CHIEF COMPLAINT: Chest pain

PRESENT ILLNESS: 58 M c h/o hyperchol, and who has had CP and left arm pain for
few weeks.  Had +ETT at OSH and transfered to [**Hospital1 18**] for cardiac
cath on [**8-9**]. Cath showed severe 3VD and he was d/c home for
CABG schedule for [**2128-8-17**]. On [**2128-8-11**] he developed
intermittent L sided chest pain lasting minutes at a time while
at rest. Not associated with diaphoresis or dyspnea. No radiaton
to neck or arms. He went to OSH and started on heparin gtt. He
was transferred to [**Hospital1 18**] for CABG.

MEDICAL HISTORY: 1. Hyperlipidemia
2. HTN
3. Anxiety
4. CAD -cath [**2128-8-10**]: 3VD
LMCA: mild diffuse dz
LAD: 95% mid lesion; distal R-L collaterals via acute marginal
LCX: 80% prox; OM1 60%
RCA: 80% distal; acute marginal 80% lesion
LVgram: EF 50% with anteriolateral HK
5. s/p appy
6. s/p hernia hydrocele repair
7. s/p anal fissure surgery

MEDICATION ON ADMISSION: 1. ASA 325 PO Qday
2. Lopressor 25 mg PO BID
3. Lipitor 10 mg PO Qday
4. Ativan 0.5 mg PO TID prn
*
had indigestion with captopril

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: 139/61  79  20  97%(2L)
Gen: NAD, comfortable, lying in bed flat
HEENT: o/p clear, mmm, eomi
Neck: jvd @ 7 cm; no carotid bruits
CV: rrr, no m/r/g
PULM: cta b/l
Abd: soft, nt, nd; no cva tenderness
EXT: +2 carotid, radial, femoral and d.pedis pulses b/l; mild
eccymosis at Right groin sight; no femoral bruits
NEURO: CN II-XII intact, moves all 4 ext

FAMILY HISTORY: Mother had AF, PM, silent MI in later years.
Father had several CVA's.

SOCIAL HISTORY: Attorney, also works in real estate and writes tour books
related to national [**Doctor Last Name **]. Lives alone. Non smoker.
Coronary atherosclerosis of native coronary artery,Intermediate coronary syndrome,Unspecified essential hypertension,Pure hypercholesterolemia,Anxiety state, unspecified,Delirium due to conditions classified elsewhere
Crnry athrscl natve vssl,Intermed coronary synd,Hypertension NOS,Pure hypercholesterolem,Anxiety state NOS,Delirium d/t other cond
Admission Date:  [**2128-8-11**]              Discharge Date:   [**2128-8-19**]

Date of Birth:  [**2070-2-17**]             Sex:   M

Service: CARDIOTHORACIC

Allergies:
Patient recorded as having No Known Allergies to Drugs

Attending:[**First Name3 (LF) 1505**]
Chief Complaint:
Chest pain

Major Surgical or Invasive Procedure:
CABGx4


History of Present Illness:
  58 M c h/o hyperchol, and who has had CP and left arm pain for
few weeks.  Had +ETT at OSH and transfered to [**Hospital1 18**] for cardiac
cath on [**8-9**]. Cath showed severe 3VD and he was d/c home for
CABG schedule for [**2128-8-17**]. On [**2128-8-11**] he developed
intermittent L sided chest pain lasting minutes at a time while
at rest. Not associated with diaphoresis or dyspnea. No radiaton
to neck or arms. He went to OSH and started on heparin gtt. He
was transferred to [**Hospital1 18**] for CABG.

Past Medical History:
1. Hyperlipidemia
2. HTN
3. Anxiety
4. CAD -cath [**2128-8-10**]: 3VD
LMCA: mild diffuse dz
LAD: 95% mid lesion; distal R-L collaterals via acute marginal
LCX: 80% prox; OM1 60%
RCA: 80% distal; acute marginal 80% lesion
LVgram: EF 50% with anteriolateral HK
5. s/p appy
6. s/p hernia hydrocele repair
7. s/p anal fissure surgery

Social History:
Attorney, also works in real estate and writes tour books
related to national [**Doctor Last Name **]. Lives alone. Non smoker.

Family History:
Mother had AF, PM, silent MI in later years.
Father had several CVA's.

Physical Exam:
139/61  79  20  97%(2L)
Gen: NAD, comfortable, lying in bed flat
HEENT: o/p clear, mmm, eomi
Neck: jvd @ 7 cm; no carotid bruits
CV: rrr, no m/r/g
PULM: cta b/l
Abd: soft, nt, nd; no cva tenderness
EXT: +2 carotid, radial, femoral and d.pedis pulses b/l; mild
eccymosis at Right groin sight; no femoral bruits
NEURO: CN II-XII intact, moves all 4 ext

Pertinent Results:
EKG: NSR @ 65, N axis, no hypertrophy, IVCD (Right bundle
pattern); TWI in III, aVF

[**2128-8-10**] 11:00AM BLOOD WBC-6.7 RBC-4.47* Hgb-14.4 Hct-38.0*
MCV-85 MCH-32.3* MCHC-38.0* RDW-12.4 Plt Ct-234
[**2128-8-10**] 11:00AM BLOOD Neuts-76.3* Lymphs-19.9 Monos-2.8 Eos-0.4
Baso-0.6
[**2128-8-10**] 11:00AM BLOOD PT-13.3 PTT-28.3 INR(PT)-1.2
[**2128-8-10**] 11:00AM BLOOD Plt Ct-234
[**2128-8-10**] 11:00AM BLOOD Glucose-125* UreaN-12 Creat-0.8 Na-138
K-3.6 Cl-104 HCO3-24 AnGap-14
[**2128-8-10**] 11:00AM BLOOD ALT-17 AST-16 CK(CPK)-62 AlkPhos-75
Amylase-22 TotBili-2.1*
[**2128-8-10**] 11:00AM BLOOD Albumin-4.2
[**2128-8-10**] 11:00AM BLOOD %HbA1c-4.9 [Hgb]-DONE [A1c]-DONE

Brief Hospital Course:
The patient was admitted to the hospital and taken to the
operating room on [**2128-8-13**], where he underwent a CABGx4. Please
see operative note for full details. The patient tolerated this
procedure well. He was taken to the CSRU immediately
post-operatively and was extubated that night. The following
day, the patient did well and was transferred to the floor. On
the night of post-op day #2, the patient became acutely confused
and agitated. He was sedated and seen the following day by the
neurologic and psychiatric services. It was felt at the time
that this acute confusion was most likely due to a combination
of narcotics and anxiety stemming from hospitalization rather
than oxygen desaturation. The patient was transferred back to
the CSRU for monitoring and was found to be mentating well
throughout the remainder of his hospital stay. The patient was
transferred back to the floor on post-op day #4. He was
ambulated and cleared by the physical therapy service. He was
discharged home on post-op day #6 in stable condition.

Medications on Admission:
1. ASA 325 PO Qday
2. Lopressor 25 mg PO BID
3. Lipitor 10 mg PO Qday
4. Ativan 0.5 mg PO TID prn
*
had indigestion with captopril

Discharge Medications:
1. Furosemide 20 mg Tablet Sig: One (1) Tablet PO once a day for
10 days.
Disp:*10 Tablet(s)* Refills:*0*
2. Potassium Chloride 10 mEq Capsule, Sustained Release Sig: Two
(2) Capsule, Sustained Release PO once a day for 10 days.
Disp:*20 Capsule, Sustained Release(s)* Refills:*0*
3. 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*
4. Atorvastatin Calcium 10 mg Tablet Sig: One (1) Tablet PO
DAILY (Daily).
Disp:*30 Tablet(s)* Refills:*2*
5. Metoprolol Tartrate 50 mg Tablet Sig: 1.5 Tablets PO BID (2
times a day).
Disp:*90 Tablet(s)* Refills:*2*


Discharge Disposition:
Home With Service

Facility:
All Care VNA

Discharge Diagnosis:
Coronary artery disease
Hypertension
Hypercholesterolemia
Anxiety disorder


Discharge Condition:
Stable


Discharge Instructions:
Please return tot he hospital or call Dr. [**Last Name (STitle) **] office of you

experience chills or fever greater than 101 degrees F. Please
call if you notice redness, swelling, or tenderness of your
chest wound, or if it begins to drain pus.
No heavy lifting or driving until follow up with Dr. [**Last Name (STitle) **].
You may shower. Wash incision with mild soap and waten, then pat

dry.

Followup Instructions:
Provider: [**Name10 (NameIs) **],[**Name11 (NameIs) **] [**Name Initial (NameIs) **].  [**Telephone/Fax (1) 170**]  Follow-up appointment
should be in 1 month
Please follow up with your primary care physician [**Name Initial (PRE) **]/or
cardiologist in 2 weeks time.
{'Coronary atherosclerosis of native coronary artery,Intermediate coronary syndrome,Unspecified essential hypertension,Pure hypercholesterolemia,Anxiety state, unspecified,Delirium due to conditions classified elsewhere'}


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: Chest pain

PRESENT ILLNESS: 58 M c h/o hyperchol, and who has had CP and left arm pain for
few weeks.  Had +ETT at OSH and transfered to [**Hospital1 18**] for cardiac
cath on [**8-9**]. Cath showed severe 3VD and he was d/c home for
CABG schedule for [**2128-8-17**]. On [**2128-8-11**] he developed
intermittent L sided chest pain lasting minutes at a time while
at rest. Not associated with diaphoresis or dyspnea. No radiaton
to neck or arms. He went to OSH and started on heparin gtt. He
was transferred to [**Hospital1 18**] for CABG.

MEDICAL HISTORY: 1. Hyperlipidemia
2. HTN
3. Anxiety
4. CAD -cath [**2128-8-10**]: 3VD
LMCA: mild diffuse dz
LAD: 95% mid lesion; distal R-L collaterals via acute marginal
LCX: 80% prox; OM1 60%
RCA: 80% distal; acute marginal 80% lesion
LVgram: EF 50% with anteriolateral HK
5. s/p appy
6. s/p hernia hydrocele repair
7. s/p anal fissure surgery

MEDICATION ON ADMISSION: 1. ASA 325 PO Qday
2. Lopressor 25 mg PO BID
3. Lipitor 10 mg PO Qday
4. Ativan 0.5 mg PO TID prn
*
had indigestion with captopril

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: 139/61  79  20  97%(2L)
Gen: NAD, comfortable, lying in bed flat
HEENT: o/p clear, mmm, eomi
Neck: jvd @ 7 cm; no carotid bruits
CV: rrr, no m/r/g
PULM: cta b/l
Abd: soft, nt, nd; no cva tenderness
EXT: +2 carotid, radial, femoral and d.pedis pulses b/l; mild
eccymosis at Right groin sight; no femoral bruits
NEURO: CN II-XII intact, moves all 4 ext

FAMILY HISTORY: Mother had AF, PM, silent MI in later years.
Father had several CVA's.

SOCIAL HISTORY: Attorney, also works in real estate and writes tour books
related to national [**Doctor Last Name **]. Lives alone. Non smoker. 

### Response:
{'Coronary atherosclerosis of native coronary artery,Intermediate coronary syndrome,Unspecified essential hypertension,Pure hypercholesterolemia,Anxiety state, unspecified,Delirium due to conditions classified elsewhere'}
