CHIEF COMPLAINT: Acute inferior myocardial infarction status
post stenting of the saphenous vein graft to the right
coronary artery.

PRESENT ILLNESS: This is an 85 year-old man with
a history of coronary artery disease status post coronary
artery bypass graft times six in [**2122**], status post stent
times two three years ago who had a laminectomy about two
weeks ago prior to admission.  He presented to the [**Hospital3 1280**]
Hospital with bilateral arm pain and profound weakness.  He
also complained of jaw and neck pain.  He took some
nitroglycerin with some relief, but had persistent discomfort
at [**Hospital3 1280**] Hospital.  His electrocardiogram there showed
ST elevation inferiorly with reciprocal ST depression.  He
was given aspirin, nitroglycerin and heparin drip there.  He
was flighted to [**Hospital1 69**] for
percutaneous transluminal coronary angioplasty.  Intracath
during the placement of the ventricular pacer wire he
developed an episode of V fibrillation, which was
successfully shocked back to sinus rhythm with 200 jewels.
Otherwise he tolerated the procedure well and had successful
thrombectomy and stenting of the saphenous vein graft to the
right coronary artery.  He was admitted to Coronary Care Unit
for overnight observation.

MEDICAL HISTORY: Coronary artery disease status post
coronary artery bypass graft times six in [**2122**], status post
stent times two three years ago.  Status post laminectomy two
to three weeks ago.  Hypertension.  No history of diabetes.

MEDICATION ON ADMISSION: 

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: Father died of pancreatic cancer.

SOCIAL HISTORY: The patient lives with wife at home.
Retired Abian salesman.  No tobacco, alcohol or drugs.
Acute myocardial infarction of other inferior wall, initial episode of care,Cardiac complications, not elsewhere classified,Ventricular fibrillation,Coronary atherosclerosis of autologous vein bypass graft,Unspecified essential hypertension,Percutaneous transluminal coronary angioplasty status
AMI inferior wall, init,Surg compl-heart,Ventricular fibrillation,Crn ath atlg vn bps grft,Hypertension NOS,Status-post ptca
Admission Date:  [**2140-9-19**]     Discharge Date:  [**2140-9-22**]


Service:  CCU

CHIEF COMPLAINT:  Acute inferior myocardial infarction status
post stenting of the saphenous vein graft to the right
coronary artery.

HISTORY OF PRESENT ILLNESS:  This is an 85 year-old man with
a history of coronary artery disease status post coronary
artery bypass graft times six in [**2122**], status post stent
times two three years ago who had a laminectomy about two
weeks ago prior to admission.  He presented to the [**Hospital3 1280**]
Hospital with bilateral arm pain and profound weakness.  He
also complained of jaw and neck pain.  He took some
nitroglycerin with some relief, but had persistent discomfort
at [**Hospital3 1280**] Hospital.  His electrocardiogram there showed
ST elevation inferiorly with reciprocal ST depression.  He
was given aspirin, nitroglycerin and heparin drip there.  He
was flighted to [**Hospital1 69**] for
percutaneous transluminal coronary angioplasty.  Intracath
during the placement of the ventricular pacer wire he
developed an episode of V fibrillation, which was
successfully shocked back to sinus rhythm with 200 jewels.
Otherwise he tolerated the procedure well and had successful
thrombectomy and stenting of the saphenous vein graft to the
right coronary artery.  He was admitted to Coronary Care Unit
for overnight observation.

PAST MEDICAL HISTORY:  Coronary artery disease status post
coronary artery bypass graft times six in [**2122**], status post
stent times two three years ago.  Status post laminectomy two
to three weeks ago.  Hypertension.  No history of diabetes.

MEDICATIONS:  Hydrochlorothiazide 25 q.d., Metoprolol 25
b.i.d., aspirin 81 q.d., vitamin E, vitamin D, eye drops,
stool softeners.

ALLERGIES:  No known drug allergies.

FAMILY HISTORY:  Father died of pancreatic cancer.

SOCIAL HISTORY:  The patient lives with wife at home.
Retired Abian salesman.  No tobacco, alcohol or drugs.

PHYSICAL EXAMINATION ON ADMISSION TO CORONARY CARE UNIT:
Temperature 96.7.  Blood pressure 131/70.  Pulse 78.
Respirations 13.  O2 sat 100% on 3 liters nasal cannula.
Weight 95 kilograms.  In general the patient is awake, alert
and oriented times three, conversant.  No acute distress.
Head and neck, no JVP.  Cardiovascular normal S1 and S2.
Lungs clear to auscultation bilaterally.  Abdomen soft,
nondistended, nontender.  Extremities no edema.  Distal
pulses bilaterally.

LABORATORY:  At [**Hospital6 3872**] white count 11.3.
Differential 74% neutrophils, 1% bands, 13% lymphocytes,
hematocrit 42.7, platelet 172, PTT 28.1, INR 0.97, sodium
138, potassium 4.0, chloride 101, bicarb 28, BUN 24,
creatinine 1.2, glucose 221, calcium 9.9, total protein 6.8,
albumin 3.5, total bilirubin .6, ALT 43, AST 28, alkaline
phosphatase 75, troponin 0.74, CK 69.  Electrocardiogram
number one sinus rate, ST elevation in 3, AVF, ST depression
with T wave inversion in 1, AVL and V1 to V3.  Q wave in 3.
At [**Hospital1 69**] white blood cell
count 11.2, hematocrit 36.7, platelet 144, PT 13.2, PTT 41.2,
INR 1.2, sodium 139, potassium 4.4, chloride 103, bicarb 24,
BUN 20, creatinine 1.0, glucose 151, calcium 8.3, magnesium
1.7, phosphate 3.1.  CK 1301, CKMB 120.

Catheterization, three vessel coronary artery disease with
total occlusion of three of four grafts, successful
thrombectomy and stenting of the saphenous vein graft to the
right coronary artery.  Left main coronary severe diffuse
disease.  Left anterior descending coronary artery total
occlusion proximally, left circumflex total occlusion
proximally, right coronary artery total occlusion proximally.
Saphenous vein graft to obtuse marginal one and two total
occlusion proximally, previously stented, but no refills.
Saphenous vein graft to diagonal one total occlusion
proximally.  Saphenous vein graft to left anterior descending
coronary artery patent with mild disease. Diagonal one with
retrograde from left anterior descending coronary artery 50
to 60% occlusion, distal to the supraventricular tachycardia
to left anterior descending coronary artery anastomosis.
Saphenous vein graft to right coronary artery total occlusion
at mid segment with thrombus.  The patient had successful
thrombectomy and stenting of the saphenous vein graft to
right coronary artery.

Echocardiogram ejection fraction 50%, [**Name Prefix (Prefixes) **] [**Last Name (Prefixes) 5660**] dilated,
left ventricular size normal with systolic function mildly
depressed, three aortic valve mildly thickened, mitral valve
mildly thickened with 2+ MR.

HOSPITAL COURSE:  Post catheterization Integrilin was held
secondary to the recent surgery, but aspirin and Plavix was
continued.  He remained chest pain free in the hospital and
had no more events on telemetry.  His episode of ventricular
fibrillation in the catheterization laboratory was likely due
to the ventricular irritation.  His cardiac enzymes trended
downward in the hospital with a peak CK of 1301.  His
echocardiogram showed an ejection fraction of 50% with 2+ MR
[**Name13 (STitle) **] was evaluated by physical therapy on the day of discharge
and deemed stable to go home.

DISCHARGE CONDITION:  Stable.

DISCHARGE STATUS:  Home.

DISCHARGE DIAGNOSES:
1.  Status post acute inferior myocardial infarction.
2.  Status post saphenous vein graft to right coronary
artery.
3.  Status post ventricular fibrillation in catheterization
laboratory.

DISCHARGE MEDICATIONS:  Plavix 75 q.d. for thirty days,
aspirin 325 q.d., Lisinopril 5 mg q.d., Metoprolol 25 b.i.d.,
sublingual nitroglycerin prn.

OUTPATIENT FOLLOW UP:  The patient will be followed by his
cardiologist Dr. [**First Name8 (NamePattern2) **] [**Name (STitle) 1968**] in [**Hospital3 1280**], phone number
[**Telephone/Fax (1) 20223**].  Outpatient cardiac rehab will be arranged by
Dr. [**Last Name (STitle) 1968**].





                          [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 1013**], M.D.  [**MD Number(1) 1014**]

Dictated By:[**Last Name (NamePattern1) 44692**]

MEDQUIST36

D:  [**2140-9-24**]  21:03
T:  [**2140-9-28**]  06:06
JOB#:  [**Job Number **]
{'Acute myocardial infarction of other inferior wall, initial episode of care,Cardiac complications, not elsewhere classified,Ventricular fibrillation,Coronary atherosclerosis of autologous vein bypass graft,Unspecified essential hypertension,Percutaneous transluminal coronary angioplasty status'}


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: Acute inferior myocardial infarction status
post stenting of the saphenous vein graft to the right
coronary artery.

PRESENT ILLNESS: This is an 85 year-old man with
a history of coronary artery disease status post coronary
artery bypass graft times six in [**2122**], status post stent
times two three years ago who had a laminectomy about two
weeks ago prior to admission.  He presented to the [**Hospital3 1280**]
Hospital with bilateral arm pain and profound weakness.  He
also complained of jaw and neck pain.  He took some
nitroglycerin with some relief, but had persistent discomfort
at [**Hospital3 1280**] Hospital.  His electrocardiogram there showed
ST elevation inferiorly with reciprocal ST depression.  He
was given aspirin, nitroglycerin and heparin drip there.  He
was flighted to [**Hospital1 69**] for
percutaneous transluminal coronary angioplasty.  Intracath
during the placement of the ventricular pacer wire he
developed an episode of V fibrillation, which was
successfully shocked back to sinus rhythm with 200 jewels.
Otherwise he tolerated the procedure well and had successful
thrombectomy and stenting of the saphenous vein graft to the
right coronary artery.  He was admitted to Coronary Care Unit
for overnight observation.

MEDICAL HISTORY: Coronary artery disease status post
coronary artery bypass graft times six in [**2122**], status post
stent times two three years ago.  Status post laminectomy two
to three weeks ago.  Hypertension.  No history of diabetes.

MEDICATION ON ADMISSION: 

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: Father died of pancreatic cancer.

SOCIAL HISTORY: The patient lives with wife at home.
Retired Abian salesman.  No tobacco, alcohol or drugs. 

### Response:
{'Acute myocardial infarction of other inferior wall, initial episode of care,Cardiac complications, not elsewhere classified,Ventricular fibrillation,Coronary atherosclerosis of autologous vein bypass graft,Unspecified essential hypertension,Percutaneous transluminal coronary angioplasty status'}
