CHIEF COMPLAINT: 

PRESENT ILLNESS: This is a 45-year-old male
with multiple risk factors including hypertension and
obesity, family history of coronary artery disease, who was
admitted to the [**Hospital Unit Name 196**] Service on [**2148-4-1**] for further
evaluation of chief complaint of chest pain. The patient
described one months worth of progressive chest pain on
exertion.  The patient was referred for an exercise stress
test on [**2148-3-18**] which needed to be stopped secondary
to fatigue after the completion of 7.5 minutes of exercise.
The patient experienced 7/10 chest pain with exercise and EKG
changes included 1-2 mm horizontal with downsloping ST
segment depressions.  The patient was subsequently referred
for cardiac catheterization on [**2148-4-1**], which
demonstrated severe left main and three vessel coronary
artery disease, in addition to moderate left ventricular
systolic dysfunction.  An intra-aortic balloon pump was
inserted during the course of this procedure and the patient
was subsequently admitted to the [**Hospital Unit Name 196**] Service for medical
stabilization and anticipation for emergent surgical
management.

MEDICAL HISTORY: 1.  Nephrotic syndrome.
2.  Hypertension.
3.  Hyperamylasemia.
4.  Obesity.

MEDICATION ON ADMISSION: 

ALLERGIES: The patient has no known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: The patient is a nonsmoker, rare alcohol
consumption.  No history of drug use.
Coronary atherosclerosis of native coronary artery,Intermediate coronary syndrome,Nephrotic syndrome with unspecified pathological lesion in kidney,Other nonspecific abnormal serum enzyme levels,Obesity, unspecified,Unspecified essential hypertension,Proteinuria,Pure hypercholesterolemia,Family history of ischemic heart disease
Crnry athrscl natve vssl,Intermed coronary synd,Nephrotic syndrome NOS,Abn serum enzy level NEC,Obesity NOS,Hypertension NOS,Proteinuria,Pure hypercholesterolem,Fam hx-ischem heart dis
Admission Date:  [**2148-4-1**]       Discharge Date:  [**2148-4-6**]

Date of Birth:   [**2102-11-12**]       Sex:  M

Service:  CARDIOTHORACIC SURGERY

HISTORY OF THE PRESENT ILLNESS:  This is a 45-year-old male
with multiple risk factors including hypertension and
obesity, family history of coronary artery disease, who was
admitted to the [**Hospital Unit Name 196**] Service on [**2148-4-1**] for further
evaluation of chief complaint of chest pain. The patient
described one months worth of progressive chest pain on
exertion.  The patient was referred for an exercise stress
test on [**2148-3-18**] which needed to be stopped secondary
to fatigue after the completion of 7.5 minutes of exercise.
The patient experienced 7/10 chest pain with exercise and EKG
changes included 1-2 mm horizontal with downsloping ST
segment depressions.  The patient was subsequently referred
for cardiac catheterization on [**2148-4-1**], which
demonstrated severe left main and three vessel coronary
artery disease, in addition to moderate left ventricular
systolic dysfunction.  An intra-aortic balloon pump was
inserted during the course of this procedure and the patient
was subsequently admitted to the [**Hospital Unit Name 196**] Service for medical
stabilization and anticipation for emergent surgical
management.

PAST MEDICAL HISTORY:
1.  Nephrotic syndrome.
2.  Hypertension.
3.  Hyperamylasemia.
4.  Obesity.

ADMISSION MEDICATIONS:
1.  Lopressor.
2.  Lisinopril.
3.  Trazodone.
4.  Aspirin.
5.  Protonix.

ALLERGIES:  The patient has no known drug allergies.

SOCIAL HISTORY:  The patient is a nonsmoker, rare alcohol
consumption.  No history of drug use.

HOSPITAL COURSE:  The patient was admitted to the [**Hospital Unit Name 196**]
Service on [**2148-4-1**] under the direction of Dr. [**First Name4 (NamePattern1) **]
[**Last Name (NamePattern1) 73**].  Following extensive discussions with the patient
and his family regarding the risks and benefits of surgery,
the patient was consented and scheduled for a coronary artery
bypass graft to take place on [**2148-4-2**].  The patient
tolerated the procedure well with a triple coronary artery
bypass graft.  Bypasses included anastomosis of the left
internal mammary artery to the left anterior descending
artery, saphenous vein graft to the obtuse marginal branch,
and saphenous vein graft to the posterior descending coronary
artery.  The patient's pericardium was left open; lines
placed intraoperatively included a right radial arterial
line, Swan-Ganz catheter, and right femoral IABP; both
ventricular and atrial wires were placed; two mediastinal
tubes and one left pleural tube were placed.  Total bypass
time was 64 minutes; cross clamp time was 58 minutes.

The patient was subsequently transferred to the Cardiac
Surgery Recovery Unit, intubated, with a mean arterial
pressure of 80, CVP of 10, PAD 15, [**Doctor First Name 1052**] 19.  The patient had a
heart rate of 90, normal sinus rhythm.  The patient was
transported on both propofol and Neo-Synephrine drips.

Shortly after arrival in the CSRU, the patient was
successfully weaned and extubated without complication.  In
the CSRU, the patient progressed well clinically.  On
postoperative day number two, the patient was cleared for
transfer to the floor and was subsequently admitted to the
Cardiothoracic Surgery Service under the direction of Dr.
[**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **].

Postoperatively, the patient demonstrated a benign clinical
course with steady improvement.  The patient was evaluated by
physical therapy who deemed him appropriate to be discharged
home following completion of his medical care.  The patient's
chest tube and Foley catheter were removed without
complication; the patient was noted by chest x-ray to have no
evidence of postremoval pneumothorax and was subsequently
noted to be independently productive of adequate amounts of
urine for the duration of his stay.  The patient was
successfully advanced to a full regular diet which he
tolerated well and was noted to have adequate pain control
via oral pain medications.

The patient was subsequently cleared for discharge to home on
postoperative day number four, [**2148-4-6**], with instructions
for follow-up.

CONDITION ON DISCHARGE:  Stable.

DISCHARGE MEDICATIONS:
1.  Lasix 20 mg p.o. q. 12 hours times ten days.
2.  Potassium chloride 20 mEq p.o. q. 12 hours times ten
days.
3.  Aspirin 325 mg p.o. q.d.
4.  Colace 100 mg p.o. b.i.d.
5.  Percocet one to two tablets p.o. q. four to six hours
p.r.n. pain.
6.  Lopressor 50 mg p.o. b.i.d.

DISCHARGE INSTRUCTIONS:  The patient is to maintain his
incision clean and dry at all times.  The patient may shower
but should pat dry incisions afterwards; no bathing or
swimming.  The patient is to resume a regular diet.  The
patient has been instructed to limit physical activity; no
heavy exertion.  No driving while taking prescription pain
medications.

FOLLOW-UP:  The patient is to follow-up with his primary care
provider within one to two weeks following discharge.  The
patient is to follow-up with Dr. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **] four weeks
following discharge; the patient is to call to schedule an
appointment.




                            [**First Name11 (Name Pattern1) 1112**] [**Last Name (NamePattern1) **], M.D.  [**MD Number(1) 3113**]

Dictated By:[**Last Name (NamePattern1) 1053**]
MEDQUIST36

D:  [**2148-4-7**]  12:52
T:  [**2148-4-7**]  08:40
JOB#:  [**Job Number 103454**]
{'Coronary atherosclerosis of native coronary artery,Intermediate coronary syndrome,Nephrotic syndrome with unspecified pathological lesion in kidney,Other nonspecific abnormal serum enzyme levels,Obesity, unspecified,Unspecified essential hypertension,Proteinuria,Pure hypercholesterolemia,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: This is a 45-year-old male
with multiple risk factors including hypertension and
obesity, family history of coronary artery disease, who was
admitted to the [**Hospital Unit Name 196**] Service on [**2148-4-1**] for further
evaluation of chief complaint of chest pain. The patient
described one months worth of progressive chest pain on
exertion.  The patient was referred for an exercise stress
test on [**2148-3-18**] which needed to be stopped secondary
to fatigue after the completion of 7.5 minutes of exercise.
The patient experienced 7/10 chest pain with exercise and EKG
changes included 1-2 mm horizontal with downsloping ST
segment depressions.  The patient was subsequently referred
for cardiac catheterization on [**2148-4-1**], which
demonstrated severe left main and three vessel coronary
artery disease, in addition to moderate left ventricular
systolic dysfunction.  An intra-aortic balloon pump was
inserted during the course of this procedure and the patient
was subsequently admitted to the [**Hospital Unit Name 196**] Service for medical
stabilization and anticipation for emergent surgical
management.

MEDICAL HISTORY: 1.  Nephrotic syndrome.
2.  Hypertension.
3.  Hyperamylasemia.
4.  Obesity.

MEDICATION ON ADMISSION: 

ALLERGIES: The patient has no known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: The patient is a nonsmoker, rare alcohol
consumption.  No history of drug use. 

### Response:
{'Coronary atherosclerosis of native coronary artery,Intermediate coronary syndrome,Nephrotic syndrome with unspecified pathological lesion in kidney,Other nonspecific abnormal serum enzyme levels,Obesity, unspecified,Unspecified essential hypertension,Proteinuria,Pure hypercholesterolemia,Family history of ischemic heart disease'}
