CHIEF COMPLAINT: 

PRESENT ILLNESS: This is a 48-year-old gentleman
who has had a known murmur for the last 15 years.  An
echocardiogram done in [**2116-10-28**] showed an ejection
fraction of 60 percent with 2 plus mitral regurgitation with
a flailed mitral leaflet, biatrial enlargement, and 1 plus
tricuspid regurgitation.  Cardiac catheterization showed
normal coronary arteries.  The patient was referred to Dr.
[**First Name (STitle) **] [**Last Name (Prefixes) **] for mitral valve repair.

MEDICAL HISTORY: 1. Hypercholesterolemia.
2. Premature ventricular contractions.
3. Myxomatous mitral valve disease.
4. Hay fever.
5. History of hand fractures bilaterally.
6. History of bronchitis and pneumonia one year ago.
7. Status post nasal septoplasty in [**2094**].
8. Status post eye surgery in [**2090**].

MEDICATION ON ADMISSION: 

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: The patient lives at home with his wife.  [**Name (NI) **]
denies tobacco, marijuana, cocaine, or intravenous drug
abuse.  He drinks alcohol occasionally.
Mitral valve disorders,Other and unspecified hyperlipidemia
Mitral valve disorder,Hyperlipidemia NEC/NOS
Admission Date: [**2117-8-31**]        Discharge Date: [**2117-9-4**]

Date of Birth:  [**2068-12-6**]        Sex:  M

Service:  CSU


HISTORY OF PRESENT ILLNESS:  This is a 48-year-old gentleman
who has had a known murmur for the last 15 years.  An
echocardiogram done in [**2116-10-28**] showed an ejection
fraction of 60 percent with 2 plus mitral regurgitation with
a flailed mitral leaflet, biatrial enlargement, and 1 plus
tricuspid regurgitation.  Cardiac catheterization showed
normal coronary arteries.  The patient was referred to Dr.
[**First Name (STitle) **] [**Last Name (Prefixes) **] for mitral valve repair.

PAST MEDICAL HISTORY:
1. Hypercholesterolemia.
2. Premature ventricular contractions.
3. Myxomatous mitral valve disease.
4. Hay fever.
5. History of hand fractures bilaterally.
6. History of bronchitis and pneumonia one year ago.
7. Status post nasal septoplasty in [**2094**].
8. Status post eye surgery in [**2090**].


ALLERGIES:  No known drug allergies.

PREOPERATIVE MEDICATIONS:
1. Lipitor 10 mg by mouth once per day.
2. Toprol-XL 25 mg by mouth once per day.
3. Aspirin 81 mg by mouth once per day.


SOCIAL HISTORY:  The patient lives at home with his wife.  [**Name (NI) **]
denies tobacco, marijuana, cocaine, or intravenous drug
abuse.  He drinks alcohol occasionally.

HOSPITAL COURSE:  The patient was admitted to [**Hospital1 346**] on [**2117-8-31**] and was taken to
the operating room with Dr. [**First Name (STitle) **] [**Last Name (Prefixes) **] for a minimally
invasive mitral valve repair through a right mini-
thoracotomy.  Total cardiopulmonary bypass time was 132
minutes.  Cross-clamp time was 90 minutes.  Please see the
Operative Note for further details.

The patient was transported to the Intensive Care Unit in
stable condition.  The patient was weaned and extubated from
mechanical ventilation on his first postoperative night with
good hemodynamics.  The patient required some Neo-Synephrine
to maintain an adequate blood pressure on his first
postoperative night.  This was weaned to off by the morning
on postoperative day one, and the patient was transferred
from the Intensive Care Unit to the regular part of the
hospital.  The patient began ambulating with Physical
Therapy.

On postoperative day two, the patient's pacing wires and
chest tube were removed without incident.  Post chest tube
removal chest x-ray showed no pneumothorax, no effusion, and
mild edema.  The patient began working with Physical Therapy
and was able to ambulate 500 feet and climb one flight of
stairs while remaining hemodynamically stable.

By postoperative day three, the patient had been weaned off
of his oxygen.  He continued with ambulation.  He continued
to have stable hemodynamics, and the patient was cleared for
discharge on postoperative day four.

CONDITION ON DISCHARGE:  Temperature maximum was 97.5, his
pulse was 73 (sinus rhythm), his blood pressure was 117/61,
his respiratory rate was 18, and his oxygen saturation was 95
percent on room air.  Neurologically, the patient was awake,
alert, and oriented times three - nonfocal examination.
Heart was regular in rate and rhythm.  No murmurs or rubs.
Respiratory examination revealed breath sounds were decreased
on the right; otherwise, they were clear bilaterally.  The
right mini-thoracotomy incision was clean, dry, and intact.
There was no erythema or drainage.  The right groin incision
was clean and dry with no erythema or drainage.

MEDICATIONS ON DISCHARGE:
1. Toprol-XL 25 mg by mouth once per day.
2. Lasix 20 mg by mouth twice per day (times five days).
3. Potassium chloride 20 mEq by mouth twice per day (times
   five days).
4. Colace 100 mg by mouth twice per day.
5. Zantac 150 mg by mouth twice per day.
6. Enteric coated aspirin 325 mg by mouth once per day.
7. Percocet 5/325 one to two tablets by mouth q.4-6h. as
   needed.
8. Ibuprofen 600 mg by mouth q.6h. times three days and then
   q.6h. as needed.
9. Atorvastatin 10 mg by mouth once per day.


DISCHARGE DIAGNOSES:
1. Mitral regurgitation.
2. Status post minimally invasive mitral valve repair.
3. Hypercholesterolemia.


DISCHARGE DISPOSITION:  The patient was to be discharged to
home in stable condition.

DISCHARGE FOLLOWUP:
1. The patient was instructed to follow up with his
   cardiologist (Dr. [**First Name (STitle) **] in one to two weeks.
2. The patient was also instructed to follow up with his
   primary care physician (Dr. [**Last Name (STitle) **] in one to two weeks.
3. The patient was to follow up with Dr. [**First Name (STitle) **] [**Last Name (Prefixes) **] on
   [**9-23**] at 1:15 p.m.




                        [**Doctor Last Name **] [**Last Name (Prefixes) **], M.D. [**MD Number(1) 1288**]

Dictated By:[**Last Name (NamePattern4) 8524**]
MEDQUIST36
D:  [**2117-9-3**] 16:44:42
T:  [**2117-9-3**] 18:05:31
Job#:  [**Job Number 19124**]


Name:  [**Known lastname 3122**], [**Known firstname 2147**]              Unit No:  [**Numeric Identifier 3123**]

Admission Date: [**2117-8-31**]        Discharge Date: [**2117-9-4**]

Date of Birth:  [**2068-12-6**]        Sex:  M

Service:  CSU


ADDENDUM:
This 48-year-old man, as previously described in the previous
discharge summary, had a minimally invasive procedure on
[**2117-8-31**] to repair the mitral valve.  On postoperative day 4,
the patient did well.  On discharge, his heart was regular in
rate and rhythm, had no murmurs, rubs or gallops.  His lungs
were clear to auscultation bilaterally.  His abdomen was
soft, nontender, nondistended.  Bowel sounds were positive.
The patient was taking a regular diet and tolerating p.o.
liquids.

MEDICATIONS:  Medications were described in pervious
discharge summary.

DISCHARGE DIAGNOSES:  Mitral regurgitation, status post
minimally invasive mitral valve repair.

Hypercholesterolemia.

DISCHARGE DISPOSITION:  To home in stable condition.

FO[**Last Name (STitle) **]P PLANS:  The patient is to follow up with Dr. [**First Name (STitle) **]
in 1 to 2 weeks.  The patient also has been instructed to
follow up with his PCP [**Last Name (NamePattern4) **]. [**Last Name (STitle) 3124**] in 1 to 2 weeks.  The patient
is to follow up with Dr. [**Last Name (Prefixes) **] on [**2117-9-23**] at 1:15 p.m.

DISCHARGE STATUS:  Three were no other issues with this
patient over night between postoperative day 3 and 4.  He is
in stable condition and looks excellent.


                        [**Doctor Last Name **] [**Last Name (Prefixes) **], M.D. [**MD Number(1) 3125**]

Dictated By:[**Last Name (NamePattern1) 3126**]
MEDQUIST36
D:  [**2117-9-4**] 12:31:54
T:  [**2117-9-4**] 15:10:26
Job#:  [**Job Number 3127**]
{'Mitral valve disorders,Other and unspecified hyperlipidemia'}


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 is a 48-year-old gentleman
who has had a known murmur for the last 15 years.  An
echocardiogram done in [**2116-10-28**] showed an ejection
fraction of 60 percent with 2 plus mitral regurgitation with
a flailed mitral leaflet, biatrial enlargement, and 1 plus
tricuspid regurgitation.  Cardiac catheterization showed
normal coronary arteries.  The patient was referred to Dr.
[**First Name (STitle) **] [**Last Name (Prefixes) **] for mitral valve repair.

MEDICAL HISTORY: 1. Hypercholesterolemia.
2. Premature ventricular contractions.
3. Myxomatous mitral valve disease.
4. Hay fever.
5. History of hand fractures bilaterally.
6. History of bronchitis and pneumonia one year ago.
7. Status post nasal septoplasty in [**2094**].
8. Status post eye surgery in [**2090**].

MEDICATION ON ADMISSION: 

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: The patient lives at home with his wife.  [**Name (NI) **]
denies tobacco, marijuana, cocaine, or intravenous drug
abuse.  He drinks alcohol occasionally. 

### Response:
{'Mitral valve disorders,Other and unspecified hyperlipidemia'}
