CHIEF COMPLAINT: intermittent chest pain, diaphoresis and SOB that resolved with
rest over the past month

PRESENT ILLNESS: 47 yo male with know history of CAD and prior PTCA of LAD and
RCA in 8/[**2107**]. He had a repeat atherectomy of the LAD in 11/94.
Has had medical mgmt. and was running six days a week until 2
years ago. He had a normal ETT in [**8-1**], and a negative stress
echo in [**10-30**]. He began to develop anginal symptoms again about
one month ago. He had a + ETT and was referred for cath at
[**Hospital1 18**].

MEDICAL HISTORY: remote ETOH abuse
elev. chol.
anxiety
cluster headaches
CAD (PTCA LAD and RCA)

MEDICATION ON ADMISSION: ASA 325 mg daily
lipitor 20 mg daily
valium 5 mg prn ( uses 2-3 times/mo.)

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: 97 T, SR 56, 130/70, 98% RA sat, RR 22
PERLA , EOMI, normocephalic, atraumatic
RRR S1S2, no m/r/g , no JVD or carotid bruits
R fem drsg, 2+ DP/PT/radials
no varicosities
CTA bilat.
abd, soft, NT, ND, + BS, no HSM
[**6-2**] strengths, MAE, non focal neurologically

FAMILY HISTORY: mother had CABG
father had congenital heart abnormality

SOCIAL HISTORY: works as NStar technician
married with 2 children
smoked for 15 years, then quit for 8 years. Now smokes one ppd X
2 years.
States he quit drinking 18 years ago ( wife not sure this is
true), may still be drinking
Coronary atherosclerosis of native coronary artery,Intermediate coronary syndrome,Pure hypercholesterolemia,Anxiety state, unspecified,Family history of ischemic heart disease,Tobacco use disorder,Personal history of alcoholism
Crnry athrscl natve vssl,Intermed coronary synd,Pure hypercholesterolem,Anxiety state NOS,Fam hx-ischem heart dis,Tobacco use disorder,Hx of alcoholism
Admission Date:  [**2118-11-11**]              Discharge Date:   [**2118-11-15**]

Date of Birth:  [**2071-9-10**]             Sex:   M

Service: CARDIOTHORACIC

Allergies:
Patient recorded as having No Known Allergies to Drugs

Attending:[**First Name3 (LF) 1505**]
Chief Complaint:
intermittent chest pain, diaphoresis and SOB that resolved with
rest over the past month

Major Surgical or Invasive Procedure:
CABGx3


History of Present Illness:
47 yo male with know history of CAD and prior PTCA of LAD and
RCA in 8/[**2107**]. He had a repeat atherectomy of the LAD in 11/94.
Has had medical mgmt. and was running six days a week until 2
years ago. He had a normal ETT in [**8-1**], and a negative stress
echo in [**10-30**]. He began to develop anginal symptoms again about
one month ago. He had a + ETT and was referred for cath at
[**Hospital1 18**].

Past Medical History:
remote ETOH abuse
elev. chol.
anxiety
cluster headaches
CAD (PTCA LAD and RCA)

Social History:
works as NStar technician
married with 2 children
smoked for 15 years, then quit for 8 years. Now smokes one ppd X
2 years.
States he quit drinking 18 years ago ( wife not sure this is
true), may still be drinking

Family History:
mother had CABG
father had congenital heart abnormality


Physical Exam:
97 T, SR 56, 130/70, 98% RA sat, RR 22
PERLA , EOMI, normocephalic, atraumatic
RRR S1S2, no m/r/g , no JVD or carotid bruits
R fem drsg, 2+ DP/PT/radials
no varicosities
CTA bilat.
abd, soft, NT, ND, + BS, no HSM
[**6-2**] strengths, MAE, non focal neurologically

Pertinent Results:
[**2118-11-11**] 09:00AM BLOOD WBC-5.8 RBC-4.45* Hgb-12.7* Hct-38.1*
MCV-86 MCH-28.5 MCHC-33.3 RDW-13.7 Plt Ct-156
[**2118-11-15**] 06:20AM BLOOD WBC-6.2 RBC-2.77* Hgb-8.0* Hct-23.2*
MCV-84 MCH-29.0 MCHC-34.6 RDW-13.6 Plt Ct-144*
[**2118-11-15**] 10:40AM BLOOD Hct-24.2*
[**2118-11-11**] 09:00AM BLOOD Neuts-60.1 Lymphs-28.6 Monos-6.2 Eos-4.9*
Baso-0.3
[**2118-11-11**] 09:00AM BLOOD PT-12.0 PTT-27.8 INR(PT)-1.0
[**2118-11-15**] 06:20AM BLOOD Plt Ct-144*
[**2118-11-11**] 09:00AM BLOOD Glucose-131* UreaN-22* Creat-0.9 Na-139
K-3.8 Cl-105 HCO3-26 AnGap-12
[**2118-11-15**] 06:20AM BLOOD Glucose-109* UreaN-17 Creat-0.9 Na-138
K-4.1 Cl-102 HCO3-28 AnGap-12
[**2118-11-11**] 09:00AM BLOOD ALT-21 AST-19 AlkPhos-55 Amylase-79
TotBili-0.1
[**2118-11-11**] 09:00AM BLOOD %HbA1c-5.5 [Hgb]-DONE [A1c]-DONE
[**2118-11-11**] 09:00AM BLOOD Triglyc-58 HDL-71 CHOL/HD-2.5 LDLcalc-96

Brief Hospital Course:
Admitted on [**11-11**] for cath which revealed: 95% LM, LAD mild prox
dz, CX/OM1 50%, small RCA 80% EF 60%. Refered to Dr. [**Last Name (STitle) **] for
urgent CABG, and taken to the OR for CABG x3 (LIMA to LAD, SVG
to OM, SVG to PDA). Transferred to CSRU in stable condition on
titrated neosynephrine and propofol drips. Extubated early the
next day and was on ativan for protection from possible post-op
delirium given his uncertain ETOH history.Remained on neo and
started diuresis on POD #1. He was alert and oriented and
hemodynamically stable. Was encouraged to increase his pulm.
toilet and neo weaned off on POD #2 and chest tubes were
removed. On POD #3, he was transfused one unit PRBCs for Hct of
25.2, and then transferred to the floor. Beta blockade continued
with lopressor. He completed a level 5 with PT on POD #4. His
Hct was 24 and the patient was given the option of transfusion,
but he declined it, so iron will be given postoperatively for
one month. Tobacco cessation was also discussed with the
patient, but he declined the use of a nicotine patch at this
time. He is discharged to home with VNA services today in stable
condition.
SR 80, T 97.8, 107/64, RR 18, 95% RA sat., wt. 72.2 kg (pre-op
70 kg)

Medications on Admission:
ASA 325 mg daily
lipitor 20 mg daily
valium 5 mg prn ( uses 2-3 times/mo.)

Discharge Medications:
1. Metoprolol Tartrate 25 mg Tablet Sig: One (1) Tablet PO BID
(2 times a day).
Disp:*60 Tablet(s)* Refills:*2*
2. Potassium Chloride 10 mEq Capsule, Sustained Release Sig: Two
(2) Capsule, Sustained Release PO once a day for 7 days.
Disp:*14 Capsule, Sustained Release(s)* Refills:*0*
3. Furosemide 20 mg Tablet Sig: One (1) Tablet PO once a day for
7 days.
Disp:*7 Tablet(s)* Refills:*0*
4. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2
times a day).
Disp:*60 Capsule(s)* Refills:*1*
5. Atorvastatin 20 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
Disp:*30 Tablet(s)* Refills:*2*
6. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO
Q4-6H (every 4 to 6 hours) as needed for pain.
Disp:*40 Tablet(s)* Refills:*0*
7. Ferrous Gluconate 324 (36) mg Tablet Sig: One (1) Tablet PO
twice a day for 1 months.
Disp:*60 Tablet(s)* Refills:*1*
8. Ranitidine HCl 150 mg Tablet Sig: One (1) Tablet PO BID (2
times a day) for 2 weeks.
Disp:*28 Tablet(s)* Refills:*0*
9. 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:*2*


Discharge Disposition:
Home With Service

Facility:
[**Hospital 119**] Homecare

Discharge Diagnosis:
s/p CABG x3(LIMA->LAD, SVG->OM, SVG->PDA)
CAD,^chol,anxiety, ETOH abuse, cluster headaches.


Discharge Condition:
good


Discharge Instructions:
keep wounds clean and d ry. OK to shower, no bathing or
swimming.
Take all medications as prescribed.
Call for any fever, redness or drainage from wounds
no lifting greater than 10 pounds for 10 weeks
may not drive for one month

Followup Instructions:
wound clinic in 2 weeks
Dr [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **] in [**3-3**] weeks
Dr. [**Last Name (STitle) **] in 4 weeks



Completed by:[**2118-11-15**]
{'Coronary atherosclerosis of native coronary artery,Intermediate coronary syndrome,Pure hypercholesterolemia,Anxiety state, unspecified,Family history of ischemic heart disease,Tobacco use disorder,Personal history of alcoholism'}


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: intermittent chest pain, diaphoresis and SOB that resolved with
rest over the past month

PRESENT ILLNESS: 47 yo male with know history of CAD and prior PTCA of LAD and
RCA in 8/[**2107**]. He had a repeat atherectomy of the LAD in 11/94.
Has had medical mgmt. and was running six days a week until 2
years ago. He had a normal ETT in [**8-1**], and a negative stress
echo in [**10-30**]. He began to develop anginal symptoms again about
one month ago. He had a + ETT and was referred for cath at
[**Hospital1 18**].

MEDICAL HISTORY: remote ETOH abuse
elev. chol.
anxiety
cluster headaches
CAD (PTCA LAD and RCA)

MEDICATION ON ADMISSION: ASA 325 mg daily
lipitor 20 mg daily
valium 5 mg prn ( uses 2-3 times/mo.)

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: 97 T, SR 56, 130/70, 98% RA sat, RR 22
PERLA , EOMI, normocephalic, atraumatic
RRR S1S2, no m/r/g , no JVD or carotid bruits
R fem drsg, 2+ DP/PT/radials
no varicosities
CTA bilat.
abd, soft, NT, ND, + BS, no HSM
[**6-2**] strengths, MAE, non focal neurologically

FAMILY HISTORY: mother had CABG
father had congenital heart abnormality

SOCIAL HISTORY: works as NStar technician
married with 2 children
smoked for 15 years, then quit for 8 years. Now smokes one ppd X
2 years.
States he quit drinking 18 years ago ( wife not sure this is
true), may still be drinking 

### Response:
{'Coronary atherosclerosis of native coronary artery,Intermediate coronary syndrome,Pure hypercholesterolemia,Anxiety state, unspecified,Family history of ischemic heart disease,Tobacco use disorder,Personal history of alcoholism'}
