CHIEF COMPLAINT: cludication

PRESENT ILLNESS: PREOPERATIVE DIAGNOSIS: Bilateral common femoral and
profunda femoris artery stenosis.

MEDICAL HISTORY: -CAD, s/p cath in [**1-21**] with EF 35%, 3vd, s/p 3 v. CABG, c/b
sternal drainage and rewiring in [**2116-2-23**]
-atrial fibrillation, s/p MAZE procedure, on coumadin
-hypertension
-hypercholesterolemia
-diabetes
-AAA, s/p repair in '[**11**]
-h/o colon CA s/p resection
-DJD s/p b/l total knee replacement
-h/o e. coli urosepsis in [**8-20**]

MEDICATION ON ADMISSION: [**Last Name (un) 1724**]: metoprolol 50 mg [**Hospital1 **], aspirin 81 mg qd, Coumadin 6',
Lisinopril 20 mg qd, glipizide 2.5", Lipitor 40 mg qd, Protonix
40', amiodarone 200 mg qd, Magnesium, lasix 40'

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: Physical Exam:
96.2, 158/88, 78, 24, 96% on RA, FS161, I/O 1630/1300
gen - NAD, no dyspnea
HEENT - MMM, OPC, subconj pallor improved
neck - supple, no LAD, no JVD
chest - well healed sternal incision with some scarring. No
erythema/tend or drainage
lungs - CTAB
c/v - RRR, no m/g/r
abd - s/nt/nd
extr - no c/c/e, 2+ b/l radial, fem, & pedal pulses, no bleeding

FAMILY HISTORY: Father died of prostate carcinoma.

SOCIAL HISTORY: Patient lives alone.  He has a remote tobacco history, quit over
18 years ago alcohol use limited to one drink per day.
Atherosclerosis of native arteries of the extremities with intermittent claudication,Chronic airway obstruction, not elsewhere classified,Atrial fibrillation,Stricture of artery,Aortocoronary bypass status,Coronary atherosclerosis of unspecified type of vessel, native or graft,Unspecified essential hypertension,Pure hypercholesterolemia,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Personal history of malignant neoplasm of large intestine,Knee joint replacement
Ath ext ntv at w claudct,Chr airway obstruct NEC,Atrial fibrillation,Stricture of artery,Aortocoronary bypass,Cor ath unsp vsl ntv/gft,Hypertension NOS,Pure hypercholesterolem,DMII wo cmp nt st uncntr,Hx of colonic malignancy,Joint replaced knee
Admission Date:  [**2117-3-11**]              Discharge Date:   [**2117-3-16**]

Date of Birth:  [**2043-5-20**]             Sex:   M

Service: SURGERY

Allergies:
Patient recorded as having No Known Allergies to Drugs

Attending:[**First Name3 (LF) 2597**]
Chief Complaint:
cludication

Major Surgical or Invasive Procedure:
B/L fem endarterectomy


History of Present Illness:
PREOPERATIVE DIAGNOSIS: Bilateral common femoral and
profunda femoris artery stenosis.

POSTOPERATIVE DIAGNOSIS: Bilateral common femoral and
profunda femoris artery stenosis.

PROCEDURE: On the right side, right common femoral and
profunda femoris artery endarterectomy.
Bypass graft from right common femoral artery to distal
profunda femoris artery with 8 mm Dacron graft.
On the left side, left common femoral and profunda femoris
endarterectomy.
Dacron patch angioplasty and angioplasty and stenting of left
external iliac artery with a 10 x 40 self-expanding stent and
completion arteriography.

Past Medical History:
-CAD, s/p cath in [**1-21**] with EF 35%, 3vd, s/p 3 v. CABG, c/b
sternal drainage and rewiring in [**2116-2-23**]
-atrial fibrillation, s/p MAZE procedure, on coumadin
-hypertension
-hypercholesterolemia
-diabetes
-AAA, s/p repair in '[**11**]
-h/o colon CA s/p resection
-DJD s/p b/l total knee replacement
-h/o e. coli urosepsis in [**8-20**]


Social History:
Patient lives alone.  He has a remote tobacco history, quit over
18 years ago alcohol use limited to one drink per day.


Family History:
Father died of prostate carcinoma.

Physical Exam:
Physical Exam:
96.2, 158/88, 78, 24, 96% on RA, FS161, I/O 1630/1300
gen - NAD, no dyspnea
HEENT - MMM, OPC, subconj pallor improved
neck - supple, no LAD, no JVD
chest - well healed sternal incision with some scarring. No
erythema/tend or drainage
lungs - CTAB
c/v - RRR, no m/g/r
abd - s/nt/nd
extr - no c/c/e, 2+ b/l radial, fem, & pedal pulses, no bleeding


neuro - A+Ox3, ambulating well, no focal weakness or loss
sensation

Pertinent Results:
[**2117-3-15**] 03:20AM BLOOD WBC-8.2 RBC-3.50* Hgb-10.0* Hct-28.9*
MCV-82 MCH-28.5 MCHC-34.6 RDW-18.0* Plt Ct-180
[**2117-3-15**] 03:20AM BLOOD PT-14.1* PTT-29.9 INR(PT)-1.3*
[**2117-3-15**] 03:20AM BLOOD Plt Ct-180

Brief Hospital Course:
Patient was admitted and procedure described in brief was
performed

PREOPERATIVE DIAGNOSIS: Bilateral common femoral and
profunda femoris artery stenosis.

POSTOPERATIVE DIAGNOSIS: Bilateral common femoral and
profunda femoris artery stenosis.

PROCEDURE: On the right side, right common femoral and
profunda femoris artery endarterectomy.
Bypass graft from right common femoral artery to distal
profunda femoris artery with 8 mm Dacron graft.
On the left side, left common femoral and profunda femoris
endarterectomy.
Dacron patch angioplasty and angioplasty and stenting of left
external iliac artery with a 10 x 40 self-expanding stent and
completion arteriography.

Patient did well post operatively and and was able to void after
removal of foley catheter and was abulating and working with
physical therapy. Physical therapy deemed the patient
appropriate candidate for D/C to rehab facility. Patient was
restarted on his coumadin for his parosysmal A-fib and his
levels will be evaluated at the rehab facility and his coumadin
dosing will likely need adjusting

Medications on Admission:
[**Last Name (un) 1724**]: metoprolol 50 mg [**Hospital1 **], aspirin 81 mg qd, Coumadin 6',
Lisinopril 20 mg qd, glipizide 2.5", Lipitor 40 mg qd, Protonix
40', amiodarone 200 mg qd, Magnesium, lasix 40'

Discharge Medications:
1. Heparin (Porcine) 5,000 unit/mL Solution Sig: One (1)
Injection TID (3 times a day).
2. Aspirin 325 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).
3. Lisinopril 20 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).

4. Amiodarone 200 mg Tablet Sig: One (1) Tablet PO DAILY (Daily)
for 10 days.
5. Glipizide 5 mg Tablet Sig: 0.5 Tablet PO BID (2 times a day).
Tablet(s)
6. Furosemide 20 mg Tablet Sig: One (1) Tablet PO BID (2 times a
day).
7. Pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One
(1) Tablet, Delayed Release (E.C.) PO Q24H (every 24 hours).
8. Insulin Regular Human 100 unit/mL Solution Sig: One (1)
Injection ASDIR (AS DIRECTED).
9. Atorvastatin 40 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
10. Warfarin 2 mg Tablet Sig: Three (3) Tablet PO HS (at
bedtime).
11. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO
Q4-6H (every 4 to 6 hours) as needed.
12. Albuterol Sulfate 0.083 % Solution Sig: One (1)  Inhalation
Q6H (every 6 hours) as needed.
13. Zolpidem 5 mg Tablet Sig: One (1) Tablet PO HS (at bedtime)
as needed.
14. Metoprolol Tartrate 25 mg Tablet Sig: 1.5 Tablets PO BID (2
times a day).


Discharge Disposition:
Extended Care

Facility:
[**Doctor Last Name **] house

Discharge Diagnosis:
B/L fem endarterectomy


Discharge Condition:
stable


Discharge Instructions:
Weigh yourself every morning, [**Name8 (MD) 138**] MD if weight > 3 lbs.
Adhere to 2 gm sodium diet
Fluid Restriction:1500 cc

Do not remove staples until discussion with Dr. [**Last Name (STitle) **] and
have appointment in 2 weeks, return

Followup Instructions:
F/U in 2 weeks



Completed by:[**2117-3-15**]
{'Atherosclerosis of native arteries of the extremities with intermittent claudication,Chronic airway obstruction, not elsewhere classified,Atrial fibrillation,Stricture of artery,Aortocoronary bypass status,Coronary atherosclerosis of unspecified type of vessel, native or graft,Unspecified essential hypertension,Pure hypercholesterolemia,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Personal history of malignant neoplasm of large intestine,Knee joint replacement'}


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: cludication

PRESENT ILLNESS: PREOPERATIVE DIAGNOSIS: Bilateral common femoral and
profunda femoris artery stenosis.

MEDICAL HISTORY: -CAD, s/p cath in [**1-21**] with EF 35%, 3vd, s/p 3 v. CABG, c/b
sternal drainage and rewiring in [**2116-2-23**]
-atrial fibrillation, s/p MAZE procedure, on coumadin
-hypertension
-hypercholesterolemia
-diabetes
-AAA, s/p repair in '[**11**]
-h/o colon CA s/p resection
-DJD s/p b/l total knee replacement
-h/o e. coli urosepsis in [**8-20**]

MEDICATION ON ADMISSION: [**Last Name (un) 1724**]: metoprolol 50 mg [**Hospital1 **], aspirin 81 mg qd, Coumadin 6',
Lisinopril 20 mg qd, glipizide 2.5", Lipitor 40 mg qd, Protonix
40', amiodarone 200 mg qd, Magnesium, lasix 40'

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: Physical Exam:
96.2, 158/88, 78, 24, 96% on RA, FS161, I/O 1630/1300
gen - NAD, no dyspnea
HEENT - MMM, OPC, subconj pallor improved
neck - supple, no LAD, no JVD
chest - well healed sternal incision with some scarring. No
erythema/tend or drainage
lungs - CTAB
c/v - RRR, no m/g/r
abd - s/nt/nd
extr - no c/c/e, 2+ b/l radial, fem, & pedal pulses, no bleeding

FAMILY HISTORY: Father died of prostate carcinoma.

SOCIAL HISTORY: Patient lives alone.  He has a remote tobacco history, quit over
18 years ago alcohol use limited to one drink per day. 

### Response:
{'Atherosclerosis of native arteries of the extremities with intermittent claudication,Chronic airway obstruction, not elsewhere classified,Atrial fibrillation,Stricture of artery,Aortocoronary bypass status,Coronary atherosclerosis of unspecified type of vessel, native or graft,Unspecified essential hypertension,Pure hypercholesterolemia,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Personal history of malignant neoplasm of large intestine,Knee joint replacement'}
