF of 65%, patent left main, 50% proximal
obstruction and 80% mid distal obstruction of the left
anterior descending, 90% proximal obstruction of D1, 50%
proximal obstruction of the left circumflex.  For more
detailed account please see catheterization report from
[**2200-10-6**].  The patient now presenting for elective coronary
artery bypass graft surgery.

MEDICAL HISTORY: 1.  Hypertension.
2.  Hypercholesterolemia.
3.  Noninsulin dependent diabetes mellitus.
4.  Nephrolithiasis.
5.  History of cerebrovascular accident.

MEDICATION ON ADMISSION: 1.  Hydrochlorothiazide 75 mg po q day.
2.  Atenolol 25 mg po q day.
3.  Actos 45 mg po q.d.
4.  Captopril 75 mg po b.i.d.
5.  Glyburide 10 mg po b.i.d.
6.  Glucophage 500 mg po b.i.d.
7.  Aspirin 325 mg po q.d.

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: Noncontributory.

SOCIAL HISTORY: The patient lives alone.  Has a 60 year pack
history.  The patient quit in [**2188**].  The patient does not
drink alcohol. 

### Response:
{'Coronary atherosclerosis of native coronary artery,Cardiac complications, not elsewhere classified,Atrial fibrillation,Anemia, unspecified,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Unspecified essential hypertension,Pure hypercholesterolemia,Personal history of tobacco use'}
