CHIEF COMPLAINT: Dyspnea

PRESENT ILLNESS: 51 year old male with known coronary artery disease and
cardiomyopathy who has been treated medically since his last
myocardial infarction in [**2134**]. Recently he was admitted for
heart failure and a repeat cardiac catheterization revealed
severe, diffuse three vessel disease with a markedly decreased
EF. He was quite symptomatic of his disease with significant
dyspnea on exertion and daily exertional angina. Given the
progression of his symptoms and severity of his
coronary artery disease, he has been referred for surgical
revascularization.

MEDICAL HISTORY: Ischemic Cardiomyopathy - EF 15% [**2131**], 16% [**2138**]
chronic systolic heart failure
-Coronary Artery Disease
- MI [**2131**]/[**2134**]
acute renal failure [**1-28**]
-Hypertension
-Hyperlipidemia
-CHF
-Diabetes Mellitus
-Morbid Obesity
-History of PNA [**2131**] c/b multi system organ failure requiring
intubation [**2131**]
-Sleep Apnea, uses CPAP intermittently
-BPH
-Erectile Dysfunction
-Bilateral Achilles Tendonitis
- orthopnea,syncopal event [**1-21**]

MEDICATION ON ADMISSION: :***Plavix 75mg po daily ( last dose 2/11)
Ranolazine 1000mg po BID
Coreg 25 mg po BID
Isosorbide Mononitrate 120mg po daily
Novolog Mix 70/30: 80 units qAM, 30 units qPM
Novolog 100u/ml solution 50units with dinner
ASA 325mg po daily
Cardura 4mg po daily
Crestor 40mg po daily
Glucophage 1000mg po BID
Nitrostat PRN

ALLERGIES: Morphine

PHYSICAL EXAM: Pulse:89 Resp:18  O2 sat: 98% on RA
B/P  Right: 140/74   Left:
Height:     Weight:(on [**2-3**]) 139 kg

FAMILY HISTORY: No family history of early MI, arrhythmia, cardiomyopathies, or
sudden cardiac death; otherwise non-contributory.

SOCIAL HISTORY: Occupation: Teacher
Tobacco: 1ppd x 20 years
ETOH: Rare
Other: History of heavy marijuana use
Coronary atherosclerosis of native coronary artery,Acute on chronic systolic heart failure,Atrial fibrillation,Obstructive sleep apnea (adult)(pediatric),Unspecified essential hypertension,Other and unspecified hyperlipidemia,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Morbid obesity,Hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (LUTS),Other and unspecified angina pectoris
Crnry athrscl natve vssl,Ac on chr syst hrt fail,Atrial fibrillation,Obstructive sleep apnea,Hypertension NOS,Hyperlipidemia NEC/NOS,DMII wo cmp nt st uncntr,Morbid obesity,BPH w/o urinary obs/LUTS,Angina pectoris NEC/NOS
Admission Date:  [**2139-1-30**]              Discharge Date:   [**2139-2-10**]

Date of Birth:  [**2087-10-17**]             Sex:   M

Service: CARDIOTHORACIC

Allergies:
Morphine

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

Major Surgical or Invasive Procedure:
[**2139-2-3**] Urgent coronary artery bypass grafting x5: Left internal
mammary artery graft to left anterior descending; reverse
saphenous vein graft to the marginal branch, ramus intermedius,
diagonal branch, and posterior descending artery.


History of Present Illness:
51 year old male with known coronary artery disease and
cardiomyopathy who has been treated medically since his last
myocardial infarction in [**2134**]. Recently he was admitted for
heart failure and a repeat cardiac catheterization revealed
severe, diffuse three vessel disease with a markedly decreased
EF. He was quite symptomatic of his disease with significant
dyspnea on exertion and daily exertional angina. Given the
progression of his symptoms and severity of his
coronary artery disease, he has been referred for surgical
revascularization.

Past Medical History:
Ischemic Cardiomyopathy - EF 15% [**2131**], 16% [**2138**]
chronic systolic heart failure
-Coronary Artery Disease
- MI [**2131**]/[**2134**]
acute renal failure [**1-28**]
-Hypertension
-Hyperlipidemia
-CHF
-Diabetes Mellitus
-Morbid Obesity
-History of PNA [**2131**] c/b multi system organ failure requiring
intubation [**2131**]
-Sleep Apnea, uses CPAP intermittently
-BPH
-Erectile Dysfunction
-Bilateral Achilles Tendonitis
- orthopnea,syncopal event [**1-21**]

Social History:
Occupation: Teacher
Tobacco: 1ppd x 20 years
ETOH: Rare
Other: History of heavy marijuana use


Family History:
No family history of early MI, arrhythmia, cardiomyopathies, or
sudden cardiac death; otherwise non-contributory.

Physical Exam:
Pulse:89 Resp:18  O2 sat: 98% on RA
B/P  Right: 140/74   Left:
Height:     Weight:(on [**2-3**]) 139 kg

General:
Skin: Dry [x] intact [x]
HEENT: PERRLA [x] EOMI [x]
Neck:  Supple [x] Full ROM [x]
Chest: Lungs clear bilaterally [x]
Heart: RRR []  Irregular []  Murmur
Abdomen: Soft [x] non-distended, obese [x] non-tender [x]  bowel
sounds + [x]
Extremities: Warm [x], well-perfused [x]  Edema Varicosities:
None [x]
Neuro: Grossly intact
Pulses:
Femoral      Right: +1     Left: +1
DP           Right: +1     Left: +1
PT           [**Name (NI) 167**]: +1     Left: +1
Radial       Right: +1     Left: +1

Carotid Bruit        Right: 0   Left: 0


Pertinent Results:
[**2139-2-9**] 06:10AM BLOOD WBC-6.5 RBC-3.85* Hgb-10.5* Hct-32.0*
MCV-83 MCH-27.3 MCHC-32.8 RDW-15.0 Plt Ct-236
[**2139-1-31**] 08:15AM BLOOD WBC-6.4 RBC-4.47* Hgb-12.6* Hct-36.0*
MCV-81* MCH-28.2 MCHC-35.0 RDW-14.7 Plt Ct-250
[**2139-2-3**] 11:50AM BLOOD Neuts-77.6* Lymphs-18.8 Monos-1.9*
Eos-1.3 Baso-0.4
[**2139-1-31**] 08:15AM BLOOD Neuts-64.0 Lymphs-26.1 Monos-7.8 Eos-1.9
Baso-0.2
[**2139-2-10**] 05:30AM BLOOD PT-14.3* INR(PT)-1.2*
[**2139-2-9**] 06:10AM BLOOD Plt Ct-236
[**2139-1-31**] 08:15AM BLOOD Plt Ct-250
[**2139-1-31**] 08:15AM BLOOD PT-12.2 PTT-24.2 INR(PT)-1.0
[**2139-2-10**] 05:30AM BLOOD UreaN-20 Creat-1.0 K-4.2 HCO3-30
[**2139-2-9**] 06:10AM BLOOD Glucose-128* UreaN-24* Creat-1.0 Na-141
K-4.6 Cl-100 HCO3-35* AnGap-11
[**2139-1-31**] 08:15AM BLOOD Glucose-249* UreaN-21* Creat-1.1 Na-138
K-4.2 Cl-95* HCO3-31 AnGap-16
[**2139-2-2**] 09:30AM BLOOD ALT-27 AST-17 LD(LDH)-175 AlkPhos-56
TotBili-0.5
[**2139-1-31**] 08:15AM BLOOD Calcium-9.8 Phos-4.4 Mg-1.7
[**2139-2-2**] 09:30AM BLOOD %HbA1c-10.6* eAG-258*

Radiology Report CHEST (PA & LAT) Study Date of [**2139-2-9**] 6:52 PM



[**Last Name (LF) **],[**First Name3 (LF) **] [**Initials (NamePattern4) **] [**Last Name (NamePattern4) 147**] FA6A [**2139-2-9**] 6:52 PM
CHEST (PA & LAT)   Clip # [**Clip Number (Radiology) 84222**]
Reason: evaluate for effusion



[**Hospital 93**] MEDICAL CONDITION:
   51 year old man with s/p cabg
REASON FOR THIS EXAMINATION:
   evaluate for effusion



Wet Read: EAGg MON [**2139-2-9**] 10:42 PM
No definite effusion. Prominent gastric bubble, clinically
correlate.


Final Report
CHEST RADIOGRAPH

INDICATION: Evaluation for pleural effusion.

COMPARISON: [**2139-2-5**].

FINDINGS: As compared to the previous radiograph, the Swan-Ganz
catheter has
been removed. The clips and sternal wires after CABG are
unchanged.
Unchanged elevation of the left hemidiaphragm due to an
overinflated stomach.
The presence of a minimal left-sided pleural effusion cannot be
excluded. The
ventilation of the retrocardiac lung areas, has improved.
Minimal fissural
density on the left suggests a small amount of intrafissural
effusion.

The study and the report were reviewed by the staff radiologist.


DR. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **]
DR. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 4130**]
Approved: TUE [**2139-2-10**] 11:00 AM

[**Hospital1 18**] ECHOCARDIOGRAPHY REPORT

[**Known lastname 84223**], [**Known firstname 177**]       [**Hospital1 18**] [**Numeric Identifier 84224**]Portable TTE
(Complete) Done [**2139-2-9**] at 3:06:22 PM      FINAL
Referring Physician     [**Name9 (PRE) **] Information
[**Name9 (PRE) **], [**First Name3 (LF) **] R.
[**Hospital1 18**], Division of Cardiothorac
[**Hospital Unit Name 4081**]
[**Location (un) 86**], [**Numeric Identifier 718**]  Status: Inpatient DOB: [**2087-10-17**]
Age (years): 51 M  Hgt (in): 72
BP (mm Hg): 120/70  Wgt (lb): 315
HR (bpm): 81  BSA (m2): 2.59 m2
Indication: Left ventricular function. Congestive heart failure.

ICD-9 Codes: 428.0, 424.0
Test Information
Date/Time: [**2139-2-9**] at 15:06    Interpret MD: [**Name6 (MD) **] [**Name8 (MD) 4082**], MD
Test Type: Portable TTE (Complete) Son[**Name (NI) 930**]: [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **]
Doppler: Full Doppler and color Doppler Test Location: [**Location 13333**]/[**Hospital Ward Name 121**] 6
Contrast: None Tech Quality: Suboptimal
Tape #: 2010W001-1:50 Machine: Vivid [**6-23**]
Echocardiographic Measurements
Results  Measurements  Normal Range
Left Atrium - Long Axis Dimension:  *6.2 cm  <= 4.0 cm
Left Atrium - Four Chamber Length:  *6.8 cm  <= 5.2 cm
Right Atrium - Four Chamber Length:  *6.4 cm  <= 5.0 cm
Left Ventricle - Septal Wall Thickness:  *1.5 cm  0.6 - 1.1 cm
Left Ventricle - Inferolateral Thickness:  *1.6 cm  0.6 - 1.1 cm

Left Ventricle - Diastolic Dimension:  5.4 cm  <= 5.6 cm
Left Ventricle - Systolic Dimension:  4.4 cm
Left Ventricle - Fractional Shortening:  *0.19  >= 0.29
Left Ventricle - Ejection Fraction:  25% to 30%  >= 55%
Aorta - Sinus Level:  3.4 cm  <= 3.6 cm
Aorta - Ascending:  3.3 cm  <= 3.4 cm
Aortic Valve - Peak Velocity:  1.3 m/sec  <= 2.0 m/sec
Mitral Valve - E Wave:  0.8 m/sec
Mitral Valve - A Wave:  0.9 m/sec
Mitral Valve - E/A ratio:  0.89

Findings
LEFT ATRIUM: Moderate LA enlargement.

RIGHT ATRIUM/INTERATRIAL SEPTUM: Moderately dilated RA.

LEFT VENTRICLE: Mild symmetric LVH with normal cavity size.
Moderate-severe global left ventricular hypokinesis. No resting
LVOT gradient.

RIGHT VENTRICLE: RV not well seen.

AORTA: Normal aortic diameter at the sinus level. Normal
ascending aorta diameter.

AORTIC VALVE: Normal aortic valve leaflets (?#). No AS. No AR.

MITRAL VALVE: Normal mitral valve leaflets with trivial MR.

TRICUSPID VALVE: Indeterminate PA systolic pressure.

PERICARDIUM: No pericardial effusion.

GENERAL COMMENTS: Suboptimal image quality - poor echo windows.
Suboptimal image quality - poor parasternal views. Suboptimal
image quality - poor apical views. Suboptimal image quality -
bandages, defibrillator pads or electrodes. Suboptimal image
quality - body habitus.
Conclusions
The left atrium is moderately dilated. The right atrium is
moderately dilated. There is mild symmetric left ventricular
hypertrophy with normal cavity size. There is moderate to severe
global left ventricular hypokinesis (LVEF = 25-30 %). The right
ventricle is not well seen. The aortic valve leaflets (?#)
appear structurally normal with good leaflet excursion. There is
no aortic valve stenosis. No aortic regurgitation is seen. The
mitral valve appears structurally normal with trivial mitral
regurgitation. The pulmonary artery systolic pressure could not
be determined. There is no pericardial effusion.

IMPRESSION: Suboptimal image quality. Mild symmetric left
ventricular hypertrophy with moderate to severe global
hypokinesis.
If more definitive information regarding biventricular systolic
function is desired, a MUGA scan or cardiac MRI are suggested.
Compared with the prior study (images reviewed) of [**2139-1-15**], the
findings are similar.

CLINICAL IMPLICATIONS:
The left ventricular ejection fraction is <40%, a threshold for
which the patient may benefit from a beta blocker and an ACE
inhibotor or [**Last Name (un) **].
  Electronically signed by [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 4083**], MD, Interpreting
physician [**Last Name (NamePattern4) **] [**2139-2-9**] 18:27




Brief Hospital Course:
Transferred in from OSH on [**1-30**] after admission for dehydration,
acute renal failure, and hypotension. [**Last Name (un) **] was consulted due
to elevated hemoglobin A1C.  Preoperative workup was completed
and underwent coronary artery bypass graft surgery.  See
operative report for further details.  He was noted in the
operating room as grade three airway and difficult intubation.
He received vancomycin for perioperative antibiotics and was
transported to the intensive care unit for postoperative
management.  In the first twenty four hours postoperatively he
was weaned from sedation, awoke neurologically intact and was
extubated with anesthesia at the bedside.  He remained in the
intensive care unit on inotropes for the next few days as they
were slowly weaned off.  [**Last Name (un) **] continued to follow for diabetes
management and physical therapy worked with him on mobility.  He
had episodes of atrial fibrillation treated with betablockers,
amiodarone, and coumadin for anticoagulation.  He remained in
sinus rhythm for greater than forty eight hours prior to
discharge.  On post operative day seven he was ready for
discharge home with services.

Medications on Admission:
:***Plavix 75mg po daily ( last dose 2/11)
Ranolazine 1000mg po BID
Coreg 25 mg po BID
Isosorbide Mononitrate 120mg po daily
Novolog Mix 70/30: 80 units qAM, 30 units qPM
Novolog 100u/ml solution 50units with dinner
ASA 325mg po daily
Cardura 4mg po daily
Crestor 40mg po daily
Glucophage 1000mg po BID
Nitrostat PRN


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. Crestor 40 mg Tablet Sig: One (1) Tablet PO once a day.
Disp:*30 Tablet(s)* Refills:*0*
4. Ranitidine HCl 150 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
Disp:*30 Tablet(s)* Refills:*0*
5. Amiodarone 200 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
Disp:*30 Tablet(s)* Refills:*0*
6. Guaifenesin 600 mg Tablet Sustained Release Sig: Two (2)
Tablet Sustained Release PO BID  () for 3 days.
Disp:*12 Tablet Sustained Release(s)* Refills:*0*
7. Hydromorphone 2 mg Tablet Sig: 1-2 Tablets PO Q3Hour as
needed for pain.
Disp:*70 Tablet(s)* Refills:*0*
8. Losartan 25 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).
Disp:*30 Tablet(s)* Refills:*0*
9. Carvedilol 6.25 mg Tablet Sig: One (1) Tablet PO BID (2 times
a day).
Disp:*60 Tablet(s)* Refills:*0*
10. Furosemide 40 mg Tablet Sig: One (1) Tablet PO BID (2 times
a day): take twice a day for seven days - then decrease to once
a day until follow up with cardiologist in 2 weeks .
Disp:*37 Tablet(s)* Refills:*0*
11. Potassium Chloride 10 mEq Capsule, Sustained Release Sig:
One (1) Capsule, Sustained Release PO twice a day: take twice a
day for seven days - then decrease to once a day until follow up
with cardiologist in 2 weeks .
Disp:*37 Capsule, Sustained Release(s)* Refills:*0*
12. Cephalexin 500 mg Capsule Sig: One (1) Capsule PO Q6H (every
6 hours) for 7 days.
Disp:*28 Capsule(s)* Refills:*0*
13. Warfarin 5 mg Tablet Sig: goal INR 2.0-2.5 Tablets PO once a
day: Dose to vary based on INR - please take 7.5mg on [**2-10**] and
[**2-11**] with [**Month/Year (2) **] draw [**2-12**] for further dosing by coumadin clinic .
Disp:*60 Tablet(s)* Refills:*0*
14. Coumadin 2 mg Tablet Sig: goal INR 2.0-2.5 Tablets PO once a
day: dose to varyu based on INR .
Disp:*60 Tablet(s)* Refills:*0*
15. coumadin
You have two different doses of coumadin so that it can be
adjusted based on your [**Month/Year (2) **] results - coumadin 5 mg tablets and
coumadin 2 mg tablets - please take 7.5 mg total on [**2-10**] and
[**2-11**] - [**Month/Year (2) **] draw [**2-12**] with results to coumadin clinic for further
dosing
16. Outpatient [**Name (NI) **] Work
PT/INR for coumadin dosing - indication atrial fibrillation with
goal INR 2.0-2.5
Results to Dr [**Last Name (STitle) **] coumadin clinic # [**Numeric Identifier 84225**] fax
[**Telephone/Fax (1) 7165**]
first draw [**2-12**]
17. Insulin Glargine 100 unit/mL Solution Sig: Eighty (80) units
 Subcutaneous twice a day.
Disp:*qs qs* Refills:*2*
18. Humalog 100 unit/mL Solution Sig: per sliding scale
Subcutaneous ac and hs .
Disp:*qs qs* Refills:*2*
19. sliding scale insulin
Breakfast Lunch Dinner Bedtime
Humalog Humalog Humalog Humalog
Glucose Insulin Dose Insulin Dose Insulin Dose Insulin Dose

71-119   mg/dL 0   Units 0   Units 0   Units 0   Units
120-159   mg/dL 10   Units 10   Units 10   Units 0   Units
160-199   mg/dL 15   Units 15   Units 15   Units 10   Units
200-239   mg/dL 20   Units 20   Units 20   Units 15   Units
240-280   mg/dL 25   Units 25   Units 25   Units 20   Units



Discharge Disposition:
Home With Service

Facility:
[**Hospital1 1474**] VNA

Discharge Diagnosis:
Coronary artery disease s/p CABG
Acute on chronic systolic heart failure
Post operative atrial fibrillation
Hypertension
hyperlipidemia
ischemic cardiomyopathy
Diabetes mellitus type 2
PNA [**2131**] (multisystem ogran failure with intubation)
Obstructive sleep apnea
Acute renal failure on presentation to outside hospital [**2139-1-28**]
BPH
erectile dysfunction
bilat. Achilles tendonitis

Discharge Condition:
Alert and oriented x3
Ambulating with steady gait
Sternal pain managed with dilaudid prn


Discharge Instructions:
Please shower daily including washing incisions gently with mild
soap, no baths or swimming, and look at your incisions
Please NO lotions, cream, powder, or ointments to incisions
Each morning you should weigh yourself and then in the evening
take your temperature, these should be written down on the chart

No driving for approximately one month until follow up with
surgeon
No lifting more than 10 pounds for 10 weeks
Please call with any questions or concerns [**Telephone/Fax (1) 170**]
Please check your blood sugar before each meal, bedtime and as
needed for symptoms, goal is less than 150 however if you are
running greater than 200 more than once and having issues with
low blood sugars - please call office for assistance with
management [**Telephone/Fax (1) 170**]

Followup Instructions:
[**Name6 (MD) **] [**Name8 (MD) 6144**], MD Phone:[**Telephone/Fax (1) 170**] Date/Time:[**2139-2-26**] 3:30
[**Last Name (un) **] [**Location (un) 620**] - [**Street Address(2) 3001**] [**Location (un) 620**], [**Numeric Identifier 3002**]
Phone: [**Telephone/Fax (1) 19946**] - [**3-24**] at 9am with Dr [**First Name (STitle) **]/NP[**First Name4 (NamePattern1) **]
[**3-4**] at 1pm - diabetes educator at [**Last Name (un) 387**] [**Location (un) **]
[**3-3**] at 3pm - nutritionist at [**Last Name (un) 387**] [**Location (un) **]
Please call to schedule appointments
Primary Care Dr. [**Last Name (STitle) **] in [**12-20**] weeks [**Telephone/Fax (1) 7164**]
Cardiologist Dr. [**Last Name (STitle) **] in [**12-20**] weeks [**Telephone/Fax (1) 57372**]
Labs: PT/INR for coumadin dosing - indication atrial
fibrillation with goal INR 2.0-2.5
Results to Dr [**Last Name (STitle) **] coumadin clinic # [**Numeric Identifier 84225**] fax
[**Telephone/Fax (1) 7165**]
first draw [**2-12**]



Completed by:[**2139-2-10**]
{'Coronary atherosclerosis of native coronary artery,Acute on chronic systolic heart failure,Atrial fibrillation,Obstructive sleep apnea (adult)(pediatric),Unspecified essential hypertension,Other and unspecified hyperlipidemia,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Morbid obesity,Hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (LUTS),Other and unspecified angina pectoris'}


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: Dyspnea

PRESENT ILLNESS: 51 year old male with known coronary artery disease and
cardiomyopathy who has been treated medically since his last
myocardial infarction in [**2134**]. Recently he was admitted for
heart failure and a repeat cardiac catheterization revealed
severe, diffuse three vessel disease with a markedly decreased
EF. He was quite symptomatic of his disease with significant
dyspnea on exertion and daily exertional angina. Given the
progression of his symptoms and severity of his
coronary artery disease, he has been referred for surgical
revascularization.

MEDICAL HISTORY: Ischemic Cardiomyopathy - EF 15% [**2131**], 16% [**2138**]
chronic systolic heart failure
-Coronary Artery Disease
- MI [**2131**]/[**2134**]
acute renal failure [**1-28**]
-Hypertension
-Hyperlipidemia
-CHF
-Diabetes Mellitus
-Morbid Obesity
-History of PNA [**2131**] c/b multi system organ failure requiring
intubation [**2131**]
-Sleep Apnea, uses CPAP intermittently
-BPH
-Erectile Dysfunction
-Bilateral Achilles Tendonitis
- orthopnea,syncopal event [**1-21**]

MEDICATION ON ADMISSION: :***Plavix 75mg po daily ( last dose 2/11)
Ranolazine 1000mg po BID
Coreg 25 mg po BID
Isosorbide Mononitrate 120mg po daily
Novolog Mix 70/30: 80 units qAM, 30 units qPM
Novolog 100u/ml solution 50units with dinner
ASA 325mg po daily
Cardura 4mg po daily
Crestor 40mg po daily
Glucophage 1000mg po BID
Nitrostat PRN

ALLERGIES: Morphine

PHYSICAL EXAM: Pulse:89 Resp:18  O2 sat: 98% on RA
B/P  Right: 140/74   Left:
Height:     Weight:(on [**2-3**]) 139 kg

FAMILY HISTORY: No family history of early MI, arrhythmia, cardiomyopathies, or
sudden cardiac death; otherwise non-contributory.

SOCIAL HISTORY: Occupation: Teacher
Tobacco: 1ppd x 20 years
ETOH: Rare
Other: History of heavy marijuana use 

### Response:
{'Coronary atherosclerosis of native coronary artery,Acute on chronic systolic heart failure,Atrial fibrillation,Obstructive sleep apnea (adult)(pediatric),Unspecified essential hypertension,Other and unspecified hyperlipidemia,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Morbid obesity,Hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (LUTS),Other and unspecified angina pectoris'}
