CHIEF COMPLAINT: disabling claudication

PRESENT ILLNESS: Patient well known to Dr. [**Last Name (STitle) **].who presents with
progressive bilateral leg claudication which limits his
activities. Has reconsidered the option of revascularization and
now admitted for aortobifemoral bypass for his aorto-iliac
disease and abdominal aaa.

MEDICAL HISTORY: aortoiliac, aaa
carotid stenosis bilaterally 60-69%
gout
coronary artery disease
history of congestive heart failure
chronic renal insuffiency ( 2.0-2.8)

MEDICATION ON ADMISSION: atenolol 10mgm daily
norvasc 10mgm daily
hydralizine 40mgm qid
allopurinol 150mgm daily
ASA
lipitor 20mgm daily
prazosin 4mgm [**Hospital1 **]
colchicine 6mgm q 48 hrs
folic acid 1mgm daily
procrit 5000u every 4 days

ALLERGIES: Lisinopril / Cozaar

PHYSICAL EXAM: Vital Signs: b/p 155/58 pulse 61 oxygen saturation 99% on room
air
general: alert
HEENT bilateral caroits bruits, carotids palpable bilaterally
Lungs: clear to ausculation bilaterally
Heart: regular rate rythmn
abdominal: begnin
Extremities: no edema.
Pulse exam: femoral pulses palpable bilaterally,left pedal
pulses monophasic signal only. right dp palpable
Neuro: intact

FAMILY HISTORY: unknown

SOCIAL HISTORY: smoker current
previous alcohol use( heavy) discontinued
Atherosclerosis of native arteries of the extremities with intermittent claudication,Congestive heart failure, unspecified,Other disorders of calcium metabolism,Unspecified disorder of kidney and ureter
Ath ext ntv at w claudct,CHF NOS,Dis calcium metablsm NEC,Renal & ureteral dis NOS
Admission Date:  [**2196-9-30**]              Discharge Date:   [**2196-10-11**]

Date of Birth:  [**2125-5-11**]             Sex:   M

Service: VSURG

Allergies:
Lisinopril / Cozaar

Attending:[**First Name3 (LF) 2597**]
Chief Complaint:
disabling claudication

Major Surgical or Invasive Procedure:
aorto- [**Hospital1 **] femoral by pass graft w left accesory renal artery
embolectomy and reimplantation [**2196-9-30**]


History of Present Illness:
Patient well known to Dr. [**Last Name (STitle) **].who presents with
progressive bilateral leg claudication which limits his
activities. Has reconsidered the option of revascularization and
now admitted for aortobifemoral bypass for his aorto-iliac
disease and abdominal aaa.

Past Medical History:
aortoiliac, aaa
carotid stenosis bilaterally 60-69%
gout
coronary artery disease
history of congestive heart failure
chronic renal insuffiency ( 2.0-2.8)

Social History:
smoker current
previous alcohol use( heavy) discontinued

Family History:
unknown

Physical Exam:
Vital Signs: b/p 155/58 pulse 61 oxygen saturation 99% on room
air
general: alert
HEENT bilateral caroits bruits, carotids palpable bilaterally
Lungs: clear to ausculation bilaterally
Heart: regular rate rythmn
abdominal: begnin
Extremities: no edema.
Pulse exam: femoral pulses palpable bilaterally,left pedal
pulses monophasic signal only. right dp palpable
Neuro: intact

Pertinent Results:
[**2196-9-30**] 11:02PM   TYPE-ART PO2-145* PCO2-38 PH-7.31* TOTAL
CO2-20* BASE XS--6
[**2196-9-30**] 11:02PM   LACTATE-1.3
[**2196-9-30**] 09:27PM   TYPE-ART PO2-170* PCO2-46* PH-7.28* TOTAL
CO2-23 BASE XS--4
[**2196-9-30**] 09:10PM   GLUCOSE-128* UREA N-58* CREAT-2.3* SODIUM-141
POTASSIUM-3.9 CHLORIDE-112* TOTAL CO2-19* ANION GAP-14
[**2196-9-30**] 09:10PM   CALCIUM-7.4* PHOSPHATE-4.4 MAGNESIUM-1.4*
[**2196-9-30**] 09:10PM   WBC-15.1*# RBC-3.83* HGB-11.8* HCT-32.7*
MCV-85 MCH-30.9 MCHC-36.1* RDW-16.5*
[**2196-9-30**] 09:10PM   PLT COUNT-139*
[**2196-9-30**] 08:02PM   TYPE-ART PO2-183* PCO2-46* PH-7.27* TOTAL
CO2-22 BASE XS--5
[**2196-9-30**] 08:02PM   LACTATE-1.5
[**2196-9-30**] 08:02PM   HGB-10.5* calcHCT-32
[**2196-9-30**] 07:50PM   WBC-9.5 RBC-3.45* HGB-10.1* HCT-30.1* MCV-87
MCH-29.4 MCHC-33.7 RDW-16.7*
[**2196-9-30**] 07:50PM   PLT COUNT-161
[**2196-9-30**] 07:50PM   PT-13.9* PTT-31.7 INR(PT)-1.2
[**2196-9-30**] 07:25PM   TYPE-ART PO2-176* PCO2-47* PH-7.26* TOTAL
CO2-22 BASE XS--5
[**2196-9-30**] 07:25PM   GLUCOSE-131* LACTATE-2.4* NA+-137 K+-4.1
CL--109
[**2196-9-30**] 07:25PM   HGB-10.7* calcHCT-32 O2 SAT-97
[**2196-9-30**] 07:25PM   freeCa-1.01*
[**2196-9-30**] 06:33PM   TYPE-ART PO2-207* PCO2-44 PH-7.23* TOTAL
CO2-19* BASE XS--8
[**2196-9-30**] 06:33PM   GLUCOSE-125* LACTATE-1.2 NA+-137 K+-3.6
CL--112
[**2196-9-30**] 06:33PM   HGB-9.2* calcHCT-28
[**2196-9-30**] 06:33PM   freeCa-1.06*
[**2196-9-30**] 04:37PM   TYPE-ART PO2-274* PCO2-46* PH-7.31* TOTAL
CO2-24 BASE XS--3
[**2196-9-30**] 04:37PM   GLUCOSE-107* K+-3.9 CL--105
[**2196-9-30**] 04:37PM   HGB-10.9* calcHCT-33 O2 SAT-97
[**2196-9-30**] 01:25PM   TYPE-ART PO2-99 PCO2-38 PH-7.36 TOTAL CO2-22
BASE XS--3
[**2196-9-30**] 01:25PM   TYPE-ART PO2-99 PCO2-38 PH-7.36 TOTAL CO2-22
BASE XS--3
[**2196-9-30**] 01:25PM   GLUCOSE-103 LACTATE-0.8 NA+-137 K+-4.0
CL--106
[**2196-9-30**] 01:25PM   HGB-10.3* calcHCT-31
[**2196-9-30**] 01:25PM   HGB-10.3* calcHCT-31

Brief Hospital Course:
[**2196-9-30**] admitted to preoperative holdi;ng area. S/P
aortobifemoral bypass graft, left accessory renal artery
embolectomy with reimplantation.Transfered to PACU in stable
condition. Remained intubated secondary for need of fluid
resusitation.
[**2196-10-1**] POD#1 afebrile hemodynamically stable. Extubated.
Abdominal exame mild distention but bowel sounds present.NTG
discontinued. remains NPO. Epidural for analgesic controll.
perioperative kefzol continued. Transfered to VICU.
[**2196-10-2**] POD#2 remaines in VICu stable afebrile. Moblilzation of
fluids.
9/13/04POD#3 gout attack given colchicine and rhematology
consulted.s/p joint aspiration wich  was consistant with pseudo
gout.predisone  started.
[**2196-10-4**] POD# 4 epidural catheter removed.Continues with rt.
elbow and left knee pain.
elbow fluid culture no growth,bood cultures x2 no growth, CVL
tip gram stain with grampositive cocci.
[**2196-10-5**] POD#5 swan discontinued. foley discontinued . ambulation
to chair began. Physical theraphy evaluation recommended
rehablititaion when medically stable.
[**2196-10-6**] POD#6 afebrile. stool c. diff negative. Repeat blood
cultures obtained for temerature elevation.
[**Date range (1) 14449**] POD#[**7-1**] continued to work with physical
thearphy.Keflex started for wound changes. normal saline wet to
dry [**Hospital1 **] dressing changes began for right groin
infection.discharged to home.

Medications on Admission:
atenolol 10mgm daily
norvasc 10mgm daily
hydralizine 40mgm qid
allopurinol 150mgm daily
ASA
lipitor 20mgm daily
prazosin 4mgm [**Hospital1 **]
colchicine 6mgm q 48 hrs
folic acid 1mgm daily
procrit 5000u every 4 days

Discharge Medications:
1. Aspirin 325 mg Tablet Sig: One (1) Tablet PO QD (once a day).

2. Hydromorphone HCl 2 mg Tablet Sig: 1-2 Tablets PO Q4H (every
4 hours) as needed.
3. Metoprolol Tartrate 50 mg Tablet Sig: One (1) Tablet PO TID
(3 times a day).
4. Amlodipine Besylate 5 mg Tablet Sig: Two (2) Tablet PO QD
(once a day).
5. Hydralazine HCl 50 mg Tablet Sig: One (1) Tablet PO Q6H
(every 6 hours).
6. Atorvastatin Calcium 20 mg Tablet Sig: One (1) Tablet PO QD
(once a day).
7. Prazosin HCl 5 mg Capsule Sig: One (1) Capsule PO BID (2
times a day).
8. Folic Acid 1 mg Tablet Sig: One (1) Tablet PO QD (once a
day).
9. Colchicine 0.6 mg Tablet Sig: One (1) Tablet PO EVERY OTHER
DAY (Every Other Day).
10. Furosemide 20 mg Tablet Sig: One (1) Tablet PO QD (once a
day).
11. Prednisone 10 mg Tablet Sig: One (1) Tablet PO once a day
for 3 days: start [**Date range (1) 32271**].
Disp:*3 Tablet(s)* Refills:*0*
12. Prednisone 5 mg Tablet Sig: One (1) Tablet PO once a day for
3 days: start [**Date range (1) 32272**]
then d/c.
Disp:*3 Tablet(s)* Refills:*0*
13. Allopurinol 100 mg Tablet Sig: One (1) Tablet PO once a day:
do not start until [**2196-11-4**].
Disp:*30 Tablet(s)* Refills:*2*
14. Cephalexin 500 mg Capsule Sig: One (1) Capsule PO Q8H (every
8 hours) for 2 weeks.
Disp:*2 Capsule(s)* Refills:*0*


Discharge Disposition:
Home with Service

Facility:
Bostonian - [**Location (un) 86**]

Discharge Diagnosis:
symptomatic aortoiliac disease
abdominal aortic aneyrysm
pseudo gout
right groin wound infection


Discharge Condition:
stable

Discharge Instructions:
call if wound does not improve, or becomes more red, swollen or
drainage changes
call if develope fever >101.5


Followup Instructions:
2 weeks Dr. [**Last Name (STitle) **]. call for appointment. [**Telephone/Fax (1) 3121**]



Completed by:[**2196-10-11**]
{'Atherosclerosis of native arteries of the extremities with intermittent claudication,Congestive heart failure, unspecified,Other disorders of calcium metabolism,Unspecified disorder of kidney and ureter'}


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: disabling claudication

PRESENT ILLNESS: Patient well known to Dr. [**Last Name (STitle) **].who presents with
progressive bilateral leg claudication which limits his
activities. Has reconsidered the option of revascularization and
now admitted for aortobifemoral bypass for his aorto-iliac
disease and abdominal aaa.

MEDICAL HISTORY: aortoiliac, aaa
carotid stenosis bilaterally 60-69%
gout
coronary artery disease
history of congestive heart failure
chronic renal insuffiency ( 2.0-2.8)

MEDICATION ON ADMISSION: atenolol 10mgm daily
norvasc 10mgm daily
hydralizine 40mgm qid
allopurinol 150mgm daily
ASA
lipitor 20mgm daily
prazosin 4mgm [**Hospital1 **]
colchicine 6mgm q 48 hrs
folic acid 1mgm daily
procrit 5000u every 4 days

ALLERGIES: Lisinopril / Cozaar

PHYSICAL EXAM: Vital Signs: b/p 155/58 pulse 61 oxygen saturation 99% on room
air
general: alert
HEENT bilateral caroits bruits, carotids palpable bilaterally
Lungs: clear to ausculation bilaterally
Heart: regular rate rythmn
abdominal: begnin
Extremities: no edema.
Pulse exam: femoral pulses palpable bilaterally,left pedal
pulses monophasic signal only. right dp palpable
Neuro: intact

FAMILY HISTORY: unknown

SOCIAL HISTORY: smoker current
previous alcohol use( heavy) discontinued 

### Response:
{'Atherosclerosis of native arteries of the extremities with intermittent claudication,Congestive heart failure, unspecified,Other disorders of calcium metabolism,Unspecified disorder of kidney and ureter'}
