CHIEF COMPLAINT: Chest pain

PRESENT ILLNESS: 79M with h/o CAD s/p CABG in [**2106**] c/b longstanding sternal wound
infection transferred from [**Hospital6 **] for inferior
STEMI. He reports that he was in his USOH until last night ~ 11
PM. He was lying down to go to sleep and had the acute onset of
SSCP - described as pressure, [**2125-7-23**], no diaphoresis/nausea,
radiated to L shoulder and up L neck. He denies having pain like
this since his last MI in [**2106**]. He called 911 and went to [**Hospital **]. At [**Hospital3 15402**], EKG showed 2mm STE in II, III,
and aVF and subtle ST depressions in V1. He was Plavix loaded
with 600 mg, received ASA 325 mg, was started on heparin bolus
and gtt and nitro gtt. Of note, he was hypertensive to 200/116
at OSH. He also received morphine IV x 2, which relieved the
pain. CP resolved at [**Hospital3 **].
.
At [**Hospital1 18**] ED, initial VS 98.2 77 181/118 18 97% on 2L. EKG showed
NSR 82, LAD, Q-waves in II, III, aVF and subtle depressions in
V2. Labs showed Cr 0.8, Hct 35.7, PTT 76.3, Trop 0.05. CXR was
performed and showed mild pulmonary vascular congestion, prior
sternotomy and CABG clips (my read), no infiltrate. BP trended
down to 110s-120s/70s-80s - nitro gtt on at 1.5 mcg/kg/min.
Heparin gtt was continued.
.
Currently, the patient denies CP though does endorse pain in his
L shoulder and L neck. He had mild SOB on presentation to [**Hospital **] but denies this at present. He denies any history of HTN.
He also mentions increased swelling in his bilateral feet for
the past 2-3 days - has never had this in the past. He is active
at baseline and has not noticed any chest discomfort until last
night. Finally, the patient has a 1-cm open wound on his chest
with some superficial purulence - he states that his CABG
incision has remained open since his surgery in [**2106**]. He was
initially treated for a sternal wound infection but never
followed-up when the infection recurred a few months later.
.
On review of systems, he denies any prior history of stroke,
TIA, deep venous thrombosis, pulmonary embolism, bleeding at the
time of surgery, myalgias, joint pains, cough, hemoptysis, black
stools or red stools. He denies recent fevers, chills or rigors.
He denies exertional buttock or calf pain. All of the other
review of systems were negative.
.
Cardiac review of systems is notable for absence dyspnea on
exertion, paroxysmal nocturnal dyspnea, orthopnea, palpitations,
syncope or presyncope.

MEDICAL HISTORY: . CARDIAC RISK FACTORS: -Diabetes, ? Dyslipidemia, -
Hypertension per patient
2. CARDIAC HISTORY:
- CABG: [**2106**] - [**Hospital6 **], c/b sternal wound infection
that was initially treated post-op, but recurred several months
later - has not followed up for this
3. OTHER PAST MEDICAL HISTORY:
None per patient

MEDICATION ON ADMISSION: ASA 81 mg qday

ALLERGIES: No Known Allergies / Adverse Drug Reactions

PHYSICAL EXAM: Admission Exam
VS: 98.2  83  117/74  22  97% on 2L
GENERAL: NAD. Oriented x3. Pleasant.
HEENT: NCAT. Sclera anicteric. PERRL, EOMI. Conjunctiva were
pink, no pallor or cyanosis of the oral mucosa. No xanthalesma.

FAMILY HISTORY: - No family history of early MI, arrhythmia, cardiomyopathies,
or sudden cardiac death; otherwise non-contributory.

SOCIAL HISTORY: Lives in [**Location 21487**], MA with his wife. Had 7 children (1
passed away from rheumatic fever as child) - several live near
him. Worked as a fisherman and then dockside repairman - now
retired. Still active painting houses. Walks without a cane.
- Tobacco history: 40 pack-year smoking history - quit in [**2106**]
- ETOH: no history of heavy drinking, no current EtOh
- Illicit drugs: none
Acute myocardial infarction of other inferior wall, initial episode of care,Coronary atherosclerosis of autologous vein bypass graft,Other postoperative infection,Methicillin susceptible Staphylococcus aureus in conditions classified elsewhere and of unspecified site,Other specified surgical operations and procedures causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation,Unspecified essential hypertension
AMI inferior wall, init,Crn ath atlg vn bps grft,Other postop infection,Mth sus Stph aur els/NOS,Abn react-surg proc NEC,Hypertension NOS
Admission Date:  [**2126-5-26**]              Discharge Date:   [**2126-5-29**]

Date of Birth:  [**2046-7-1**]             Sex:   M

Service: MEDICINE

Allergies:
No Known Allergies / Adverse Drug Reactions

Attending:[**First Name3 (LF) 106**]
Chief Complaint:
Chest pain

Major Surgical or Invasive Procedure:
Cardiac catheterization s/p BMS placed to SVG to PDA graft
([**2126-5-27**])


History of Present Illness:
79M with h/o CAD s/p CABG in [**2106**] c/b longstanding sternal wound
infection transferred from [**Hospital6 **] for inferior
STEMI. He reports that he was in his USOH until last night ~ 11
PM. He was lying down to go to sleep and had the acute onset of
SSCP - described as pressure, [**2125-7-23**], no diaphoresis/nausea,
radiated to L shoulder and up L neck. He denies having pain like
this since his last MI in [**2106**]. He called 911 and went to [**Hospital **]. At [**Hospital3 15402**], EKG showed 2mm STE in II, III,
and aVF and subtle ST depressions in V1. He was Plavix loaded
with 600 mg, received ASA 325 mg, was started on heparin bolus
and gtt and nitro gtt. Of note, he was hypertensive to 200/116
at OSH. He also received morphine IV x 2, which relieved the
pain. CP resolved at [**Hospital3 **].
.
At [**Hospital1 18**] ED, initial VS 98.2 77 181/118 18 97% on 2L. EKG showed
NSR 82, LAD, Q-waves in II, III, aVF and subtle depressions in
V2. Labs showed Cr 0.8, Hct 35.7, PTT 76.3, Trop 0.05. CXR was
performed and showed mild pulmonary vascular congestion, prior
sternotomy and CABG clips (my read), no infiltrate. BP trended
down to 110s-120s/70s-80s - nitro gtt on at 1.5 mcg/kg/min.
Heparin gtt was continued.
.
Currently, the patient denies CP though does endorse pain in his
L shoulder and L neck. He had mild SOB on presentation to [**Hospital **] but denies this at present. He denies any history of HTN.
He also mentions increased swelling in his bilateral feet for
the past 2-3 days - has never had this in the past. He is active
at baseline and has not noticed any chest discomfort until last
night. Finally, the patient has a 1-cm open wound on his chest
with some superficial purulence - he states that his CABG
incision has remained open since his surgery in [**2106**]. He was
initially treated for a sternal wound infection but never
followed-up when the infection recurred a few months later.
.
On review of systems, he denies any prior history of stroke,
TIA, deep venous thrombosis, pulmonary embolism, bleeding at the
time of surgery, myalgias, joint pains, cough, hemoptysis, black
stools or red stools. He denies recent fevers, chills or rigors.
He denies exertional buttock or calf pain. All of the other
review of systems were negative.
.
Cardiac review of systems is notable for absence dyspnea on
exertion, paroxysmal nocturnal dyspnea, orthopnea, palpitations,
syncope or presyncope.


Past Medical History:
. CARDIAC RISK FACTORS: -Diabetes, ? Dyslipidemia, -
Hypertension per patient
2. CARDIAC HISTORY:
- CABG: [**2106**] - [**Hospital6 **], c/b sternal wound infection
that was initially treated post-op, but recurred several months
later - has not followed up for this
3. OTHER PAST MEDICAL HISTORY:
None per patient


Social History:
Lives in [**Location 21487**], MA with his wife. Had 7 children (1
passed away from rheumatic fever as child) - several live near
him. Worked as a fisherman and then dockside repairman - now
retired. Still active painting houses. Walks without a cane.
- Tobacco history: 40 pack-year smoking history - quit in [**2106**]
- ETOH: no history of heavy drinking, no current EtOh
- Illicit drugs: none


Family History:
- No family history of early MI, arrhythmia, cardiomyopathies,
or sudden cardiac death; otherwise non-contributory.

Physical Exam:
Admission Exam
VS: 98.2  83  117/74  22  97% on 2L
GENERAL: NAD. Oriented x3. Pleasant.
HEENT: NCAT. Sclera anicteric. PERRL, EOMI. Conjunctiva were
pink, no pallor or cyanosis of the oral mucosa. No xanthalesma.

NECK: Supple with JVP not elevated
CARDIAC: Prior sternotomy - 1 cm open wound at top of healed
incision with small amt of purulence on bandaid. Frequent
premature beats, normal S1, S2. No m/r/g.
LUNGS: Resp were unlabored, no accessory muscle use. Crackles at
L base > R, otherwise clear.
ABDOMEN: Soft, NTND. No HSM or tenderness.
EXTREMITIES: No c/c/e. No edema appreciated in patient's ankles.

PULSES: 2+ dps and pts bil, 2+ radials bil
.
On discharge:
clear lungs, heart with RR, no murmurs, JVP not elevated, clear
lungs, R groin without hematoma, good distal pulses


Pertinent Results:
[**2126-5-26**] 02:15AM BLOOD WBC-6.7 RBC-4.24* Hgb-12.1* Hct-35.7*
MCV-84 MCH-28.4 MCHC-33.7 RDW-14.3 Plt Ct-218
[**2126-5-26**] 02:15AM BLOOD Neuts-85.5* Lymphs-11.6* Monos-1.7*
Eos-0.6 Baso-0.6

[**2126-5-26**] 02:15AM BLOOD Glucose-143* UreaN-23* Creat-0.8 Na-142
K-3.8 Cl-108 HCO3-23 AnGap-15
[**2126-5-26**] 03:09PM BLOOD Glucose-95 UreaN-25* Creat-0.8 Na-142
K-4.0 Cl-108 HCO3-22 AnGap-16

[**2126-5-26**] 02:15AM BLOOD CK(CPK)-271
[**2126-5-26**] 03:09PM BLOOD CK(CPK)-698*
[**2126-5-26**] 02:15AM BLOOD cTropnT-0.05*
[**2126-5-26**] 08:40AM BLOOD CK-MB-46* cTropnT-0.36*
[**2126-5-26**] 03:09PM BLOOD CK-MB-78* MB Indx-11.2* cTropnT-0.67*

[**2126-5-26**] 03:09PM BLOOD Calcium-8.5 Phos-2.6* Mg-1.9
.
CXR ([**2126-5-26**])
Sternotomy wires are midline and intact.  Surgical clips are
noted along the left mediastinum. There is mild-to-moderate
cardiomegaly. Mild pulmonary vascular congestion is noted. The
bilateral lung volumes are low with crowding of bronchovascular
markings; however, no focal consolidation, pleural effusion or
pneumothorax is noted. A
large hiatal hernia is noted.
.

COMMENTS:
1. Selective coronary angiography of this right dominant system
revealed
native 3 vessel coronary artery disease. The LM had 30% ostial
stenosis.
The LAD had 60% proximal stenosis; mid 70% from D2 to subtotally

occluded S1; modest high D1 with moderate origin stenosis; large

branching D2 with moderarte origin stenosis; mild diffuse
disease in
mid-distal LAD without competitive flow seen. The LCx had
proximal 30%;
mid 50%; high OM1; OM2 proximal 50% followed by tubular 50%;
small AV
groove LCx; large OM3 with 70% stenosis at first bifurcation
into LPL.
The RCA had proximal 60%, mid subtotal occlusion followed by
total
occlusion at AM2.
2. Selective conduit angiography revealed LIMA-LAD with atretic,

functionally occluded at mid-chest. The SVG-RPDA had slow TIMI1
flow in
a slightly ectatic graft (with some contrast hang-up) with
mid-distal
35%; the distal anastomosis had a hazy filling defect (?avulsed
plaque
vs thrombus) to about 60% stenosed into the moderate caliber
RPDA with
mild plaquing in the proximal RPDA; there was retrograde filling
of
small RPL.
3. Limited resting hemodynamics revealed mildly elevated left
sided
filling pressures with an LVEDP of 20mmHg. There was normal
systemic
arterial pressure of 132/61mmHg.

FINAL DIAGNOSIS:
1. Native 3 vessel coronary artery disease.
2. Occluded LIMA to LAD.
3. Moderate stenosis at the distal anastomosis of the SVG-RPDA
with hazy
filling defect suggesting thrombus or avulsed plaque.
4. Tortous right iliac artery.
.
[**2126-5-26**] 03:09PM BLOOD CK-MB-78* MB Indx-11.2* cTropnT-0.67*
[**2126-5-26**] 07:53PM BLOOD CK-MB-77* cTropnT-0.94*
[**2126-5-28**] 05:42AM BLOOD CK-MB-13* MB Indx-3.8
.
The left atrium is elongated. The right atrium is moderately
dilated. No atrial septal defect is seen by 2D or color Doppler.
There is mild symmetric left ventricular hypertrophy. The left
ventricular cavity size is normal. There is mild regional left
ventricular systolic dysfunction with inferior and
infero-lateral hypokinesis. No masses or thrombi are seen in the
left ventricle. There is no ventricular septal defect. The
aortic root is mildly dilated at the sinus level. The ascending
aorta is mildly dilated. The aortic arch is mildly dilated. The
aortic valve leaflets (3) are mildly thickened but aortic
stenosis is not present. No masses or vegetations are seen on
the aortic valve. Trace aortic regurgitation is seen. The mitral
valve leaflets are mildly thickened. There is no mitral valve
prolapse. No mass or vegetation is seen on the mitral valve.
Mild (1+) mitral regurgitation is seen. The tricuspid valve
leaflets are mildly thickened. There is borderline pulmonary
artery systolic hypertension. No vegetation/mass is seen on the
pulmonic valve.


Brief Hospital Course:
79M with h/o CAD s/p CABG in [**2106**] c/b longstanding sternal wound
infection transferred from [**Hospital6 **] for inferior
STEMI.

# CAD s/p CABG: Inferior STEMI though STE and CP resolved since
transfer. He had Q-waves present inferiorly and thus decision
was made to initially treat him medically. He was continued on
aspirin, plavix, atorvastatin, metoprolol, heparin and nitro
gtt.  His troponins continued to rise with peak at 1.77, MB
peaked at 78. He was taken to cardiac catheterization on [**5-27**],
which showed occluded LIMA to LAD, native 3-vessel CAD, and a
thrombus in the distal SVG. A bare metal stent was placed to the
distal SVG. He was scheduled with cardiology f/u. Discharge
regimen was ASA 325, Toprol 25 mg, atorvastatin 80 mg, Plavix 75
mg qday x at least 1 month, and lisinopril 2.5 mg qday.

# PUMP: TTE showed mild LV hypertrophy and systolic dysfunction.
Study also showed inferior and inferolateral hypokinesis. EF was
estimated at 50%. He was discharged on Toprol 25 mg qday and
lisinopril 2.5 mg qday to be uptitrated as tolerated as an
outpatient.

# RHYTHM: NSR w/ occasional PVCs and rare 3-4 beat runs of NSVT.


# HTN: 200/116 on arrival to OSH. Patient reported no history of
hypertension. His blood pressure remained elevated the day after
admission. Discharge regimen was lisinopril 2.5 mg qday and
metoprolol 25 mg [**Hospital1 **].

# Sternal wound: Patient reports that wound has been open since
[**2106**]. It intermittently drains small amounts of purulence. No
fevers/chills, no leukocytosis. Wound swab and blood cultures
were obtained - wound culture grew staph species. Blood cultures
were negative. He was scheduled with an outpatient plastic
surgery follow-up. The patient may need further imaging to rule
out sternal involvement and osteomyelitis.

CODE: Full code, confirmed
COMM: wife [**Name (NI) 88816**] [**Name (NI) 931**] [**Telephone/Fax (1) 88817**]

Medications on Admission:
ASA 81 mg qday

Discharge Medications:
1. aspirin 325 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).
Disp:*30 Tablet(s)* Refills:*11*
2. atorvastatin 80 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
Disp:*30 Tablet(s)* Refills:*11*
3. clopidogrel 75 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
Disp:*30 Tablet(s)* Refills:*11*
4. Nitrostat 0.3 mg Tablet, Sublingual Sig: One (1) tablet
Sublingual ASDIR as needed for chest pain: take 1 tablet at
onset of chest pain, can take 2nd tablet after 5 minutes if no
relief, take 3rd tablet 5 min after 2nd if continued pain . Call
911 if chest pain persists. .
Disp:*1 bottle* Refills:*3*
5. lisinopril 5 mg Tablet Sig: 0.5 Tablet PO DAILY (Daily).
Disp:*30 Tablet(s)* Refills:*11*
6. metoprolol succinate 25 mg Tablet Extended Release 24 hr Sig:
0.5 Tablet Extended Release 24 hr PO DAILY (Daily).
Disp:*30 Tablet Extended Release 24 hr(s)* Refills:*11*


Discharge Disposition:
Home With Service

Facility:
VNA of Southeastern Mass.

Discharge Diagnosis:
Primary:
STEMI s/p bare metal stent placed to SVG graft to PDA
Sternal Wound infection
Hypertension


Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.


Discharge Instructions:
It was a pleasure caring for you at the [**Hospital1 827**]. You had a heart attack and subsequently went to
the catheterization lab and had a stent placed. You also have
diffuse remaining coronary artery disease. You were started on
medications called PLAVIX, ATORVASTATIN, LISINOPRIL, AND
METOPROLOL.  Your aspirin was increased to 325 mg daily. A bare
metal stent was placed in your vein graft supplying your
posterior descending artery of the heart.

IT IS EXTREMELY IMPORTANT YOU CONTINUE TO TAKE YOUR MEDICATIONS
AS PRESCRIBED.  YOU SHOULD NEVER STOP YOUR ASPIRIN UNLESS
DIRECTED BY YOUR CARDIOLOGIST. YOU SHOULD ALSO TAKE PLAVIX FOR
AT LEAST NEXT 30 DAYS AND DISCUSS WITH YOUR CARDIOLOGIST HOW
LONG YOU SHOULD TAKE YOUR PLAVIX.

FOLLOWING MEDICATION CHANGES WERE MADE TO YOUR MEDICAL REGIMEN
INCREASE ASPIRIN TO 325 mg by mouth daily
START METOPROLOL SUCCINATE 12.5 mg by mouth daily
START ATORVASTATIN 80 mg by mouth daily
START PLAVIX 75 mg by mouth daily
START Lisinopril 2.5 mg per day
.
Your follow-up information is listed below.

Followup Instructions:
Please call [**Telephone/Fax (1) 4105**] to schedule Nuclear (MIBI/Thallium)
stress test which should be performed prior to seeing your
cardiologist on [**6-5**]

Plastic Surgery
Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **]
4pm, Thursday [**5-30**]
[**Apartment Address(1) **], [**Street Address(2) **]., [**Location (un) **] MA

Department: [**Hospital **] HEALTHCARE OF [**Location (un) **]
When: WEDNESDAY [**2126-6-5**] at 2:30 PM
With: [**First Name11 (Name Pattern1) 20**] [**Initial (NamePattern1) **]. [**Last Name (NamePattern1) **] [**Name8 (MD) **], MD [**Telephone/Fax (1) 3070**]
Building: [**Street Address(2) 8172**] ([**Location (un) 620**], MA) Ground
Campus: OFF CAMPUS     Best Parking: Parking on Site

Name: [**Last Name (LF) **],[**First Name3 (LF) **]
Location: [**Hospital1 **]-[**Location (un) **]
Address: [**Street Address(2) **], [**Location (un) **],[**Numeric Identifier 3002**]
Phone: [**Telephone/Fax (1) 4105**]
Appointment: Thursday [**2126-6-20**] 11:00am
{'Acute myocardial infarction of other inferior wall, initial episode of care,Coronary atherosclerosis of autologous vein bypass graft,Other postoperative infection,Methicillin susceptible Staphylococcus aureus in conditions classified elsewhere and of unspecified site,Other specified surgical operations and procedures causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation,Unspecified essential hypertension'}


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: Chest pain

PRESENT ILLNESS: 79M with h/o CAD s/p CABG in [**2106**] c/b longstanding sternal wound
infection transferred from [**Hospital6 **] for inferior
STEMI. He reports that he was in his USOH until last night ~ 11
PM. He was lying down to go to sleep and had the acute onset of
SSCP - described as pressure, [**2125-7-23**], no diaphoresis/nausea,
radiated to L shoulder and up L neck. He denies having pain like
this since his last MI in [**2106**]. He called 911 and went to [**Hospital **]. At [**Hospital3 15402**], EKG showed 2mm STE in II, III,
and aVF and subtle ST depressions in V1. He was Plavix loaded
with 600 mg, received ASA 325 mg, was started on heparin bolus
and gtt and nitro gtt. Of note, he was hypertensive to 200/116
at OSH. He also received morphine IV x 2, which relieved the
pain. CP resolved at [**Hospital3 **].
.
At [**Hospital1 18**] ED, initial VS 98.2 77 181/118 18 97% on 2L. EKG showed
NSR 82, LAD, Q-waves in II, III, aVF and subtle depressions in
V2. Labs showed Cr 0.8, Hct 35.7, PTT 76.3, Trop 0.05. CXR was
performed and showed mild pulmonary vascular congestion, prior
sternotomy and CABG clips (my read), no infiltrate. BP trended
down to 110s-120s/70s-80s - nitro gtt on at 1.5 mcg/kg/min.
Heparin gtt was continued.
.
Currently, the patient denies CP though does endorse pain in his
L shoulder and L neck. He had mild SOB on presentation to [**Hospital **] but denies this at present. He denies any history of HTN.
He also mentions increased swelling in his bilateral feet for
the past 2-3 days - has never had this in the past. He is active
at baseline and has not noticed any chest discomfort until last
night. Finally, the patient has a 1-cm open wound on his chest
with some superficial purulence - he states that his CABG
incision has remained open since his surgery in [**2106**]. He was
initially treated for a sternal wound infection but never
followed-up when the infection recurred a few months later.
.
On review of systems, he denies any prior history of stroke,
TIA, deep venous thrombosis, pulmonary embolism, bleeding at the
time of surgery, myalgias, joint pains, cough, hemoptysis, black
stools or red stools. He denies recent fevers, chills or rigors.
He denies exertional buttock or calf pain. All of the other
review of systems were negative.
.
Cardiac review of systems is notable for absence dyspnea on
exertion, paroxysmal nocturnal dyspnea, orthopnea, palpitations,
syncope or presyncope.

MEDICAL HISTORY: . CARDIAC RISK FACTORS: -Diabetes, ? Dyslipidemia, -
Hypertension per patient
2. CARDIAC HISTORY:
- CABG: [**2106**] - [**Hospital6 **], c/b sternal wound infection
that was initially treated post-op, but recurred several months
later - has not followed up for this
3. OTHER PAST MEDICAL HISTORY:
None per patient

MEDICATION ON ADMISSION: ASA 81 mg qday

ALLERGIES: No Known Allergies / Adverse Drug Reactions

PHYSICAL EXAM: Admission Exam
VS: 98.2  83  117/74  22  97% on 2L
GENERAL: NAD. Oriented x3. Pleasant.
HEENT: NCAT. Sclera anicteric. PERRL, EOMI. Conjunctiva were
pink, no pallor or cyanosis of the oral mucosa. No xanthalesma.

FAMILY HISTORY: - No family history of early MI, arrhythmia, cardiomyopathies,
or sudden cardiac death; otherwise non-contributory.

SOCIAL HISTORY: Lives in [**Location 21487**], MA with his wife. Had 7 children (1
passed away from rheumatic fever as child) - several live near
him. Worked as a fisherman and then dockside repairman - now
retired. Still active painting houses. Walks without a cane.
- Tobacco history: 40 pack-year smoking history - quit in [**2106**]
- ETOH: no history of heavy drinking, no current EtOh
- Illicit drugs: none 

### Response:
{'Acute myocardial infarction of other inferior wall, initial episode of care,Coronary atherosclerosis of autologous vein bypass graft,Other postoperative infection,Methicillin susceptible Staphylococcus aureus in conditions classified elsewhere and of unspecified site,Other specified surgical operations and procedures causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation,Unspecified essential hypertension'}
