CHIEF COMPLAINT: exertional indigestion and abnormal ETT

PRESENT ILLNESS: 70 year old man that over the last several months has been
bothered ny epigastric burning.  Symptoms occured with over
exertion and responded to rest and nitroglycerin SL.  +ETT,
referred for cardiac catherization

MEDICAL HISTORY: HTN
DM
GERD
Gout
Hernia repair

MEDICATION ON ADMISSION: glipizide, hctz, atenolol, colchicine, asa, prilosec

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: NAD
Lungs CTAB ant/lat
RRR No M/R/G
Abd benign
Extrem warm, no edema, 2+Fem, DP and radial pulses bilat. 1+ PT
pulses bilat.
No carotid bruits

FAMILY HISTORY: NC

SOCIAL HISTORY: retired carnival worker
lives with wife
- [**Name (NI) **]
- etoh
Coronary atherosclerosis of native coronary artery,Other and unspecified angina pectoris,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Unspecified essential hypertension,Esophageal reflux,Gout, unspecified
Crnry athrscl natve vssl,Angina pectoris NEC/NOS,DMII wo cmp nt st uncntr,Hypertension NOS,Esophageal reflux,Gout NOS
Admission Date:  [**2193-9-13**]              Discharge Date:   [**2193-9-21**]

Date of Birth:  [**2122-9-23**]             Sex:   M

Service: CARDIOTHORACIC

Allergies:
Patient recorded as having No Known Allergies to Drugs

Attending:[**First Name3 (LF) 1505**]
Chief Complaint:
exertional indigestion and abnormal ETT

Major Surgical or Invasive Procedure:
[**2193-9-16**] CABG x 4 (LIMA->LAD, SVG->PDA/[**Last Name (LF) 48199**], [**First Name3 (LF) **])
[**2193-9-13**] Cardiac Catherization


History of Present Illness:
70 year old man that over the last several months has been
bothered ny epigastric burning.  Symptoms occured with over
exertion and responded to rest and nitroglycerin SL.  +ETT,
referred for cardiac catherization

Past Medical History:
HTN
DM
GERD
Gout
Hernia repair

Social History:
retired carnival worker
lives with wife
- [**Name (NI) **]
- etoh

Family History:
NC

Physical Exam:
NAD
Lungs CTAB ant/lat
RRR No M/R/G
Abd benign
Extrem warm, no edema, 2+Fem, DP and radial pulses bilat. 1+ PT
pulses bilat.
No carotid bruits

Pertinent Results:
CHEST (PA & LAT)  [**2193-9-20**] 10:20 AM

CHEST (PA & LAT)

Reason: evaluate pleural effusions

[**Hospital 93**] MEDICAL CONDITION:
70 year old man s/p CABGx4
REASON FOR THIS EXAMINATION:
evaluate pleural effusions
REASON FOR EXAMINATION: Evaluation of the patient after recent
CABG.

PA and lateral upright chest radiographs compared to [**2193-9-18**] and [**2193-9-15**] (pre-operative examination).

The cardiomediastinal contours is stable post-operatively. The
right internal jugular line has been removed. The bibasilar
retrocardiac atelectasis are unchanged. The bilateral pleural
effusion is small, left more than right, slightly increased on
the left. The previously demonstrated bilateral pleural plaques
are unchanged. There is no evidence of congestive heart failure.

IMPRESSION:
1. Stable cardiomediastinal post-operative appearance.
2. Slightly increased left pleural effusion, still small size.

The study and the report were reviewed by the staff radiologist.
DR. [**First Name4 (NamePattern1) 2618**] [**Last Name (NamePattern1) 2619**]

GENERAL COMMENTS: A TEE was performed in the location listed
above. I certify
I was present in compliance with HCFA regulations. No TEE
related
complications. The patient was under general anesthesia
throughout the
procedure. The patient appears to be in sinus rhythm. Results
were personally
post-bypass
data

Conclusions:
PRE-BYPASS:

1. Overall left ventricular systolic function is low normal
(LVEF 50-55%).
There is mild regional left ventricular systolic dysfunction
with hypokinesis
of the inferior wall. The left ventricular cavity size is
normal.
2. The aortic valve leaflets (3) are mildly thickened. The
non-coronary cusp
is heavily calcified with restricted systolic motion. However,
there is no
aortic valve stenosis. No aortic regurgitation is seen.
3. Right ventricular chamber size and free wall motion are
normal.
4. The mitral valve leaflets are mildly thickened. Mild (1+)
mitral
regurgitation is seen.
5. The descending thoracic aorta is mildly dilated. There are
simple atheroma
in the descending thoracic aorta.
6. No atrial septal defect is seen by 2D or color Doppler. .

POST-BYPASS:

1. There is regional left ventricular systolic dysfunction with
hypokinesis of
the inferior wall.
2. The estimated LVEF may be slightly improved from pre-bypass.

3. There is mild eccendtric tricuspid regurgitation
4. The aortic contours are intact
4. The remaining exam is unchanged
5. All results discussed with surgeons at the time of the exam.


Electronically signed by [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **], MD on [**2193-9-17**] 09:24.

[**Location (un) **] PHYSICIAN:

[**2193-9-13**] 07:13PM URINE  COLOR-Straw APPEAR-Clear SP [**Last Name (un) 155**]-1.015
[**2193-9-13**] 07:13PM URINE  BLOOD-NEG NITRITE-NEG PROTEIN-NEG
GLUCOSE-250 KETONE-NEG BILIRUBIN-NEG UROBILNGN-NEG PH-8.0
LEUK-NEG
[**2193-9-13**] 01:00PM   UREA N-29* CREAT-1.1 SODIUM-134 POTASSIUM-3.8
CHLORIDE-100 TOTAL CO2-25 ANION GAP-13
[**2193-9-13**] 01:00PM   ALT(SGPT)-20 AST(SGOT)-16 ALK PHOS-89
AMYLASE-39 TOT BILI-0.3
[**2193-9-13**] 01:00PM   ALBUMIN-3.9 CHOLEST-113
[**2193-9-13**] 01:00PM   %HbA1c-8.9* [Hgb]-DONE [A1c]-DONE
[**2193-9-13**] 01:00PM   TRIGLYCER-205* HDL CHOL-25 CHOL/HDL-4.5
LDL(CALC)-47
[**2193-9-13**] 01:00PM   WBC-6.5 RBC-4.28* HGB-13.2* HCT-37.6* MCV-88
MCH-30.8 MCHC-35.0 RDW-12.6
[**2193-9-13**] 01:00PM   PLT COUNT-235
[**2193-9-13**] 01:00PM   PT-12.4 PTT-24.2 INR(PT)-1.1

Brief Hospital Course:
Mr. [**Known lastname 68757**] was referred for cardiac catherization [**2193-9-13**]
which found left main and 2 vessel CAD.  He was medically
managed and preoperative workup completed.  On [**2193-9-16**] he was
taken to the operating room and Dr [**Last Name (STitle) **] performed a coronary
artery bypass graft surgery, see operative report for further
details. He was tranferred to the CSRU.  Sedation was weaned off
and he awoke neurologically intact and was extubated. He was
weaned from his vasoactive drips and transferred to the floor by
POD #2. He continued to do well postoperatively, easily
diuresed, and no atrial dysrhythmias.  He was ready for
discharge on post operative day 6 with VNA services.

Medications on Admission:
glipizide, hctz, atenolol, colchicine, asa, prilosec

Discharge Medications:
1. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2
times a day).
Disp:*60 Capsule(s)* Refills:*0*
2. Aspirin 81 mg Tablet, Delayed Release (E.C.) Sig: One (1)
Tablet, Delayed Release (E.C.) PO DAILY (Daily).
Disp:*30 Tablet, Delayed Release (E.C.)(s)* Refills:*0*
3. Atorvastatin 10 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
Disp:*30 Tablet(s)* Refills:*0*
4. Glipizide 10 mg Tab,Sust Rel Osmotic Push 24HR Sig: One (1)
Tab,Sust Rel Osmotic Push 24HR PO DAILY (Daily).
Disp:*30 Tab,Sust Rel Osmotic Push 24HR(s)* Refills:*0*
5. Ferrous Sulfate 325 (65) mg Tablet Sig: One (1) Tablet PO
DAILY (Daily).
Disp:*30 Tablet(s)* Refills:*0*
6. Ascorbic Acid 500 mg Tablet Sig: One (1) Tablet PO BID (2
times a day).
Disp:*60 Tablet(s)* Refills:*0*
7. Metoprolol Tartrate 25 mg Tablet Sig: 1.5 Tablets PO BID (2
times a day).
Disp:*90 Tablet(s)* Refills:*0*
8. Hydromorphone 2 mg Tablet Sig: One (1) Tablet PO Q3-4H as
needed.
Disp:*50 Tablet(s)* Refills:*0*
9. Prilosec 20 mg Capsule, Delayed Release(E.C.) Sig: One (1)
Capsule, Delayed Release(E.C.) PO once a day.
Disp:*30 Capsule, Delayed Release(E.C.)(s)* Refills:*0*
10. Furosemide 20 mg Tablet Sig: One (1) Tablet PO BID (2 times
a day) for 7 days.
Disp:*14 Tablet(s)* Refills:*0*
11. Potassium Chloride 20 mEq Packet Sig: One (1) Packet PO Q12H
(every 12 hours) for 7 days.
Disp:*14 Packet(s)* Refills:*0*


Discharge Disposition:
Home With Service

Facility:
tba

Discharge Diagnosis:
CAD
angina
HTN
NIDDM
gout
GERD
s/p hernia repair


Discharge Condition:
Good.


Discharge Instructions:
Call with fever, redness or drainage from incision or weight
gain more than 2 pounds in one day or five in one week.
Shower, no baths, no lotions, creams or powders to incisions.
No lifting more than 10 pounds in one day or five in one week.

Followup Instructions:
Dr. [**Last Name (STitle) **] 4 weeks
Dr. [**Last Name (STitle) 40027**] 2 weeks
Dr. [**Last Name (STitle) 5686**] 2 weeks



Completed by:[**2193-9-23**]
{'Coronary atherosclerosis of native coronary artery,Other and unspecified angina pectoris,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Unspecified essential hypertension,Esophageal reflux,Gout, unspecified'}


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: exertional indigestion and abnormal ETT

PRESENT ILLNESS: 70 year old man that over the last several months has been
bothered ny epigastric burning.  Symptoms occured with over
exertion and responded to rest and nitroglycerin SL.  +ETT,
referred for cardiac catherization

MEDICAL HISTORY: HTN
DM
GERD
Gout
Hernia repair

MEDICATION ON ADMISSION: glipizide, hctz, atenolol, colchicine, asa, prilosec

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: NAD
Lungs CTAB ant/lat
RRR No M/R/G
Abd benign
Extrem warm, no edema, 2+Fem, DP and radial pulses bilat. 1+ PT
pulses bilat.
No carotid bruits

FAMILY HISTORY: NC

SOCIAL HISTORY: retired carnival worker
lives with wife
- [**Name (NI) **]
- etoh 

### Response:
{'Coronary atherosclerosis of native coronary artery,Other and unspecified angina pectoris,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Unspecified essential hypertension,Esophageal reflux,Gout, unspecified'}
