CHIEF COMPLAINT: 

PRESENT ILLNESS: [**Known firstname **] [**Known lastname 35714**] is a 46-year-old
man who presented with chest pain that developed in the
morning at work, it lasted about 5 minutes, it was steady, it
was associated with nausea, vomiting, diaphoresis and
shortness of breath and it went to both arms, however, it
resolved after about 5 minutes and the patient continued at
work.  Later that afternoon around 1 p.m. the chest pain
returned and the patient drove himself to [**Hospital3 3583**]
without any resolution of the chest pain.  He also continued
to feel nauseous and short of breath.  The patient has a
history of chest pain over the past several years which she
says is not exertional.  He says that the pain comes on in
particular after a night of drinking.  He, however, does have
no history of coronary artery disease or heart attack in the
past.  The patient also denies orthopnea, PND and lower
extremity edema.  The patient was sent to [**Hospital3 3583**]
where he received Lopressor, sublingual Nitroglycerin, a
Nitro drip and Morphine.  On arrival his vitals there were
pulse of 90, blood pressure 173/111.  He received
thrombolytic therapy there and was placed on a Heparin drip
at 1700 units per hour.  His initial CK came back at 595.  At
4 p.m. that afternoon his pulse was 74, blood pressure
126/81, however, the patient continued to have chest pain
despite the thrombolytic therapy and was transferred to [**Hospital1 1444**].  On arrival to [**Hospital1 346**] the patient was taken to the cath
lab.  At the cath lab it was found that his left main was
normal, left anterior descending had a 99% thrombotic lesion
in the mid part of the LAD with timi I distal flow.  Left
circumflex was normal.  RCA had 50% diffuse mid lesion, a 95%
lesion as well as a timi II distal flow with left circumflex
collateral.  At the time of cath we did Angioject and
stenting of the LAD, however, even after stenting we had slow
flow so intercoronary Diltiazem was given and results were 0%
residual lesion with timi III flow.  At that time it was felt
that the right coronary artery was high risk and they were
going to place intraaortic balloon pump at the time of cath,
however, due to loss of the femoral sheath, it was not done
at that time and the patient was sent to the CCU.  On arrival
to the CCU, the patient's vitals were pulse 76, blood
pressure 129/78, breaths 24 and satting 98% on four liters.
His EKG showed normal sinus rhythm, 70 beats per minute,
resolution of ST changes, however, he has Q waves in 2, 3 and
F, axis of 0.

MEDICAL HISTORY: Significant for angina over the past
two years for which he has sought no treatment, back surgery,
L4,L5, history of penile cancer operated on 15 years ago as
well as 2 years ago.  The patient denies diabetes, denies
hypertension.

MEDICATION ON ADMISSION: 

ALLERGIES: The patient is allergic only to Codeine which
causes GI upset.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: The patient smokes 1?????? packs of tobacco per
day.  He also has a heavy alcohol history of a pint of hard
liquor a day or 8-9 beers.  The patient has many children and
grandchildren.  He is married.
Acute myocardial infarction of other anterior wall, initial episode of care,Other chronic pulmonary heart diseases,Obesity, unspecified,Tobacco use disorder,Pure hyperglyceridemia,Edema of male genital organs,Family history of ischemic heart disease,Personal history of malignant neoplasm of other male genital organs
AMI anterior wall, init,Chr pulmon heart dis NEC,Obesity NOS,Tobacco use disorder,Pure hyperglyceridemia,Edema, male genital orgn,Fam hx-ischem heart dis,Hx-male genit malig NEC
Admission Date:  [**2124-7-17**]     Discharge Date:  [**2124-7-19**]

Date of Birth:   [**2077-11-13**]     Sex:  M

Service:

HISTORY OF PRESENT ILLNESS:  [**Known firstname **] [**Known lastname 35714**] is a 46-year-old
man who presented with chest pain that developed in the
morning at work, it lasted about 5 minutes, it was steady, it
was associated with nausea, vomiting, diaphoresis and
shortness of breath and it went to both arms, however, it
resolved after about 5 minutes and the patient continued at
work.  Later that afternoon around 1 p.m. the chest pain
returned and the patient drove himself to [**Hospital3 3583**]
without any resolution of the chest pain.  He also continued
to feel nauseous and short of breath.  The patient has a
history of chest pain over the past several years which she
says is not exertional.  He says that the pain comes on in
particular after a night of drinking.  He, however, does have
no history of coronary artery disease or heart attack in the
past.  The patient also denies orthopnea, PND and lower
extremity edema.  The patient was sent to [**Hospital3 3583**]
where he received Lopressor, sublingual Nitroglycerin, a
Nitro drip and Morphine.  On arrival his vitals there were
pulse of 90, blood pressure 173/111.  He received
thrombolytic therapy there and was placed on a Heparin drip
at 1700 units per hour.  His initial CK came back at 595.  At
4 p.m. that afternoon his pulse was 74, blood pressure
126/81, however, the patient continued to have chest pain
despite the thrombolytic therapy and was transferred to [**Hospital1 1444**].  On arrival to [**Hospital1 346**] the patient was taken to the cath
lab.  At the cath lab it was found that his left main was
normal, left anterior descending had a 99% thrombotic lesion
in the mid part of the LAD with timi I distal flow.  Left
circumflex was normal.  RCA had 50% diffuse mid lesion, a 95%
lesion as well as a timi II distal flow with left circumflex
collateral.  At the time of cath we did Angioject and
stenting of the LAD, however, even after stenting we had slow
flow so intercoronary Diltiazem was given and results were 0%
residual lesion with timi III flow.  At that time it was felt
that the right coronary artery was high risk and they were
going to place intraaortic balloon pump at the time of cath,
however, due to loss of the femoral sheath, it was not done
at that time and the patient was sent to the CCU.  On arrival
to the CCU, the patient's vitals were pulse 76, blood
pressure 129/78, breaths 24 and satting 98% on four liters.
His EKG showed normal sinus rhythm, 70 beats per minute,
resolution of ST changes, however, he has Q waves in 2, 3 and
F, axis of 0.

PAST MEDICAL HISTORY:  Significant for angina over the past
two years for which he has sought no treatment, back surgery,
L4,L5, history of penile cancer operated on 15 years ago as
well as 2 years ago.  The patient denies diabetes, denies
hypertension.

MEDICATIONS:  The patient was on no medications except for an
herbal supplement for the last 4-5 weeks that contains
Ephedrine.

ALLERGIES:  The patient is allergic only to Codeine which
causes GI upset.

SOCIAL HISTORY:  The patient smokes 1?????? packs of tobacco per
day.  He also has a heavy alcohol history of a pint of hard
liquor a day or 8-9 beers.  The patient has many children and
grandchildren.  He is married.

PHYSICAL EXAMINATION:  On admission patient was awake and
alert.  Vitals were pulse 76, respirations 24, blood pressure
128/78, O2 saturation 98% on four liters.  Weight 114 kg.
Generally he was awake and alert, in no acute distress.
HEENT, pupils equal, round or reactive to light, extraocular
movements full.  Oropharynx clear, mucus membranes moist.
Neck supple, no JVD.  Lungs clear to auscultation anteriorly.
Heart was regular rate and rhythm, no murmurs, rubs or
gallops.  Abdomen soft, nontender, non distended, positive
bowel sounds.  Extremities, warm, good distal pulses, no
edema.

LABORATORY DATA:  White count on admission 11.6, hematocrit
39.6, platelet count 222,000, sodium 139, potassium 4.4,
chloride 103, CO2 22, BUN 12, creatinine 0.9.  His CKs were
608, then 853.  The third CK was 777.

HOSPITAL COURSE:  The patient returned to the cath lab the
following morning where it was planned to intervene on the
RCA.  On the second catheterization they noted the RCA had
diffusely diseased mid vessel, 100% post AM branch with
bridging collaterals and right to left collaterals, however,
they were not able to pass a wire through the lesion and it
was deemed to be too risky to intervene at that time.  The
patient returned to the floor, his lipid levels were checked
and it was noted he has a total cholesterol of 219,
triglycerides 559, HDL 29 and LDL could not be calculated due
to the high triglycerides.  The patient had an uneventful
hospital course, was sent out to the floor, had no further
chest pain, was set up with cardiac rehab and was sent out on
Lipitor, Wellbutrin, Nicotine patch, sublingual
Nitroglycerin, Aspirin, Plavix and Lopressor, Captopril.  The
patient is to follow-up with Dr. [**First Name (STitle) **] in one week.




                          [**First Name8 (NamePattern2) 1575**] [**Last Name (NamePattern1) 12203**], MD  [**MD Number(1) 12204**]

Dictated By:[**Last Name (NamePattern1) 1203**]

MEDQUIST36

D:  [**2124-7-26**]  19:31
T:  [**2124-7-30**]  18:01
JOB#:  [**Job Number 35715**]
{'Acute myocardial infarction of other anterior wall, initial episode of care,Other chronic pulmonary heart diseases,Obesity, unspecified,Tobacco use disorder,Pure hyperglyceridemia,Edema of male genital organs,Family history of ischemic heart disease,Personal history of malignant neoplasm of other male genital organs'}


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: [**Known firstname **] [**Known lastname 35714**] is a 46-year-old
man who presented with chest pain that developed in the
morning at work, it lasted about 5 minutes, it was steady, it
was associated with nausea, vomiting, diaphoresis and
shortness of breath and it went to both arms, however, it
resolved after about 5 minutes and the patient continued at
work.  Later that afternoon around 1 p.m. the chest pain
returned and the patient drove himself to [**Hospital3 3583**]
without any resolution of the chest pain.  He also continued
to feel nauseous and short of breath.  The patient has a
history of chest pain over the past several years which she
says is not exertional.  He says that the pain comes on in
particular after a night of drinking.  He, however, does have
no history of coronary artery disease or heart attack in the
past.  The patient also denies orthopnea, PND and lower
extremity edema.  The patient was sent to [**Hospital3 3583**]
where he received Lopressor, sublingual Nitroglycerin, a
Nitro drip and Morphine.  On arrival his vitals there were
pulse of 90, blood pressure 173/111.  He received
thrombolytic therapy there and was placed on a Heparin drip
at 1700 units per hour.  His initial CK came back at 595.  At
4 p.m. that afternoon his pulse was 74, blood pressure
126/81, however, the patient continued to have chest pain
despite the thrombolytic therapy and was transferred to [**Hospital1 1444**].  On arrival to [**Hospital1 346**] the patient was taken to the cath
lab.  At the cath lab it was found that his left main was
normal, left anterior descending had a 99% thrombotic lesion
in the mid part of the LAD with timi I distal flow.  Left
circumflex was normal.  RCA had 50% diffuse mid lesion, a 95%
lesion as well as a timi II distal flow with left circumflex
collateral.  At the time of cath we did Angioject and
stenting of the LAD, however, even after stenting we had slow
flow so intercoronary Diltiazem was given and results were 0%
residual lesion with timi III flow.  At that time it was felt
that the right coronary artery was high risk and they were
going to place intraaortic balloon pump at the time of cath,
however, due to loss of the femoral sheath, it was not done
at that time and the patient was sent to the CCU.  On arrival
to the CCU, the patient's vitals were pulse 76, blood
pressure 129/78, breaths 24 and satting 98% on four liters.
His EKG showed normal sinus rhythm, 70 beats per minute,
resolution of ST changes, however, he has Q waves in 2, 3 and
F, axis of 0.

MEDICAL HISTORY: Significant for angina over the past
two years for which he has sought no treatment, back surgery,
L4,L5, history of penile cancer operated on 15 years ago as
well as 2 years ago.  The patient denies diabetes, denies
hypertension.

MEDICATION ON ADMISSION: 

ALLERGIES: The patient is allergic only to Codeine which
causes GI upset.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: The patient smokes 1?????? packs of tobacco per
day.  He also has a heavy alcohol history of a pint of hard
liquor a day or 8-9 beers.  The patient has many children and
grandchildren.  He is married. 

### Response:
{'Acute myocardial infarction of other anterior wall, initial episode of care,Other chronic pulmonary heart diseases,Obesity, unspecified,Tobacco use disorder,Pure hyperglyceridemia,Edema of male genital organs,Family history of ischemic heart disease,Personal history of malignant neoplasm of other male genital organs'}
