CHIEF COMPLAINT: 

PRESENT ILLNESS: This 77-year-old gentleman well
known to our service with inferior myocardial infarction at
an outside hospital in early [**Month (only) **] transferred to [**Doctor First Name **]-
[**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **] [**First Name (Titles) **] [**Last Name (Titles) **] for cardiac catheterization..
This revealed 3-vessel disease with preserved ejection
fraction. He now returns on [**7-17**] for surgery the
following day.

MEDICAL HISTORY: 1.  Insulin dependent diabetes mellitus.
2.  Hypertension.
3.  Hypercholesterolemia.
4.  Peripheral vascular disease.
5.  Glaucoma.
6.  Benign prostatic hypertrophy.
7.  Chronic obstructive pulmonary disease.
8.  Coronary artery disease.
9.  Atrial fibrillation.
10. Chronic renal insufficiency with baseline creatinine of
    1.5 to 1.9.

MEDICATION ON ADMISSION: 1.  Cosopt for his glaucoma.
2.  Alphagan for glaucoma.
3.  Lisinopril 20 mg PO once daily.
4.  Insulin NPH 45 units q a.m., Insulin NPH 16 units q p.m.
5.  Rosiglitazone 4 mg PO once a day.
6.  Glucophage 1000 mg PO twice a day.
7.  Digoxin 0.25 mg PO once a day.
8.  Hydrochlorothiazide 25 mg PO once a day.
9.  Aspirin 81 mg PO once a day.
10. Zocor 20 mg PO once a day.
11. Plavix 75 mg PO once a day which was discontinued at
    admission on [**7-17**].
12. Isordil 10 mg 3 times a day.
13. Sublingual nitroglycerine as needed.
14. Gemfibrozil 600 mg PO once a day.
15. Finasteride 5 mg PO once a day.

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: 
Coronary atherosclerosis of native coronary artery,Intermediate coronary syndrome,Atrial fibrillation,Chronic airway obstruction, not elsewhere classified,Peripheral vascular disease, unspecified,Unspecified disorder of kidney and ureter,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Unspecified essential hypertension,Unspecified glaucoma,Hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (LUTS)
Crnry athrscl natve vssl,Intermed coronary synd,Atrial fibrillation,Chr airway obstruct NEC,Periph vascular dis NOS,Renal & ureteral dis NOS,DMII wo cmp nt st uncntr,Hypertension NOS,Glaucoma NOS,BPH w/o urinary obs/LUTS
Admission Date: [**2155-7-17**]        Discharge Date: [**2155-7-22**]

Date of Birth:  [**2077-9-25**]        Sex:  M

Service:  CSU


HISTORY OF PRESENT ILLNESS:  This 77-year-old gentleman well
known to our service with inferior myocardial infarction at
an outside hospital in early [**Month (only) **] transferred to [**Doctor First Name **]-
[**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **] [**First Name (Titles) **] [**Last Name (Titles) **] for cardiac catheterization..
This revealed 3-vessel disease with preserved ejection
fraction. He now returns on [**7-17**] for surgery the
following day.

PAST MEDICAL HISTORY:
1.  Insulin dependent diabetes mellitus.
2.  Hypertension.
3.  Hypercholesterolemia.
4.  Peripheral vascular disease.
5.  Glaucoma.
6.  Benign prostatic hypertrophy.
7.  Chronic obstructive pulmonary disease.
8.  Coronary artery disease.
9.  Atrial fibrillation.
10. Chronic renal insufficiency with baseline creatinine of
    1.5 to 1.9.

PAST SURGICAL HISTORY:
1.  Right carotid endarterectomy in [**2153**] with known occluded
    left internal carotid.
2.  Cataract surgery.

ALLERGIES:  No known drug allergies.

MEDICATIONS ON ADMISSION:
1.  Cosopt for his glaucoma.
2.  Alphagan for glaucoma.
3.  Lisinopril 20 mg PO once daily.
4.  Insulin NPH 45 units q a.m., Insulin NPH 16 units q p.m.
5.  Rosiglitazone 4 mg PO once a day.
6.  Glucophage 1000 mg PO twice a day.
7.  Digoxin 0.25 mg PO once a day.
8.  Hydrochlorothiazide 25 mg PO once a day.
9.  Aspirin 81 mg PO once a day.
10. Zocor 20 mg PO once a day.
11. Plavix 75 mg PO once a day which was discontinued at
    admission on [**7-17**].
12. Isordil 10 mg 3 times a day.
13. Sublingual nitroglycerine as needed.
14. Gemfibrozil 600 mg PO once a day.
15. Finasteride 5 mg PO once a day.

Cardiac catheterization revealed 90% LAD lesion, 80% diagonal
1 lesion, 90% circumflex lesion at the OM1 take off and a
totally occluded RCA of EDP 31, wedge 33.

PREOPERATIVE LABORATORY DATA:  White blood cell count 7.3,
hematocrit 32.7, platelet count 192,000, PT 14.0, PTT 29.1,
INR 1.3. Sodium 140, K 4.9, chloride 103, bicarb 29, BUN 28,
creatinine 1.6, blood sugar of 102. Magnesium 2.1.

Preoperative chest x-ray as follows: No acute cardiopulmonary
process identified preoperatively.

Preoperative EKG showed sinus bradycardia of 51 with diffuse
ST-T wave changes that were nonspecific. Please refer to the
official report dated [**2155-7-17**].

Preoperative echocardiogram showed a ejection fraction of 45
to 50% with 1+ MR and mild left ventricular hypertrophy.

Preoperative carotid ultrasound showed totally occluded left
internal carotid and no plaque in his right internal carotid
artery with antegrade vertebral flow bilaterally.

Renal ultrasound showed no hydronephrosis.

PHYSICAL EXAMINATION:  His temperature was 98, heart rate 56,
with blood pressure of 180/80, respiratory rate 20, oxygen
saturations 96% on room air. He was sitting in his chair
eating his dinner. He was alert and oriented x 3, moving all
extremities, following commands, with a nonfocal neurologic
examination. His pupils were equal, round and reactive to
light with extraocular muscles intact. He was anicteric with
normal buccal mucosa. Neck was supple with no lymphadenopathy
or thyromegaly. No jugular venous distention. Bruits on the
right carotid and no bruit appreciated on the left. His lungs
were clear bilaterally. His heart had regular rate and rhythm
with no murmurs. Abdomen was soft and nontender,
nondistended. Normal bowel sounds. Extremities warm and well
perfused with no varicosities.

He was referred to Dr. [**Last Name (STitle) **] for coronary artery bypass
grafting. On [**7-18**], the following day, he underwent
coronary artery bypass grafting x 4 with left internal
mammary artery to the LAD, vein graft to the patent ductus
arteriosus and a vein graft to the OM and a vein graft to the
LAD. He was transferred to cardiothoracic ICU in stable
condition.

On postoperative day 1, he had been extubated overnight, was
in sinus rhythm maintaining a good blood pressure.

POSTOPERATIVE LABORATORY DATA:  White blood cell count 9.2,
hematocrit 35, K 5.0,  BUN 17, creatinine 1.3, INR 1.4. He
was saturating 100% on 4 liters via nasal cannula.

He was alert and oriented. His examination was unremarkable.
Incisions were clean, dry and intact. He began Lasix diuresis
and Lopressor beta blockade. His Swan was discontinued and he
was transferred up to floor 4. On the floor he was encouraged
to work with the nurses and physical therapist for increasing
his activity level which he did as well as his exercise
tolerance. He appeared to be fairly motivated. He was alert
and oriented but occasionally had some confusion regarding
person and place. His lungs were clear bilaterally on
postoperative day 2. His blood pressure was up slightly at
264/73. Lopressor was increased to 37.5 twice a day. His
chest tubes were removed. Repeat chest x-ray was performed.
His examination was otherwise unremarkable. He was re-started
on his Plavix and continued with Lasix diuresis as well as
completing his perioperative antibiotics.

On postoperative day 3, he discontinued his Foley himself. It
was reinserted for resulting hematuria. His examination was
otherwise unremarkable. His Foley did remain in place. He was
encouraged to increase his physical therapy as well as his
pulmonary toilet and his Lasix dosing was decreased. His
epicardial pacing wires were removed without incident. He
continued to increase his activity level. He was very anxious
to get home. He appeared to be very motivated and on [**7-22**], postoperative day 4, he was discharged to home with
visiting nurses with the following discharge diagnoses.

DISCHARGE DIAGNOSES:
1.  Status post coronary artery bypass grafting x 4.
2.  Insulin dependent diabetes mellitus.
3.  Hypertension.
4.  Hypercholesterolemia.
5.  Peripheral vascular disease with known carotid artery
    disease and status post right CEA.
6.  Glaucoma.
7.  Benign prostatic hyperplasia.
8.  Chronic obstructive pulmonary disease.
9.  Coronary artery disease.
10. Atrial fibrillation.
11. Chronic renal insufficiency.

He was instructed to follow up with Dr. [**Last Name (STitle) **] at 4 weeks
post discharge for his postoperative surgical visit, and to
see his cardiologist and primary care physicians also at 2
weeks post discharge.

DISCHARGE MEDICATIONS:
1.  Colace 100 mg PO twice a day.
2.  Enteric coated aspirin 81 mg PO once a day.
3.  Plavix 75 mg PO once a day.
4.  Zocor 20 mg PO q h.s
5.  Tylenol 650 mg PO p.r.n. q 4 hours for pain.
6.  Lisinopril 5 mg PO once daily.
7.  Lasix 40 mg PO once a day.
8.  Finasteride 5 mg PO once a day.
9.  Metoprolol 37.5 mg PO twice a day.
10. Protonix 40 mg PO once a day.
11. His home dosing of Recombinant Human Insulin NPH.
12. Cosopt 2-0.5% ophthalmic drops.
13. Preoperative dose of Alphagan ophthalmic drops.
14. Gemfibrozil 600 mg PO once a day.

The patient was discharged home with VNA services in stable
condition on [**2155-7-22**].



                        [**Name6 (MD) **] [**Name8 (MD) **], M.D. [**MD Number(2) 5897**]

Dictated By:[**Last Name (NamePattern1) **]
MEDQUIST36
D:  [**2155-8-1**] 14:52:52
T:  [**2155-8-2**] 01:25:15
Job#:  [**Job Number 63321**]
{'Coronary atherosclerosis of native coronary artery,Intermediate coronary syndrome,Atrial fibrillation,Chronic airway obstruction, not elsewhere classified,Peripheral vascular disease, unspecified,Unspecified disorder of kidney and ureter,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Unspecified essential hypertension,Unspecified glaucoma,Hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (LUTS)'}


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: This 77-year-old gentleman well
known to our service with inferior myocardial infarction at
an outside hospital in early [**Month (only) **] transferred to [**Doctor First Name **]-
[**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **] [**First Name (Titles) **] [**Last Name (Titles) **] for cardiac catheterization..
This revealed 3-vessel disease with preserved ejection
fraction. He now returns on [**7-17**] for surgery the
following day.

MEDICAL HISTORY: 1.  Insulin dependent diabetes mellitus.
2.  Hypertension.
3.  Hypercholesterolemia.
4.  Peripheral vascular disease.
5.  Glaucoma.
6.  Benign prostatic hypertrophy.
7.  Chronic obstructive pulmonary disease.
8.  Coronary artery disease.
9.  Atrial fibrillation.
10. Chronic renal insufficiency with baseline creatinine of
    1.5 to 1.9.

MEDICATION ON ADMISSION: 1.  Cosopt for his glaucoma.
2.  Alphagan for glaucoma.
3.  Lisinopril 20 mg PO once daily.
4.  Insulin NPH 45 units q a.m., Insulin NPH 16 units q p.m.
5.  Rosiglitazone 4 mg PO once a day.
6.  Glucophage 1000 mg PO twice a day.
7.  Digoxin 0.25 mg PO once a day.
8.  Hydrochlorothiazide 25 mg PO once a day.
9.  Aspirin 81 mg PO once a day.
10. Zocor 20 mg PO once a day.
11. Plavix 75 mg PO once a day which was discontinued at
    admission on [**7-17**].
12. Isordil 10 mg 3 times a day.
13. Sublingual nitroglycerine as needed.
14. Gemfibrozil 600 mg PO once a day.
15. Finasteride 5 mg PO once a day.

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY:  

### Response:
{'Coronary atherosclerosis of native coronary artery,Intermediate coronary syndrome,Atrial fibrillation,Chronic airway obstruction, not elsewhere classified,Peripheral vascular disease, unspecified,Unspecified disorder of kidney and ureter,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Unspecified essential hypertension,Unspecified glaucoma,Hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (LUTS)'}
