CHIEF COMPLAINT: 

PRESENT ILLNESS: The patient is a 62-year-old
male with no prior history of coronary artery disease who
presented with a 2-day history of substernal chest pain.

MEDICAL HISTORY: 1.  Hypercholesterolemia.
2.  Asthma.
3.  Vitiligo.
4.  Low back pain with disk disease.
5.  Status post multiple stab wounds approximately 24 years
ago.

MEDICATION ON ADMISSION: 1.  Percocet p.o. t.i.d.
2.  Lipitor 10 mg p.o. q.d.
3.  Albuterol 1 to 2 puffs q.8h.
4.  Prilosec 30 mg p.o. q.d.

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: The patient reportedly lives alone.  He
smoked one pack per day for about 10 years, but he quit 25
years ago.  The patient does not drink alcohol or use drugs.
Subendocardial infarction, initial episode of care,Cellulitis and abscess of upper arm and forearm,Infection and inflammatory reaction due to other vascular device, implant, and graft,Coronary atherosclerosis of native coronary artery,Methicillin susceptible Staphylococcus aureus in conditions classified elsewhere and of unspecified site,Infection with microorganisms resistant to penicillins,Vitiligo,Asthma, unspecified type, unspecified,Degeneration of lumbar or lumbosacral intervertebral disc
Subendo infarct, initial,Cellulitis of arm,React-oth vasc dev/graft,Crnry athrscl natve vssl,Mth sus Stph aur els/NOS,Inf mcrg rstn pncllins,Vitiligo,Asthma NOS,Lumb/lumbosac disc degen
Admission Date:  [**2100-12-17**]     Discharge Date:  [**2101-1-1**]

Date of Birth:   [**2038-4-1**]     Sex:  M

Service:

HISTORY OF PRESENT ILLNESS:  The patient is a 62-year-old
male with no prior history of coronary artery disease who
presented with a 2-day history of substernal chest pain.

The patient stated the pain started as a pressure at rest,
but the pain awoke him from sleep and turned to frank pain
with an intensity of [**8-18**].  The patient was diaphoretic with
chills and had a pain in his throat with deep breaths and
positive shortness of breath.  The patient had no nausea,
vomiting, or other radiation.  Because the patient thought
the pain was musculoskeletal in origin, the patient did not
immediately seek medical attention.

The patient reported the pain was constant until he was seen
by his primary care physician.  [**Name10 (NameIs) **] patient reported he had a
similar episode of substernal chest pain approximately five
to six months prior to admission; lasting about 45 minutes
and resolving spontaneously.

The patient reportedly went to his primary care physician's
office on the day of admission and was given three doses of
sublingual nitroglycerin which relieved his pain but dropped
his blood pressure.

The patient was found to have new Q waves in the inferior
leads and was therefore transferred to the Emergency
Department.  There, the patient was started on heparin,
nitroglycerin, nitroglycerin paste, aspirin, and oxygen.
Since then, the patient was most pain free; although, he did
have some pain when walking.

PAST MEDICAL HISTORY:
1.  Hypercholesterolemia.
2.  Asthma.
3.  Vitiligo.
4.  Low back pain with disk disease.
5.  Status post multiple stab wounds approximately 24 years
ago.

MEDICATIONS ON ADMISSION:
1.  Percocet p.o. t.i.d.
2.  Lipitor 10 mg p.o. q.d.
3.  Albuterol 1 to 2 puffs q.8h.
4.  Prilosec 30 mg p.o. q.d.

ALLERGIES:  No known drug allergies.

SOCIAL HISTORY:  The patient reportedly lives alone.  He
smoked one pack per day for about 10 years, but he quit 25
years ago.  The patient does not drink alcohol or use drugs.

HOSPITAL COURSE:  The patient was evaluated by the Medicine
team upon arrival in the Emergency Department.  The patient
was started on aspirin, Lopressor, Integrilin, morphine as
needed, heparin, nitroglycerin, and Lipitor with relief in
his pain symptoms.  Thereafter, the patient was evaluated by
Cardiology.

The patient remained symptom free throughout hospital days
number two, three, and four and was ultimately taken to the
cardiac catheterization laboratory on hospital day five with
the following findings.  The patient had a left ventricular
ejection fraction of 35% with inferior akinesis and
anteroapical hypokinesis.  The patient was noted to have an
occlusion of the left anterior descending artery proximally
but with filling from the left and right collaterals.  The
patient had 90% stenosis of the first diagonal.  The left
circumflex had minimal irregularities.  The right coronary
artery had 95% medial stenosis with intraluminal thrombus.

Cardiac Surgery was consulted thereafter and saw the patient
on the same day.  The decision was made to take the patient
to the operating room for coronary artery bypass graft.
Surgery was delayed by a few days when the patient developed
a left thrombophlebitis at the site of an intravenous line.
Cultures from the site ultimately grew methicillin-resistant
Staphylococcus aureus.  The site of the patient's cellulitis
was incised and drained on [**2100-12-23**].

Following improvement in the patient's symptoms from the
cellulitis, the patient was taken to the operating room on
[**2100-12-27**] for coronary artery bypass graft.  The
patient had a 2-vessel bypass with the internal mammary being
grafted to the left anterior descending artery and the
saphenous vein graft to the diagonal.

The patient had an uneventful stay in the Cardiothoracic
Recovery Care Unit and was transferred to the Cardiothoracic
Surgery floor on postoperative day two.

The patient also had an uneventful stay on the Cardiac
Surgery floor.  Given the patient's need for intravenous
antibiotics for two weeks following discharge, a peripherally
inserted central catheter line was placed on postoperative
day four.  Arrangements were made for the patient to receive
the required supplies and nursing visits in order to continue
this therapy.

The patient was ultimately discharged on postoperative day
five.  By the time of discharge, the patient's pain was well
controlled on oral pain medication, and he was ambulating
well on the floor.

CONDITION AT DISCHARGE:  Condition on discharge was stable.

MEDICATIONS ON DISCHARGE:
 1.  Lopressor 37.5 mg p.o. b.i.d.
 2.  Lasix 20 mg p.o. b.i.d.
 3.  Potassium chloride 20 mEq p.o. b.i.d.
 4.  Colace 100 mg p.o. b.i.d.
 5.  Enteric-coated aspirin 325 mg p.o. q.d.
 6.  Motrin 400 mg p.o. q.4-6h. as needed.
 7.  Percocet.
 8.  Vancomycin 1 g intravenously q.12h.
 9.  Atorvastatin 10 mg p.o. q.d.
10.  Captopril 12.5 mg p.o. t.i.d.

DISCHARGE FOLLOWUP:
1.  The patient was to follow up with Dr. [**Last Name (STitle) 70**] six weeks
following discharge.
2.  The patient was also to follow up with his primary care
physician following discharge.

DISCHARGE DIAGNOSES:
1.  Coronary artery disease requiring coronary artery bypass
graft.
2.  Methicillin-resistant Staphylococcus aureus
thrombophlebitis.





                          [**First Name11 (Name Pattern1) **] [**Initials (NamePattern4) **] [**Last Name (NamePattern4) **], M.D.  [**MD Number(1) 75**]

Dictated By:[**Name8 (MD) 997**]

MEDQUIST36

D:  [**2101-1-1**]  21:56
T:  [**2101-1-4**]  10:17
JOB#:  [**Job Number 45123**]
{'Subendocardial infarction, initial episode of care,Cellulitis and abscess of upper arm and forearm,Infection and inflammatory reaction due to other vascular device, implant, and graft,Coronary atherosclerosis of native coronary artery,Methicillin susceptible Staphylococcus aureus in conditions classified elsewhere and of unspecified site,Infection with microorganisms resistant to penicillins,Vitiligo,Asthma, unspecified type, unspecified,Degeneration of lumbar or lumbosacral intervertebral disc'}


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 62-year-old
male with no prior history of coronary artery disease who
presented with a 2-day history of substernal chest pain.

MEDICAL HISTORY: 1.  Hypercholesterolemia.
2.  Asthma.
3.  Vitiligo.
4.  Low back pain with disk disease.
5.  Status post multiple stab wounds approximately 24 years
ago.

MEDICATION ON ADMISSION: 1.  Percocet p.o. t.i.d.
2.  Lipitor 10 mg p.o. q.d.
3.  Albuterol 1 to 2 puffs q.8h.
4.  Prilosec 30 mg p.o. q.d.

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: The patient reportedly lives alone.  He
smoked one pack per day for about 10 years, but he quit 25
years ago.  The patient does not drink alcohol or use drugs. 

### Response:
{'Subendocardial infarction, initial episode of care,Cellulitis and abscess of upper arm and forearm,Infection and inflammatory reaction due to other vascular device, implant, and graft,Coronary atherosclerosis of native coronary artery,Methicillin susceptible Staphylococcus aureus in conditions classified elsewhere and of unspecified site,Infection with microorganisms resistant to penicillins,Vitiligo,Asthma, unspecified type, unspecified,Degeneration of lumbar or lumbosacral intervertebral disc'}
