CHIEF COMPLAINT: 

PRESENT ILLNESS: This 57-year-old white male has
a history of diabetes, hypertension, and peripheral vascular
disease.  He presented to [**Hospital 5871**] Hospital after episodes of
chest pain and shortness of breath.

MEDICAL HISTORY: Insulin-dependent diabetes for 17
years.  Peripheral vascular disease status post right
popliteal to right plantar bypass in [**2170-1-8**].  History
of hypertension.  History of retinopathy.  History of
peripheral neuropathy.

MEDICATION ON ADMISSION: Lopressor 25 mg p.o. b.i.d.,
Zantac 150 mg p.o. b.i.d., NPH Insulin 54 U q.a.m., 59 U
q.p.m., Percocet p.r.n.

ALLERGIES: NO KNOWN DRUG ALLERGIES.

PHYSICAL EXAM: 

FAMILY HISTORY: Unremarkable.

SOCIAL HISTORY: He lives alone.  He does not smoke
cigarettes.  He has a 10 pack-year history, but quit 35 years
ago.  He does not drink alcohol.
Acute myocardial infarction of other anterior wall, initial episode of care,Ulcer of heel and midfoot,Coronary atherosclerosis of native coronary artery,Peripheral vascular disease, unspecified,Unspecified essential hypertension,Diabetes with neurological manifestations, type II or unspecified type, not stated as uncontrolled,Polyneuropathy in diabetes
AMI anterior wall, init,Ulcer of heel & midfoot,Crnry athrscl natve vssl,Periph vascular dis NOS,Hypertension NOS,DMII neuro nt st uncntrl,Neuropathy in diabetes
Admission Date:  [**2170-3-3**]       Discharge Date:  [**2170-3-14**]

Date of Birth:   [**2112-4-3**]       Sex:  M

Service:

HISTORY OF PRESENT ILLNESS:  This 57-year-old white male has
a history of diabetes, hypertension, and peripheral vascular
disease.  He presented to [**Hospital 5871**] Hospital after episodes of
chest pain and shortness of breath.

An electrocardiogram revealed anterior ischemia with ST
elevations in V2-V3, along with anterior Qs.  He also had
positive enzymes and was placed on a Heparin drip,
Integrilin, Plavix, and Nitropaste.

He was transferred to [**Hospital6 256**]
and was admitted.

He recently had a right popliteal to right plantar bypass in
[**2170-1-8**] at [**Hospital6 256**].

PAST MEDICAL HISTORY:  Insulin-dependent diabetes for 17
years.  Peripheral vascular disease status post right
popliteal to right plantar bypass in [**2170-1-8**].  History
of hypertension.  History of retinopathy.  History of
peripheral neuropathy.

MEDICATIONS ON ADMISSION:  Lopressor 25 mg p.o. b.i.d.,
Zantac 150 mg p.o. b.i.d., NPH Insulin 54 U q.a.m., 59 U
q.p.m., Percocet p.r.n.

ALLERGIES:  NO KNOWN DRUG ALLERGIES.

SOCIAL HISTORY:  He lives alone.  He does not smoke
cigarettes.  He has a 10 pack-year history, but quit 35 years
ago.  He does not drink alcohol.

FAMILY HISTORY:  Unremarkable.

REVIEW OF SYSTEMS:  As above.

PHYSICAL EXAMINATION:  General:  He was a well-developed,
well-nourished white male in no apparent distress.  Vital
signs:  Stable and afebrile.  HEENT:  Normocephalic,
atraumatic.  Extraocular movements intact.  Oropharynx
benign.  Neck:  Supple.  Full range of motion.  No
lymphadenopathy or thyromegaly.  Carotids 2+ and equal
bilaterally without bruits.  Lungs:  Clear to auscultation
and percussion.  Cardiovascular:  Regular, rate and rhythm.
Normal S1 and S2.  No murmurs, rubs, or gallops.  Abdomen:
Soft and nontender.  Positive bowel sounds.  No masses or
hepatosplenomegaly.  Extremities:  Without clubbing,
cyanosis, or edema.  He had a right lower extremity scar
which was clean, dry, and intact.  He had an ulcer on his
right medial malleolus and the bottom of his foot.  Pulses:
Exam showed 2+ and equal on carotids, brachial, and femorals.
Neurological:  He had decreased sensation on the bilateral
feet.

He was admitted to Cardiology and was kept on his Heparin
drip, Nitroglycerin drip, and Aggrastat.  He was also seen by
Vascular, and they stated that his right surgery failed, and
he had a thrombectomy.  He also had a right foot debridement
on [**2170-1-26**].  His wounds were healing well.

He remained stable and underwent cardiac catheterization on
[**2170-3-5**], which revealed that the left main had no
significant obstructive disease, the left anterior descending
had an ostial 70% and a distal 80% lesion, the left
circumflex had no disease, the ramus 1 had a 50% midlesion,
ramus 2 had a 90% ostial lesion, right coronary artery had a
70% posterior descending artery lesion at the ostium and an
80% mid posterior descending artery lesion.

Dr. [**Last Name (STitle) **] was consulted, and on [**3-6**], the patient
underwent coronary artery bypass grafting times four with
LIMA to the left anterior descending, reversed saphenous vein
graft to posterior descending artery, obtuse marginal and
diagonal.  Cross-clamp time was 55 min.  Total bypass time
was 65 min.

He was transferred to the CSRU on Dobutamine, Lasix,
Neo-Synephrine, and Propofol.  He had a stable postoperative
night.  His Dobutamine was discontinued, and he was
extubated.

On postoperative day #1, he was transferred to the floor.  He
had 1 U of blood on postoperative day #2 for a hematocrit of
23.  He continued to slowly progress.  He was followed by
Vascular Surgery who felt he should be seen a week after
discharge by Dr. [**Last Name (STitle) **] and agreed with continuing b.i.d.
dressing changes.

He had his chest tubes discontinued on postoperative day #2.
His pacing wires were discontinued on postoperative day #3.
He had a slight bit of lower sternal drainage.  This
resolved, and the sternum was stable.

He was also seen by [**Last Name (un) **], as he would like to change his
Insulin to Lantus and Humalog sliding scale.  He also was
seen by ophthalmology and has proliferative diabetic
retinopathy in both eyes, and vitreous subhyaloid hemorrhage
of the left eye, and he requires follow-up for this.

He continued to progress slowly with Physical Therapy, and on
postoperative day #8, he was discharged to rehabilitation in
stable condition.

DISCHARGE LABORATORY DATA:  Hematocrit 25.2, white count
10,100, platelet count 440,000; sodium 141, potassium 4.7,
chloride 103, CO2 29, BUN 19, creatinine 0.9, blood sugar 97.

DISCHARGE MEDICATIONS:  Colace 100 mg p.o. b.i.d., Zantac 150
mg p.o. b.i.d., Percocet [**2-9**] p.o. q.4-6 hours p.r.n. pain,
Lopressor 50 mg p.o. b.i.d., Lasix 40 mg p.o. b.i.d. x 1
week, Captopril 6.25 mg p.o. t.i.d., Glargine 45 U subcue
q.h.s., Humalog sliding scale.

FOLLOW-UP:  He will be followed by Dr. [**Last Name (STitle) 1007**] in [**2-9**] weeks,
Dr. [**Last Name (STitle) **] in four weeks, Dr. [**Last Name (STitle) **] in one week, Dr.
................ within a month, and the [**Hospital **] Clinic on
[**2170-4-6**].

DISCHARGE DIAGNOSIS:
1.  Coronary artery disease.
2.  Myocardial infarction.
3.  Coronary artery bypass grafting.
4.  Insulin-dependent diabetes.




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

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

D:  [**2170-3-14**]  13:54
T:  [**2170-3-14**]  14:01
JOB#:  [**Job Number 54302**]
{'Acute myocardial infarction of other anterior wall, initial episode of care,Ulcer of heel and midfoot,Coronary atherosclerosis of native coronary artery,Peripheral vascular disease, unspecified,Unspecified essential hypertension,Diabetes with neurological manifestations, type II or unspecified type, not stated as uncontrolled,Polyneuropathy in diabetes'}


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 57-year-old white male has
a history of diabetes, hypertension, and peripheral vascular
disease.  He presented to [**Hospital 5871**] Hospital after episodes of
chest pain and shortness of breath.

MEDICAL HISTORY: Insulin-dependent diabetes for 17
years.  Peripheral vascular disease status post right
popliteal to right plantar bypass in [**2170-1-8**].  History
of hypertension.  History of retinopathy.  History of
peripheral neuropathy.

MEDICATION ON ADMISSION: Lopressor 25 mg p.o. b.i.d.,
Zantac 150 mg p.o. b.i.d., NPH Insulin 54 U q.a.m., 59 U
q.p.m., Percocet p.r.n.

ALLERGIES: NO KNOWN DRUG ALLERGIES.

PHYSICAL EXAM: 

FAMILY HISTORY: Unremarkable.

SOCIAL HISTORY: He lives alone.  He does not smoke
cigarettes.  He has a 10 pack-year history, but quit 35 years
ago.  He does not drink alcohol. 

### Response:
{'Acute myocardial infarction of other anterior wall, initial episode of care,Ulcer of heel and midfoot,Coronary atherosclerosis of native coronary artery,Peripheral vascular disease, unspecified,Unspecified essential hypertension,Diabetes with neurological manifestations, type II or unspecified type, not stated as uncontrolled,Polyneuropathy in diabetes'}
