CHIEF COMPLAINT: 

PRESENT ILLNESS: This 59-year-old white male
has a history of exertional shortness of breath with cold
symptoms for the past three weeks.  He was treated with
Zithromax and continued to have exertional shortness of
breath.  He noticed bilateral leg swelling and presented to
the [**Hospital6 33**] where a chest x-ray revealed CHF and
bilateral pleural effusions.  He has a history of
hypertension, hypercholesterolemia, and obesity.  An
echocardiogram showed left atrial enlargement with 3+ MR [**First Name (Titles) **]
[**Last Name (Titles) 7968**] LV function with an EF of 20%, midseptal inferior
and inferoposterior hypokinesis consistent with
cardiomyopathy.  He ruled out for an MI but it is likely that
he did suffer a recent MI. The patient underwent cardiac
catheterization which reportedly showed three vessel coronary
artery disease.  He was diuresed and transferred to the [**Hospital6 1760**] for CABG.

MEDICAL HISTORY: 1.  Hypertension.
2.  Hypercholesterolemia.
3.  History of obesity.
4.  History of depression.
5.  Status post right arm fracture.
6.  Congestive heart failure.
ADMISSION MEDICATIONS:
1.  Lasix 40 mg p.o. q.d.
2.  Losartan 25 mg p.o. b.i.d.
3.  Imdur 30 mg p.o. q.d.
4.  Albuterol 4 nebulizers q.d.
5.  Ecotrin 325 mg p.o. q.d.
6.  Prozac 30 mg p.o. q.d.
7.  Protonix 40 mg p.o. q.d.
8.  Digoxin 0.25 mg p.o. q.d.
9.  Coreg 6.25 mg p.o. b.i.d.

MEDICATION ON ADMISSION: 

ALLERGIES: The patient has no known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: Unremarkable.

SOCIAL HISTORY: He lives with his wife.  [**Name (NI) **] smoked
cigarettes but quit 25 years ago and drinks alcohol
occasionally.
Coronary atherosclerosis of native coronary artery,Congestive heart failure, unspecified,Mitral valve disorders,Paroxysmal ventricular tachycardia,Cardiac complications, not elsewhere classified,Unspecified essential hypertension,Pure hypercholesterolemia,Old myocardial infarction
Crnry athrscl natve vssl,CHF NOS,Mitral valve disorder,Parox ventric tachycard,Surg compl-heart,Hypertension NOS,Pure hypercholesterolem,Old myocardial infarct
Admission Date:  [**2137-2-28**]       Discharge Date:  [**2137-3-11**]

Date of Birth:   [**2078-1-31**]       Sex:  M

Service:  CARDIOTHORACIC

HISTORY OF THE PRESENT ILLNESS:  This 59-year-old white male
has a history of exertional shortness of breath with cold
symptoms for the past three weeks.  He was treated with
Zithromax and continued to have exertional shortness of
breath.  He noticed bilateral leg swelling and presented to
the [**Hospital6 33**] where a chest x-ray revealed CHF and
bilateral pleural effusions.  He has a history of
hypertension, hypercholesterolemia, and obesity.  An
echocardiogram showed left atrial enlargement with 3+ MR [**First Name (Titles) **]
[**Last Name (Titles) 7968**] LV function with an EF of 20%, midseptal inferior
and inferoposterior hypokinesis consistent with
cardiomyopathy.  He ruled out for an MI but it is likely that
he did suffer a recent MI. The patient underwent cardiac
catheterization which reportedly showed three vessel coronary
artery disease.  He was diuresed and transferred to the [**Hospital6 1760**] for CABG.

PAST MEDICAL HISTORY:
1.  Hypertension.
2.  Hypercholesterolemia.
3.  History of obesity.
4.  History of depression.
5.  Status post right arm fracture.
6.  Congestive heart failure.
ADMISSION MEDICATIONS:
1.  Lasix 40 mg p.o. q.d.
2.  Losartan 25 mg p.o. b.i.d.
3.  Imdur 30 mg p.o. q.d.
4.  Albuterol 4 nebulizers q.d.
5.  Ecotrin 325 mg p.o. q.d.
6.  Prozac 30 mg p.o. q.d.
7.  Protonix 40 mg p.o. q.d.
8.  Digoxin 0.25 mg p.o. q.d.
9.  Coreg 6.25 mg p.o. b.i.d.

ALLERGIES:  The patient has no known drug allergies.

SOCIAL HISTORY:  He lives with his wife.  [**Name (NI) **] smoked
cigarettes but quit 25 years ago and drinks alcohol
occasionally.

FAMILY HISTORY:  Unremarkable.

REVIEW OF SYSTEMS:  Unremarkable.

PHYSICAL EXAMINATION ON ADMISSION:  General:  He was a
well-developed, well-nourished white male in no apparent
distress.  Vital signs:  Stable, afebrile.  HEENT:
Normocephalic, atraumatic.  The extraocular movements were
intact.  Pupils:  Equal and reactive to light and
accommodation.  The oropharynx was benign.  Neck:  Supple,
full range of motion.  No lymphadenopathy or thyromegaly.
Carotids were 2+ and equal bilaterally without bruits.
Lungs:  Bibasilar rales.  Cardiovascular:  Regular rate and
rhythm, normal S1, S2, with no rubs, murmurs, or gallops.
Abdomen:  Obese, soft, nontender, without masses or
hepatosplenomegaly.  Extremities: Without clubbing, cyanosis
or edema.  Pulses were 2+ and equal bilaterally except for
bilateral PTs which were trace.  Neurologic:  Nonfocal.

HOSPITAL COURSE:  He was admitted and monitored on telemetry.
He also had an echocardiogram which revealed an EF of 45%,
mild left atrial dilatation, mild global left ventricular
hypokinesis, and 1+ MR. This was a marked improvement over his
prior exam.

On [**2137-3-4**], the patient underwent a CABG times three with
LIMA to the LAD, reverse saphenous vein graft to the PL and
diagonal.  Cross-clamp time was 65 minutes, total bypass time
78 minutes.  He was transferred to the CRSU on epinephrine,
Neo, and propofol.  He had a stable postoperative night and
was extubated.  He then required aggressive diuresis and
respiratory therapy.  He had his chest tubes discontinued on
postoperative day number two.  He also went into atrial
fibrillation and was started on Lopressor and Amiodarone and
converted to sinus.

He continued to progress and on postoperative day number five
he was discharged to home in stable condition.  His
laboratories on discharge revealed a hematocrit of 28, white
count 8,000, platelets 188,000.  Sodium 141, potassium 4,
chloride 104, C02 31, BUN 9, creatinine 0.9, blood sugar 108.

DISCHARGE MEDICATIONS:
1.  Lopressor 50 mg p.o. b.i.d.
2.  Lasix 40 mg p.o. b.i.d. for seven days.
3.  Potassium 20 mEq p.o. b.i.d. for seven days.
4.  Colace 100 mg p.o. b.i.d.
5.  Ecotrin 325 mg p.o. q.d.
6.  Plavix 75 mg p.o. q.d.
7.  Prozac 30 mg p.o. q.d.
8.  Percocet one to two p.o. q. four to six hours p.r.n.
pain.
9.  Protonix 40 mg p.o. q.d.
10. Combivent one to two puffs q. four to six hours p.r.n.
11. Amiodarone 400 mg p.o. b.i.d. for seven days and then
[**Date Range 7968**] to 400 mg p.o. q.d. times seven days and then
decrease to 200 mg p.o. q.d.

DISCHARGE DIAGNOSIS:
1.  Coronary artery disease.
2.  Atrial fibrillation.
3.  Hypertension.
4.  Hypercholesterolemia.
5.  Obesity.
6.  Congestive heart failure.
FOLLOW-UP:  He will follow-up with Dr. [**Last Name (STitle) **] in one to two
weeks and Dr. [**Last Name (STitle) **] in four weeks.




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

Dictated By:[**Last Name (NamePattern1) 6516**]
MEDQUIST36

D:  [**2137-3-8**]  03:37
T:  [**2137-3-8**]  16:47
JOB#:  [**Job Number 54666**]
{'Coronary atherosclerosis of native coronary artery,Congestive heart failure, unspecified,Mitral valve disorders,Paroxysmal ventricular tachycardia,Cardiac complications, not elsewhere classified,Unspecified essential hypertension,Pure hypercholesterolemia,Old myocardial infarction'}


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 59-year-old white male
has a history of exertional shortness of breath with cold
symptoms for the past three weeks.  He was treated with
Zithromax and continued to have exertional shortness of
breath.  He noticed bilateral leg swelling and presented to
the [**Hospital6 33**] where a chest x-ray revealed CHF and
bilateral pleural effusions.  He has a history of
hypertension, hypercholesterolemia, and obesity.  An
echocardiogram showed left atrial enlargement with 3+ MR [**First Name (Titles) **]
[**Last Name (Titles) 7968**] LV function with an EF of 20%, midseptal inferior
and inferoposterior hypokinesis consistent with
cardiomyopathy.  He ruled out for an MI but it is likely that
he did suffer a recent MI. The patient underwent cardiac
catheterization which reportedly showed three vessel coronary
artery disease.  He was diuresed and transferred to the [**Hospital6 1760**] for CABG.

MEDICAL HISTORY: 1.  Hypertension.
2.  Hypercholesterolemia.
3.  History of obesity.
4.  History of depression.
5.  Status post right arm fracture.
6.  Congestive heart failure.
ADMISSION MEDICATIONS:
1.  Lasix 40 mg p.o. q.d.
2.  Losartan 25 mg p.o. b.i.d.
3.  Imdur 30 mg p.o. q.d.
4.  Albuterol 4 nebulizers q.d.
5.  Ecotrin 325 mg p.o. q.d.
6.  Prozac 30 mg p.o. q.d.
7.  Protonix 40 mg p.o. q.d.
8.  Digoxin 0.25 mg p.o. q.d.
9.  Coreg 6.25 mg p.o. b.i.d.

MEDICATION ON ADMISSION: 

ALLERGIES: The patient has no known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: Unremarkable.

SOCIAL HISTORY: He lives with his wife.  [**Name (NI) **] smoked
cigarettes but quit 25 years ago and drinks alcohol
occasionally. 

### Response:
{'Coronary atherosclerosis of native coronary artery,Congestive heart failure, unspecified,Mitral valve disorders,Paroxysmal ventricular tachycardia,Cardiac complications, not elsewhere classified,Unspecified essential hypertension,Pure hypercholesterolemia,Old myocardial infarction'}
