CHIEF COMPLAINT: critical stenosis of the right carotid artery

PRESENT ILLNESS: 61M critical stenosis of the right carotid artery, which is
asymptomatic, on [**1-18**] aborted attempt of RCEA - bradycardic
arrest probably from vagal nerve stimulation

MEDICAL HISTORY: PMH: asthma, arrythmias, HTN, hyperchol, CAD, inferior apical
ischemia, although his ejection fraction was 48%, moderate L
carotid stenosis, arrhythmia problems (currently being worked up
by Dr [**Last Name (STitle) **]
PSH: L 4th finger amputation

MEDICATION ON ADMISSION: [**Last Name (un) 1724**]: Plavix 75, Zocor 80, atenolol 50, ASA 325, Norvasc 5,
Lovenox 100 [**Hospital1 **] (stopped 2 weeks ago), Vit E, Vit C, albuterol
IH PRN, MVI,

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: afvss
a/o
nad
cta
rrr
obese
palp pulses

FAMILY HISTORY: n/c

SOCIAL HISTORY: remote smoker
non drinker
Occlusion and stenosis of carotid artery without mention of cerebral infarction,Coronary atherosclerosis of unspecified type of vessel, native or graft,Unspecified essential hypertension,Pure hypercholesterolemia,Examination of participant in clinical trial,Procedure not carried out for other reasons
Ocl crtd art wo infrct,Cor ath unsp vsl ntv/gft,Hypertension NOS,Pure hypercholesterolem,Exam-clincal trial,No proc for reasons NEC
Admission Date:  [**2198-4-18**]              Discharge Date:   [**2198-4-20**]

Date of Birth:  [**2136-5-24**]             Sex:   M

Service: SURGERY

Allergies:
Patient recorded as having No Known Allergies to Drugs

Attending:[**First Name3 (LF) 2597**]
Chief Complaint:
critical stenosis of the right carotid artery

Major Surgical or Invasive Procedure:
R carotid artery stent


History of Present Illness:
61M critical stenosis of the right carotid artery, which is
asymptomatic, on [**1-18**] aborted attempt of RCEA - bradycardic
arrest probably from vagal nerve stimulation

Past Medical History:
PMH: asthma, arrythmias, HTN, hyperchol, CAD, inferior apical
ischemia, although his ejection fraction was 48%, moderate L
carotid stenosis, arrhythmia problems (currently being worked up
by Dr [**Last Name (STitle) **]
PSH: L 4th finger amputation


Social History:
remote smoker
non drinker

Family History:
n/c

Physical Exam:
afvss
a/o
nad
cta
rrr
obese
palp pulses

Pertinent Results:
[**2198-4-20**] 05:05AM BLOOD

WBC-7.9 RBC-3.97* Hgb-12.2* Hct-34.6* MCV-87 MCH-30.9 MCHC-35.4*
RDW-13.3 Plt Ct-218

[**2198-4-20**] 05:05AM BLOOD

Glucose-106* UreaN-12 Creat-0.8 Na-143 K-4.1 Cl-109* HCO3-26
AnGap-12

[**2198-4-20**] 05:05AM BLOOD

CK(CPK)-76

Brief Hospital Course:
pt admitted

pre op'd

hydrated

transvenous pacing wires placed pre

underwent stenting of carotid without difficulty or
complications

sent to ccu

bp control / required neo

transvenous pacing wires 24 hrs

dc without complications

taking po / ambulating / urinating

stable for dc


Medications on Admission:
[**Last Name (un) 1724**]: Plavix 75, Zocor 80, atenolol 50, ASA 325, Norvasc 5,
Lovenox 100 [**Hospital1 **] (stopped 2 weeks ago), Vit E, Vit C, albuterol
IH PRN, MVI,

Discharge Medications:
1. Clopidogrel 75 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
Disp:*30 Tablet(s)* Refills:*6*
2. Simvastatin 40 mg Tablet Sig: Two (2) Tablet PO DAILY
(Daily).
3. Atenolol 25 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily).
4. Aspirin 325 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).
5. Albuterol 90 mcg/Actuation Aerosol Sig: 1-2 Puffs Inhalation
Q4H (every 4 hours) as needed.
6. Acetaminophen 325 mg Tablet Sig: 1-2 Tablets PO Q4H (every 4
hours) as needed.
7. Norvasc 5 mg Tablet Sig: One (1) Tablet PO once a day.


Discharge Disposition:
Home

Discharge Diagnosis:
R carotid artery stenosis


Discharge Condition:
Good


Discharge Instructions:
Division of [**Hospital1 **] and Endovascular Surgery
Carotid Stent Discharge Instructions

Medications:
??????	Take Aspirin 325mg (enteric coated) once daily
??????	Take Plavix (Clopidogrel) 75mg once daily
??????	Continue all other medications you were taking before surgery,
unless otherwise directed
??????	You make take Tylenol or prescribed pain medications for any
post procedure pain or discomfort

What activities you can and cannot do:
??????	When you go home, you may walk and go up and down stairs
??????	You may shower (let the soapy water run over groin incision,
rinse and pat dry)
??????	Your incision may be left uncovered, unless you have small
amounts of drainage from the wound, then place a dry dressing or
band aid over the area that is draining, as needed
??????	No heavy lifting, pushing or pulling (greater than 5 lbs) for
1 week (to allow groin puncture to heal)
??????	After 1 week, you may resume sexual activity
??????	After 1 week, gradually increase your activities and distance
walked as you can tolerate
??????	No driving until you are no longer taking pain medications
??????	You should not have an MRI scan within the first 4 weeks after
carotid stenting
??????	Call and schedule an appointment to be seen in [**2-13**] weeks for
post procedure check and ultrasound

What to report to office:
??????	Changes in vision (loss of vision, blurring, double vision,
half vision)
??????	Slurring of speech or difficulty finding correct words to use
??????	Severe headache or worsening headache not controlled by pain
medication
??????	A sudden change in the ability to move or use your arm or leg
or the ability to feel your arm or leg
??????	Trouble swallowing, breathing, or talking
??????	Numbness, coldness or pain in lower extremities
??????	Temperature greater than 101.5F for 24 hours
??????	New or increased drainage from incision or white, yellow or
green drainage from incisions
??????	Bleeding from groin puncture site

SUDDEN, SEVERE BLEEDING OR SWELLING (Groin puncture site)
??????	Lie down, keep leg straight and have someone apply firm
pressure to area for 10 minutes. If bleeding stops, call
[**Date Range 1106**] office. If bleeding does not stop, call 911 for
transfer to closest Emergency Room.


Followup Instructions:
Provider: [**Name10 (NameIs) **] LAB Phone:[**Telephone/Fax (1) 1237**] Date/Time:[**2198-5-21**]
2:15

Provider: [**First Name11 (Name Pattern1) 1112**] [**Last Name (NamePattern4) 2604**], MD Phone:[**Telephone/Fax (1) 1237**]
Date/Time:[**2198-5-21**] 3:45



Completed by:[**2198-4-20**]
{'Occlusion and stenosis of carotid artery without mention of cerebral infarction,Coronary atherosclerosis of unspecified type of vessel, native or graft,Unspecified essential hypertension,Pure hypercholesterolemia,Examination of participant in clinical trial,Procedure not carried out for other reasons'}


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: critical stenosis of the right carotid artery

PRESENT ILLNESS: 61M critical stenosis of the right carotid artery, which is
asymptomatic, on [**1-18**] aborted attempt of RCEA - bradycardic
arrest probably from vagal nerve stimulation

MEDICAL HISTORY: PMH: asthma, arrythmias, HTN, hyperchol, CAD, inferior apical
ischemia, although his ejection fraction was 48%, moderate L
carotid stenosis, arrhythmia problems (currently being worked up
by Dr [**Last Name (STitle) **]
PSH: L 4th finger amputation

MEDICATION ON ADMISSION: [**Last Name (un) 1724**]: Plavix 75, Zocor 80, atenolol 50, ASA 325, Norvasc 5,
Lovenox 100 [**Hospital1 **] (stopped 2 weeks ago), Vit E, Vit C, albuterol
IH PRN, MVI,

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: afvss
a/o
nad
cta
rrr
obese
palp pulses

FAMILY HISTORY: n/c

SOCIAL HISTORY: remote smoker
non drinker 

### Response:
{'Occlusion and stenosis of carotid artery without mention of cerebral infarction,Coronary atherosclerosis of unspecified type of vessel, native or graft,Unspecified essential hypertension,Pure hypercholesterolemia,Examination of participant in clinical trial,Procedure not carried out for other reasons'}
