CHIEF COMPLAINT: Asymptomatic, abnormal EKG, positive stress test

PRESENT ILLNESS: Mr. [**Known lastname **] is a 58 year old male with multiple cardiac risk
factors. He has avoided routine medical care for many years. A
recent EKG at his PCPs office was reportedly abnormal.
Subsequent ETT was suggestive for distal anterior and distal
anteroseptal ischemia. Further evaluation included
echocardiogram and cardiac catheterization. The ECHO showed mild
LVH with an LVEF of 55-60%. There was no AI and only mild MR.
Coronary angiography revealed 80% lesions in the LAD and
circumflex while the RCA was totally occluded. Left
ventriculogrma showed no MR and an LVEF of 40%. Based on the
above results, he was referred for surgical revascularization.

MEDICAL HISTORY: Coronary artery disease, Type 2 diabetes mellitus, Hypertension,
Hypercholesterolemia, BPH, s/p Retinal Laser Surgery

MEDICATION ON ADMISSION: Cozaar 50 qd, Actos 15 qd, Glipizide 20 [**Hospital1 **], Metformin 1000 [**Hospital1 **],
Atenolol 25 qd, Aspirin 81 qd, Lipitor 10 qd

ALLERGIES: No Drug Allergy Information on File

PHYSICAL EXAM: Vitals: BP 145/72, HR 64, RR 16
General: well developed male in no acute distress
HEENT: oropharynx benign, EOMI, PERRL
Neck: supple, no JVD, no carotid bruits
Heart: regular rate, normal s1s2, no murmur or rub
Lungs: clear bilaterally
Abdomen: soft, nontender, normoactive bowel sounds
Ext: warm, no edema, no varicosities
Pulses: 2+ distally
Neuro: nonfocal

FAMILY HISTORY: No history of premature CAD. Brother had MI at age 66. Father
died of brain cancer at age 65.

SOCIAL HISTORY: Married, lives in [**Location 1110**]. Works full time as VP of Global
operations. He denies excessive ETOH. Admits to 60 pack year
history of tobacco. He denies recreational and IV drugs.
Coronary atherosclerosis of native coronary artery,Acute posthemorrhagic anemia,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Unspecified essential hypertension,Pure hypercholesterolemia,Hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (LUTS)
Crnry athrscl natve vssl,Ac posthemorrhag anemia,DMII wo cmp nt st uncntr,Hypertension NOS,Pure hypercholesterolem,BPH w/o urinary obs/LUTS
Admission Date:  [**2129-3-16**]              Discharge Date:   [**2129-3-20**]

Date of Birth:  [**2070-6-21**]             Sex:   M

Service: CARDIOTHORACIC

Allergies:
No Drug Allergy Information on File

Attending:[**First Name3 (LF) 1283**]
Chief Complaint:
Asymptomatic, abnormal EKG, positive stress test

Major Surgical or Invasive Procedure:
[**2129-3-16**] Three Vessel Coronary Artery Bypass Grafting utlizing
left internal mammary artery to left anterior descending,
saphenous vein grafts to first and second obtuse marginals.


History of Present Illness:
Mr. [**Known lastname **] is a 58 year old male with multiple cardiac risk
factors. He has avoided routine medical care for many years. A
recent EKG at his PCPs office was reportedly abnormal.
Subsequent ETT was suggestive for distal anterior and distal
anteroseptal ischemia. Further evaluation included
echocardiogram and cardiac catheterization. The ECHO showed mild
LVH with an LVEF of 55-60%. There was no AI and only mild MR.
Coronary angiography revealed 80% lesions in the LAD and
circumflex while the RCA was totally occluded. Left
ventriculogrma showed no MR and an LVEF of 40%. Based on the
above results, he was referred for surgical revascularization.

Past Medical History:
Coronary artery disease, Type 2 diabetes mellitus, Hypertension,
Hypercholesterolemia, BPH, s/p Retinal Laser Surgery


Social History:
Married, lives in [**Location 1110**]. Works full time as VP of Global
operations. He denies excessive ETOH. Admits to 60 pack year
history of tobacco. He denies recreational and IV drugs.

Family History:
No history of premature CAD. Brother had MI at age 66. Father
died of brain cancer at age 65.

Physical Exam:
Vitals: BP 145/72, HR 64, RR 16
General: well developed male in no acute distress
HEENT: oropharynx benign, EOMI, PERRL
Neck: supple, no JVD, no carotid bruits
Heart: regular rate, normal s1s2, no murmur or rub
Lungs: clear bilaterally
Abdomen: soft, nontender, normoactive bowel sounds
Ext: warm, no edema, no varicosities
Pulses: 2+ distally
Neuro: nonfocal


Pertinent Results:
[**2129-3-16**] 09:28AM   freeCa-1.21
[**2129-3-16**] 09:28AM   HGB-12.0* calcHCT-36
[**2129-3-16**] 09:28AM   GLUCOSE-131* NA+-140 K+-4.8
[**2129-3-16**] 09:28AM   TYPE-ART PO2-394* PCO2-44 PH-7.36 TOTAL
CO2-26 BASE XS-0
[**2129-3-16**] 09:54AM   O2 SAT-84
[**2129-3-16**] 09:54AM   TYPE-MIX
[**2129-3-16**] 11:00AM   freeCa-1.24
[**2129-3-16**] 11:00AM   HGB-11.6* calcHCT-35
[**2129-3-16**] 11:00AM   GLUCOSE-81 NA+-142 K+-4.2
[**2129-3-16**] 10:50PM   TYPE-ART PO2-135* PCO2-39 PH-7.37 TOTAL
CO2-23 BASE XS--2
[**2129-3-16**] 10:50PM   K+-4.7
[**2129-3-16**] 10:50PM   O2 SAT-98
[**2129-3-16**] 08:24PM   TYPE-ART PO2-161* PCO2-42 PH-7.34* TOTAL
CO2-24 BASE XS--2
[**2129-3-16**] 03:09PM   UREA N-20 CREAT-0.9 CHLORIDE-115* TOTAL
CO2-23
[**2129-3-16**] 03:09PM   WBC-9.5 RBC-2.76* HGB-8.3* HCT-23.0* MCV-83
MCH-30.1 MCHC-36.2* RDW-13.0
[**2129-3-16**] 03:09PM   PT-14.4* PTT-33.4 INR(PT)-1.3*
[**2129-3-16**] 01:59PM   WBC-7.4 RBC-2.91*# HGB-8.7*# HCT-24.0*#
MCV-83 MCH-30.0 MCHC-36.3* RDW-13.2
[**2129-3-16**] 12:43PM   TYPE-ART PO2-268* PCO2-42 PH-7.40 TOTAL
CO2-27 BASE XS-1

Brief Hospital Course:
On the day of admission, Mr. [**Known lastname **] [**Last Name (Titles) 1834**] coronary artery
bypass grafting. The operation was uneventful and he transferred
to the CSRU for invasive monitoring. Within 24 hours, he awoke
neurologically intact and was extubated without complication. He
maintained stable hemodynamics and successfully weaned from
inotropic support. He required packed red blood cells for a
postoperative anemia. His CSRU course was otherwise unremarkable
and he transferred to the SDU on postoperative day one. Pt had
no issues and was discharged on [**2129-3-20**].

Medications on Admission:
Cozaar 50 qd, Actos 15 qd, Glipizide 20 [**Hospital1 **], Metformin 1000 [**Hospital1 **],
Atenolol 25 qd, Aspirin 81 qd, Lipitor 10 qd

Discharge Medications:
1. Atorvastatin 10 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
Disp:*90 Tablet(s)* Refills:*2*
2. Aspirin 81 mg Tablet, Delayed Release (E.C.) Sig: One (1)
Tablet, Delayed Release (E.C.) PO DAILY (Daily).
Disp:*90 Tablet, Delayed Release (E.C.)(s)* Refills:*2*
3. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2
times a day).
Disp:*60 Capsule(s)* Refills:*2*
4. Metformin 500 mg Tablet Sig: Two (2) Tablet PO BID (2 times a
day).
Disp:*120 Tablet(s)* Refills:*2*
5. Pioglitazone 15 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
Disp:*30 Tablet(s)* Refills:*2*
6. Glipizide 10 mg Tablet Sig: Two (2) Tablet PO BID (2 times a
day).
Disp:*120 Tablet(s)* Refills:*2*
7. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO
every 6-8 hours as needed for pain.
Disp:*50 Tablet(s)* Refills:*0*


Discharge Disposition:
Home With Service

Facility:
[**Location (un) 1110**] VNA

Discharge Diagnosis:
Coronary artery disease - s/p CABG, Type 2 diabetes mellitus,
Hypertension, Hypercholesterolemia, BPH, s/p Retinal Laser
Surgery


Discharge Condition:
Good


Discharge Instructions:
Patient may shower, no baths. No creams, lotions or ointments to
incisions. No driving for at least one month. No lifting more
than 10 lbs for at least 10 weeks from the date of surgery.
Monitor wounds for signs of infection. Please call with any
concerns or questions.

Followup Instructions:
Cardiac surgeon, Dr. [**Last Name (STitle) 1290**] in [**4-6**] weeks.
Local PCP, [**Last Name (NamePattern4) **]. [**Last Name (STitle) 65721**] in [**2-4**] weeks.
Local cardiologist, Dr. [**Last Name (STitle) 32255**] in [**2-4**] weeks.



Completed by:[**2129-3-20**]
{'Coronary atherosclerosis of native coronary artery,Acute posthemorrhagic anemia,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Unspecified essential hypertension,Pure hypercholesterolemia,Hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (LUTS)'}


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: Asymptomatic, abnormal EKG, positive stress test

PRESENT ILLNESS: Mr. [**Known lastname **] is a 58 year old male with multiple cardiac risk
factors. He has avoided routine medical care for many years. A
recent EKG at his PCPs office was reportedly abnormal.
Subsequent ETT was suggestive for distal anterior and distal
anteroseptal ischemia. Further evaluation included
echocardiogram and cardiac catheterization. The ECHO showed mild
LVH with an LVEF of 55-60%. There was no AI and only mild MR.
Coronary angiography revealed 80% lesions in the LAD and
circumflex while the RCA was totally occluded. Left
ventriculogrma showed no MR and an LVEF of 40%. Based on the
above results, he was referred for surgical revascularization.

MEDICAL HISTORY: Coronary artery disease, Type 2 diabetes mellitus, Hypertension,
Hypercholesterolemia, BPH, s/p Retinal Laser Surgery

MEDICATION ON ADMISSION: Cozaar 50 qd, Actos 15 qd, Glipizide 20 [**Hospital1 **], Metformin 1000 [**Hospital1 **],
Atenolol 25 qd, Aspirin 81 qd, Lipitor 10 qd

ALLERGIES: No Drug Allergy Information on File

PHYSICAL EXAM: Vitals: BP 145/72, HR 64, RR 16
General: well developed male in no acute distress
HEENT: oropharynx benign, EOMI, PERRL
Neck: supple, no JVD, no carotid bruits
Heart: regular rate, normal s1s2, no murmur or rub
Lungs: clear bilaterally
Abdomen: soft, nontender, normoactive bowel sounds
Ext: warm, no edema, no varicosities
Pulses: 2+ distally
Neuro: nonfocal

FAMILY HISTORY: No history of premature CAD. Brother had MI at age 66. Father
died of brain cancer at age 65.

SOCIAL HISTORY: Married, lives in [**Location 1110**]. Works full time as VP of Global
operations. He denies excessive ETOH. Admits to 60 pack year
history of tobacco. He denies recreational and IV drugs. 

### Response:
{'Coronary atherosclerosis of native coronary artery,Acute posthemorrhagic anemia,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Unspecified essential hypertension,Pure hypercholesterolemia,Hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (LUTS)'}
