CHIEF COMPLAINT: 

PRESENT ILLNESS: The patient is a 48 year-old
male with a family history of coronary artery disease
presenting with chest pain at rest after eating dinner about
8 out of 10 substernal chest pain associated with nausea and
diaphoresis, but no shortness of breath.  The patient had
stuttering chest pain at rest lasting one to two minutes on
and off throughout the day and then after dinner his pain
increased to an 8 out of 10 and was constant at 6:00 p.m.  He
was taken to the [**Hospital1 **] Emergency Department and transferred
at 8:30 p.m. for emergent cardiac catheterization at [**Hospital1 1444**].  He had ST elevations
anteriorly and his catheterization revealed 100% thrombotic
occlusive lesion at the mid left anterior descending coronary
artery.  He had a percutaneous transluminal coronary
angioplasty and cipher stent placed in his mid left anterior
descending coronary artery.  The patient denies any other
history of chest pain or exertional symptoms.  At baseline he
exercises on an elliptical machine for 30 minutes at a time
without an symptoms.  He denies any paroxysmal nocturnal
dyspnea, orthopnea or lower extremity edema.

MEDICAL HISTORY: 

MEDICATION ON ADMISSION: 

ALLERGIES: 

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: 
Acute myocardial infarction of other anterior wall, initial episode of care,Coronary atherosclerosis of native coronary artery,Heart disease, unspecified,Intestinal disaccharidase deficiencies and disaccharide malabsorption,Family history of ischemic heart disease
AMI anterior wall, init,Crnry athrscl natve vssl,Heart disease NOS,Disaccharidase def/malab,Fam hx-ischem heart dis
Admission Date:  [**2104-3-8**]     Discharge Date:  [**2104-3-11**]

Date of Birth:   [**2055-3-8**]     Sex:  M

Service:  CCU/MEDICINE

HISTORY OF PRESENT ILLNESS:  The patient is a 48 year-old
male with a family history of coronary artery disease
presenting with chest pain at rest after eating dinner about
8 out of 10 substernal chest pain associated with nausea and
diaphoresis, but no shortness of breath.  The patient had
stuttering chest pain at rest lasting one to two minutes on
and off throughout the day and then after dinner his pain
increased to an 8 out of 10 and was constant at 6:00 p.m.  He
was taken to the [**Hospital1 **] Emergency Department and transferred
at 8:30 p.m. for emergent cardiac catheterization at [**Hospital1 1444**].  He had ST elevations
anteriorly and his catheterization revealed 100% thrombotic
occlusive lesion at the mid left anterior descending coronary
artery.  He had a percutaneous transluminal coronary
angioplasty and cipher stent placed in his mid left anterior
descending coronary artery.  The patient denies any other
history of chest pain or exertional symptoms.  At baseline he
exercises on an elliptical machine for 30 minutes at a time
without an symptoms.  He denies any paroxysmal nocturnal
dyspnea, orthopnea or lower extremity edema.

PHYSICAL EXAMINATION:  Temperature 98.0.  Heart rate 70.
Blood pressure 116/76.  Respirations 18.  Satting 100% on 2
liters nasal cannula.  Generally he is in no acute distress,
alert and oriented times three.  HEENT mucous membranes are
moist.  JVP at 14 cm.  Cardiovascular regular rate and
rhythm.  No murmurs, rubs or gallops.  Pulmonary clear to
auscultation bilaterally.  Abdomen is soft, nontender,
nondistended.  Normoactive bowel sounds.  Extremities no
edema.  2+ dorsalis pedis pulses.  Right groin with arterial
and venous sheaths.  No hematomas.  No bruits.

LABORATORY:  White blood cell count 11, hematocrit 44.6,
platelets 250.  Chemistries are 136, 3.9, 107, 24, 15,
creatinine .9, glucose 181, CK is 125, troponin I is 0.24.
Cardiac catheterization revealed right atrial pressure of 7,
right ventricular pressure of 24/7.  Pulmonary artery
pressure of 30/17, pulmonary capillary wedge pressure of 24.
Cardiac output of 4.21, cardiac index of 2.39.  Left anterior
descending coronary artery had a mid thrombotic occlusive
lesion just distal to the first diagonal.  The patient
underwent percutaneous transluminal coronary angioplasty and
a 3.5 cipher stent.  Electrocardiogram precatheterizatin was
normal sinus rhythm at 60 with left axis deviation and slight
intraventricular delay.  T wave flattening in 3 and AVL,
hyperacute Ts with some ST elevations in V2 through V6.
Echocardiogram showed an ejection fraction of 30 to 35% with
anterior hypokinesis.

HOSPITAL COURSE:
1.  Anterior ST elevation myocardial infarction:  The patient
had a percutaneous transluminal coronary angioplasty and
stent of mid left anterior descending coronary artery lesion.
He was started on aspirin and Plavix, Toprol XL.  He did not
tolerate an ace inhibitor as his blood pressures fell to
80/50, so ace inhibitor was discontinued and can be
reinstated as an outpatient if his blood pressure tolerates.
He was started on Coumadin 5 mg q day for risk of embolism
from anterior myocardial infarction.  He will go home on home
Lovenox injections until his INR is greater then 2. The
patient also had several runs of nonsustained ventricular
tachycardia within 24 hours of his myocardial infarction.  He
had a normal signal averaged ECG with the electrophysiology
laboratory and he is to follow up in three to four weeks to
have a T wave alternans test and follow up with Dr. [**Last Name (STitle) **]
of the Electrophisiology Service.

2.  Glucose intolerance:  The patient's glucose levels were
elevated in the hospital, but not diagnostic of diabetes.  He
should follow up with his primary care physician regarding
any treatment necessary.

DISCHARGE DISPOSITION:  Stable.

DISCHARGE STATUS:  The patient will be discharged home with
home Lovenox teaching.

FOLLOW UP PLANS:
1.  The patient is to follow up with his primary care
physician [**Last Name (NamePattern4) **]. [**Last Name (STitle) 18323**] on Friday [**2104-3-14**] at 11:45 a.m. for his
INR check.  He is also to discuss with his doctor any
treatment necessary for his elevated blood sugars.
2.  He si to follow up with his cardiologist Dr. [**First Name4 (NamePattern1) 919**] [**Last Name (NamePattern1) 911**]
on [**3-31**] at 10:30 a.m. in the [**Hospital Ward Name 23**] Building [**Location (un) **].
He is to call [**Telephone/Fax (1) 4022**] to finish his registration the day
or the day after he is discharged from the hospital.
3.  He is to come for his T wave alternans test on Monday [**4-7**] at 1:15 p.m. on the [**Hospital Ward Name 517**] [**Location (un) **] of the [**Hospital Unit Name 54755**].
4.  He is to follow up with his electrophysiologist Dr.
[**Last Name (STitle) **] after his T wave alternans test and to call
[**Telephone/Fax (1) 285**] for an appointment.

DISCHARGE MEDICATIONS:
1.  Aspirin 325 mg po q day.
2.  Plavix 75 mg po q day.
3.  Lipitor 80 mg po q day.
4.  Toprol XL 25 mg po q day.
5.  Lovenox 16 mg subq b.i.d. until INR is greater then 2.0
and then maybe discontinued.






                          [**Name6 (MD) **] [**Name8 (MD) **], M.D.  [**MD Number(1) 5214**]

Dictated By:[**Last Name (NamePattern1) 5819**]

MEDQUIST36

D:  [**2104-3-11**]  01:57
T:  [**2104-3-13**]  08:21
JOB#:  [**Job Number 54756**]
{'Acute myocardial infarction of other anterior wall, initial episode of care,Coronary atherosclerosis of native coronary artery,Heart disease, unspecified,Intestinal disaccharidase deficiencies and disaccharide malabsorption,Family history of ischemic heart disease'}


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: The patient is a 48 year-old
male with a family history of coronary artery disease
presenting with chest pain at rest after eating dinner about
8 out of 10 substernal chest pain associated with nausea and
diaphoresis, but no shortness of breath.  The patient had
stuttering chest pain at rest lasting one to two minutes on
and off throughout the day and then after dinner his pain
increased to an 8 out of 10 and was constant at 6:00 p.m.  He
was taken to the [**Hospital1 **] Emergency Department and transferred
at 8:30 p.m. for emergent cardiac catheterization at [**Hospital1 1444**].  He had ST elevations
anteriorly and his catheterization revealed 100% thrombotic
occlusive lesion at the mid left anterior descending coronary
artery.  He had a percutaneous transluminal coronary
angioplasty and cipher stent placed in his mid left anterior
descending coronary artery.  The patient denies any other
history of chest pain or exertional symptoms.  At baseline he
exercises on an elliptical machine for 30 minutes at a time
without an symptoms.  He denies any paroxysmal nocturnal
dyspnea, orthopnea or lower extremity edema.

MEDICAL HISTORY: 

MEDICATION ON ADMISSION: 

ALLERGIES: 

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY:  

### Response:
{'Acute myocardial infarction of other anterior wall, initial episode of care,Coronary atherosclerosis of native coronary artery,Heart disease, unspecified,Intestinal disaccharidase deficiencies and disaccharide malabsorption,Family history of ischemic heart disease'}
