CHIEF COMPLAINT: 69M with chest pain

PRESENT ILLNESS: 69 y.o. man with hx of ectopy and left leg DVT/PE in [**5-15**]
presented to outside hospital with right-sided chest pain
lasting 5-10 seconds x 3 days and increased fatigue while
playing golf.  Chest pain not accompanied by nausea, vomiting,
or diaphoresis.  Patient presented to outside hospital where he
was ruled out for acute coronary syndrome.  He had a scheduled
stress test yesterday and was noted to have 1-[**Street Address(2) 35144**]
depressions with a normal perfusion study.  Patient was
transferred to [**Hospital1 18**] for cardiac catheterization which showed
70% occlusion of the distal LCMA.

MEDICAL HISTORY: DVT/Pulmonary Embolism [**5-15**]
Hyperlipidemia
remote hx ulcer disease

MEDICATION ON ADMISSION: Coumadin
Sotolol
MVI
lipitor

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: VS: 119/59 51 18 98% RA weight: 222
GEN: elderly man lying in bed in NAD
HEENT: AT, NC, PERRL, EOMI, neck supple,
CV: Irregular, regular rate, no murmur
PULM: CTAB on anterior exam
ABD: soft, obese, non-tender, non-distended, no HSM, + BS
EXT: cool to touch BL, + 2 DP and radial pulses
NEURO: alert, oriented, CN II-XII grossly intact, sensation
intact in LE bilaterally

FAMILY HISTORY: Father died of MI at age 58; brother had MI

SOCIAL HISTORY: smoked 1 PPD, cigars, pipe x 15 years, quit 20 years ago
Coronary atherosclerosis of native coronary artery,Cardiac complications, not elsewhere classified,Paroxysmal ventricular tachycardia,Personal history of venous thrombosis and embolism,Long-term (current) use of anticoagulants
Crnry athrscl natve vssl,Surg compl-heart,Parox ventric tachycard,Hx-ven thrombosis/embols,Long-term use anticoagul
Admission Date:  [**2166-8-22**]              Discharge Date:   [**2166-9-2**]

Date of Birth:  [**2096-11-11**]             Sex:   M

Service: CARDIOTHORACIC

Allergies:
Patient recorded as having No Known Allergies to Drugs

Attending:[**First Name3 (LF) 1505**]
Chief Complaint:
69M with chest pain

Major Surgical or Invasive Procedure:
[**2166-8-25**] CABG x 2 (LIMA->LAD, SVG->OM)


History of Present Illness:
69 y.o. man with hx of ectopy and left leg DVT/PE in [**5-15**]
presented to outside hospital with right-sided chest pain
lasting 5-10 seconds x 3 days and increased fatigue while
playing golf.  Chest pain not accompanied by nausea, vomiting,
or diaphoresis.  Patient presented to outside hospital where he
was ruled out for acute coronary syndrome.  He had a scheduled
stress test yesterday and was noted to have 1-[**Street Address(2) 35144**]
depressions with a normal perfusion study.  Patient was
transferred to [**Hospital1 18**] for cardiac catheterization which showed
70% occlusion of the distal LCMA.


Past Medical History:
DVT/Pulmonary Embolism [**5-15**]
Hyperlipidemia
remote hx ulcer disease

Social History:
smoked 1 PPD, cigars, pipe x 15 years, quit 20 years ago

Family History:
Father died of MI at age 58; brother had MI

Physical Exam:
VS: 119/59 51 18 98% RA weight: 222
GEN: elderly man lying in bed in NAD
HEENT: AT, NC, PERRL, EOMI, neck supple,
CV: Irregular, regular rate, no murmur
PULM: CTAB on anterior exam
ABD: soft, obese, non-tender, non-distended, no HSM, + BS
EXT: cool to touch BL, + 2 DP and radial pulses
NEURO: alert, oriented, CN II-XII grossly intact, sensation
intact in LE bilaterally


Pertinent Results:
[**2166-8-31**] 12:30PM BLOOD WBC-7.1 RBC-3.52* Hgb-9.9* Hct-29.2*
MCV-83 MCH-28.2 MCHC-33.9 RDW-17.1* Plt Ct-220
[**2166-9-2**] 07:05AM BLOOD PT-16.4* PTT-76.2* INR(PT)-1.8
[**2166-8-31**] 12:30PM BLOOD Glucose-114* UreaN-18 Creat-1.0 Na-139
K-4.5 Cl-104 HCO3-24 AnGap-16

Brief Hospital Course:
Mr. [**Known lastname 35145**] was admitted and went straight to the cardiac
catheterization lab where he was discovered to have 70% distal
LCMA occlusion.  Cardiac surgery was consulted and patient was
scheduled for coronary artery bypass graft.  In light of the
patient's known history of deep venous thrombosis and pulmonary
embolism patient was anticoagulated with heparin and he received
one dose of vitamin K to normalize his INR in preparation for
surgery.  Discussed possibility of working patient up for
hypercoagulable disorder with Factor V Leiden, Homocysteine,
Antithrombin III tests but these tests are not available as
inpatient per lab.  Iron studies to evaluate anemia were all
within normal limits.  Urinalysis and chest x-ray were negative.
 Room air ABG was performed and was notable for decreased PaO2.
Patient was maintained on his outpatient medications, including
sotalol for his ectopy.  Patient went for his scheduled surgery
on [**8-25**].
On [**8-25**] he underwent a CABGx2 with LIMA->LAD, SVG->OM.  He was
transferred to the CSRU in stable condition and was extubated on
his postop night.  He had frequent ventricular ectopy and was on
Lido which was d/c'd on POD#1.  He was restarted on Sotolol with
good effect.  He was restarted on coumadin on the post op night
and was tx'd 1UPRBC.  His chest tubes were d/c'd on POD#1 and
POD#2 he was transferred to the floor.  His epicardial pacing
wires were d/c'd on POD#3 and he continued to progress.  He was
seen by Dr. [**Last Name (STitle) **] of EP and he has followed the pt. for a
long time.  He will continue to follow the pt. and may continue
ablation in the future.  He was anticoagulated with heparin and
coumadin and was discharged to home on POD#8 in stable
condition.


Medications on Admission:
Coumadin
Sotolol
MVI
lipitor

Discharge Medications:
1. 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*
2. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2
times a day).
Disp:*60 Capsule(s)* Refills:*0*
3. Ranitidine HCl 150 mg Tablet Sig: One (1) Tablet PO BID (2
times a day).
Disp:*60 Tablet(s)* Refills:*0*
4. Atorvastatin Calcium 10 mg Tablet Sig: One (1) Tablet PO
DAILY (Daily).
Disp:*30 Tablet(s)* Refills:*0*
5. Furosemide 20 mg Tablet Sig: One (1) Tablet PO BID (2 times a
day) for 1 weeks.
Disp:*14 Tablet(s)* Refills:*0*
6. Potassium Chloride 10 mEq Capsule, Sustained Release Sig: Two
(2) Capsule, Sustained Release PO Q12H (every 12 hours) for 1
weeks.
Disp:*28 Capsule, Sustained Release(s)* Refills:*0*
7. Sotalol 80 mg Tablet Sig: 1.5 Tablets PO BID (2 times a day).
Disp:*90 Tablet(s)* Refills:*0*
8. Coumadin 10 mg Tablet Sig: One (1) Tablet PO at bedtime.
Disp:*30 Tablet(s)* Refills:*0*


Discharge Disposition:
Home With Service

Facility:
[**Last Name (LF) 486**], [**First Name3 (LF) 487**]

Discharge Diagnosis:
CAD
s/p DVT/PE [**5-15**]
Frequent PVCs
hyperlipidemia
remote PUD


Discharge Condition:
Good.


Discharge Instructions:
Call with temperature more than 101, redness or drainage from
incision, or weight gain more than 2 pounds in one day or five
in one week.
No Heavy lifting or driving until followup with surgeon.
[**Month (only) 116**] shower,no baths or swimming, wash incision with mild soap
and water, no lotions creams or powders.

Followup Instructions:
Dr. [**Last Name (STitle) **] 4 weeks
Dr. [**Last Name (STitle) 1911**] 2 weeks
Dr. [**Last Name (STitle) 12816**] 2 weeks



Completed by:[**2166-9-2**]
{'Coronary atherosclerosis of native coronary artery,Cardiac complications, not elsewhere classified,Paroxysmal ventricular tachycardia,Personal history of venous thrombosis and embolism,Long-term (current) use of anticoagulants'}


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: 69M with chest pain

PRESENT ILLNESS: 69 y.o. man with hx of ectopy and left leg DVT/PE in [**5-15**]
presented to outside hospital with right-sided chest pain
lasting 5-10 seconds x 3 days and increased fatigue while
playing golf.  Chest pain not accompanied by nausea, vomiting,
or diaphoresis.  Patient presented to outside hospital where he
was ruled out for acute coronary syndrome.  He had a scheduled
stress test yesterday and was noted to have 1-[**Street Address(2) 35144**]
depressions with a normal perfusion study.  Patient was
transferred to [**Hospital1 18**] for cardiac catheterization which showed
70% occlusion of the distal LCMA.

MEDICAL HISTORY: DVT/Pulmonary Embolism [**5-15**]
Hyperlipidemia
remote hx ulcer disease

MEDICATION ON ADMISSION: Coumadin
Sotolol
MVI
lipitor

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: VS: 119/59 51 18 98% RA weight: 222
GEN: elderly man lying in bed in NAD
HEENT: AT, NC, PERRL, EOMI, neck supple,
CV: Irregular, regular rate, no murmur
PULM: CTAB on anterior exam
ABD: soft, obese, non-tender, non-distended, no HSM, + BS
EXT: cool to touch BL, + 2 DP and radial pulses
NEURO: alert, oriented, CN II-XII grossly intact, sensation
intact in LE bilaterally

FAMILY HISTORY: Father died of MI at age 58; brother had MI

SOCIAL HISTORY: smoked 1 PPD, cigars, pipe x 15 years, quit 20 years ago 

### Response:
{'Coronary atherosclerosis of native coronary artery,Cardiac complications, not elsewhere classified,Paroxysmal ventricular tachycardia,Personal history of venous thrombosis and embolism,Long-term (current) use of anticoagulants'}
