CHIEF COMPLAINT: increased DOE

PRESENT ILLNESS: 68 yo F with exertional chest pressure and DOE, diagnosed with
CAD one year prior. ETT + for ischemia, referred for surgical
revascularization.

MEDICAL HISTORY: CAD
HTN
hypercholesterolemia
PVD
COPD
TIA
Aorto-Bifem BPG
right CEA
laminectomy
bilat iliac stents
appy
pilonidal cyst
right cataract

MEDICATION ON ADMISSION: [**Doctor First Name 130**]
crestor
diovan
advair
spiriva
low dose aspirin
calcium
CoQ
Flaxseed
Fish oil
MVI
albuterol
fiber caps

ALLERGIES: Naproxen / Iodine; Iodine Containing / Rofecoxib / Sulfa
(Sulfonamides)

PHYSICAL EXAM: WDWN F in NAD, mildly overweight
Skin well healed abdominal and groin incisions.
HEENT unremarkable
Neck supple bilat carotid bruits L>R
Lungs CTAB
Heart RRR
Abd + bruit L side
extrem warm, no edema
superficial varicosities r thigh
Neuro alert and oriented, 5/5 strength t/o, MAE, normal gait

FAMILY HISTORY: sister with CABG in mid [**2082**]'s

SOCIAL HISTORY: retired
quit tobacco [**2120**], 20 pack year history
[**12-8**] glasses wine/day
Coronary atherosclerosis of native coronary artery,Chronic airway obstruction, not elsewhere classified,Iatrogenic pneumothorax,Other and unspecified angina pectoris,Peripheral vascular disease, unspecified,Pure hypercholesterolemia,Unspecified essential hypertension,Occlusion and stenosis of multiple and bilateral precerebral arteries without mention of cerebral infarction
Crnry athrscl natve vssl,Chr airway obstruct NEC,Iatrogenic pneumothorax,Angina pectoris NEC/NOS,Periph vascular dis NOS,Pure hypercholesterolem,Hypertension NOS,Ocl mlt bi art wo infrct
Admission Date:  [**2139-9-29**]              Discharge Date:   [**2139-10-5**]

Date of Birth:  [**2071-6-29**]             Sex:   F

Service: CARDIOTHORACIC

Allergies:
Naproxen / Iodine; Iodine Containing / Rofecoxib / Sulfa
(Sulfonamides)

Attending:[**First Name3 (LF) 1505**]
Chief Complaint:
increased DOE

Major Surgical or Invasive Procedure:
s/p OPCABx1(LIMA->LAD) [**2139-9-30**]


History of Present Illness:
68 yo F with exertional chest pressure and DOE, diagnosed with
CAD one year prior. ETT + for ischemia, referred for surgical
revascularization.

Past Medical History:
CAD
HTN
hypercholesterolemia
PVD
COPD
TIA
Aorto-Bifem BPG
right CEA
laminectomy
bilat iliac stents
appy
pilonidal cyst
right cataract

Social History:
retired
quit tobacco [**2120**], 20 pack year history
[**12-8**] glasses wine/day

Family History:
sister with CABG in mid [**2082**]'s

Physical Exam:
WDWN F in NAD, mildly overweight
Skin well healed abdominal and groin incisions.
HEENT unremarkable
Neck supple bilat carotid bruits L>R
Lungs CTAB
Heart RRR
Abd + bruit L side
extrem warm, no edema
superficial varicosities r thigh
Neuro alert and oriented, 5/5 strength t/o, MAE, normal gait

Pertinent Results:
[**2139-10-5**] 06:51AM BLOOD WBC-9.0 RBC-3.39* Hgb-10.8* Hct-30.2*
MCV-89 MCH-31.8 MCHC-35.6* RDW-15.9* Plt Ct-265#
[**2139-10-5**] 06:51AM BLOOD Plt Ct-265#
[**2139-10-5**] 06:51AM BLOOD Glucose-102 UreaN-12 Creat-0.6 Na-133
K-4.1 Cl-98 HCO3-25 AnGap-14

Brief Hospital Course:
Ms. [**Known lastname **] was scheduled for surgery on [**9-29**], carotid u/s on
[**9-28**] showed 100% [**Doctor First Name 3098**] stenosis & occluded L vertebral. Her
surgery was cancelled and she was admitted to F2 for further
work up. She was seen by vascular surgery who cleared her for
surgery. MRIshowed occluded [**Doctor First Name 3098**], patent L vert and moderate to
severe [**Country **] stenosis.
On 10.25 she underwent an off-pump CABG x 1. She awoke
neurologically intake and was extubated that same day. She was
weaned from her vasoactive drips and transferred to the floor on
POD #1.
She developed a small left apical pneumothorax following chest
tube removal whoch resolved spontaneously.
She was ready for discharge to home on POD #5.

Medications on Admission:
[**Doctor First Name 130**]
crestor
diovan
advair
spiriva
low dose aspirin
calcium
CoQ
Flaxseed
Fish oil
MVI
albuterol
fiber caps


Discharge Medications:
1. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2
times a day).
Disp:*60 Capsule(s)* Refills:*0*
2. 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:*0*
3. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO
every 4-6 hours as needed for pain.
Disp:*50 Tablet(s)* Refills:*0*
4. Tiotropium Bromide 18 mcg Capsule, w/Inhalation Device Sig:
One (1) Cap Inhalation DAILY (Daily).
Disp:*1 Cap(s)* Refills:*0*
5. Calcium Carbonate 500 mg Tablet, Chewable Sig: One (1)
Tablet, Chewable PO BID (2 times a day).
Disp:*60 Tablet, Chewable(s)* Refills:*0*
6. Fluticasone-Salmeterol 500-50 mcg/Dose Disk with Device Sig:
One (1) Disk with Device Inhalation [**Hospital1 **] (2 times a day).
Disp:*60 Disk with Device(s)* Refills:*0*
7. Metoprolol Tartrate 50 mg Tablet Sig: One (1) Tablet PO twice
a day.
Disp:*60 Tablet(s)* Refills:*0*
8. Potassium Chloride 10 mEq Capsule, Sustained Release Sig: Two
(2) Capsule, Sustained Release PO BID (2 times a day) for 7
days.
Disp:*40 Capsule, Sustained Release(s)* Refills:*0*
9. Furosemide 40 mg Tablet Sig: One (1) Tablet PO twice a day
for 7 days.
Disp:*14 Tablet(s)* Refills:*0*
10. Ranitidine HCl 150 mg Tablet Sig: One (1) Tablet PO BID (2
times a day).
Disp:*60 Tablet(s)* Refills:*0*
11. Ezetimibe 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).
Disp:*30 Tablet(s)* Refills:*0*
12. Rosuvastatin 10 mg Tablet Sig: One (1) Tablet PO once a day.
Disp:*30 Tablet(s)* Refills:*0*
13. Albuterol 90 mcg/Actuation Aerosol Sig: 1-2 Puffs Inhalation
Q6H (every 6 hours) as needed.
Disp:*qs * Refills:*0*


Discharge Disposition:
Home With Service

Facility:
VNA of Greater [**Location (un) 5871**]/[**Location (un) 6159**]

Discharge Diagnosis:
CAD
Bilat. severe carotid stenoses


Discharge Condition:
Good.


Discharge Instructions:
Follow medications on discharge instructions.
Do not drive for 4 weeks.
Do not lift more than 10 lbs. for 2 months.
Shower daily, let water flow over wounds, pat dry with a towel.
Do not use creams, lotions, or powders on wounds.
Call our office for temp>101.5, sternal drainage.

Followup Instructions:
Make an appointment with Dr. [**Last Name (STitle) 68568**] for 1-2 weeks.
Make an appointment with Dr. [**Last Name (STitle) 6254**] for 3-4 weeks.
Make an appointment with Dr. [**Last Name (STitle) **] for 4 weeks.



Completed by:[**2139-10-6**]
{'Coronary atherosclerosis of native coronary artery,Chronic airway obstruction, not elsewhere classified,Iatrogenic pneumothorax,Other and unspecified angina pectoris,Peripheral vascular disease, unspecified,Pure hypercholesterolemia,Unspecified essential hypertension,Occlusion and stenosis of multiple and bilateral precerebral arteries without mention of cerebral 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: increased DOE

PRESENT ILLNESS: 68 yo F with exertional chest pressure and DOE, diagnosed with
CAD one year prior. ETT + for ischemia, referred for surgical
revascularization.

MEDICAL HISTORY: CAD
HTN
hypercholesterolemia
PVD
COPD
TIA
Aorto-Bifem BPG
right CEA
laminectomy
bilat iliac stents
appy
pilonidal cyst
right cataract

MEDICATION ON ADMISSION: [**Doctor First Name 130**]
crestor
diovan
advair
spiriva
low dose aspirin
calcium
CoQ
Flaxseed
Fish oil
MVI
albuterol
fiber caps

ALLERGIES: Naproxen / Iodine; Iodine Containing / Rofecoxib / Sulfa
(Sulfonamides)

PHYSICAL EXAM: WDWN F in NAD, mildly overweight
Skin well healed abdominal and groin incisions.
HEENT unremarkable
Neck supple bilat carotid bruits L>R
Lungs CTAB
Heart RRR
Abd + bruit L side
extrem warm, no edema
superficial varicosities r thigh
Neuro alert and oriented, 5/5 strength t/o, MAE, normal gait

FAMILY HISTORY: sister with CABG in mid [**2082**]'s

SOCIAL HISTORY: retired
quit tobacco [**2120**], 20 pack year history
[**12-8**] glasses wine/day 

### Response:
{'Coronary atherosclerosis of native coronary artery,Chronic airway obstruction, not elsewhere classified,Iatrogenic pneumothorax,Other and unspecified angina pectoris,Peripheral vascular disease, unspecified,Pure hypercholesterolemia,Unspecified essential hypertension,Occlusion and stenosis of multiple and bilateral precerebral arteries without mention of cerebral infarction'}
