CHIEF COMPLAINT: 

PRESENT ILLNESS: The patient is a 54-year-old
male with a prior history significant for anginal symptoms
which have gradually progressed.  There is also a family
history of coronary artery disease.  The patient consequently
had a cardiac catheterization performed at an outside
hospital in [**2125-9-18**].  The echocardiogram showed mild
anterobasal hypokinesis and moderate anterolateral
hypokinesis.  Estimated left ventricular ejection fraction
was approximately 50%.  Coronary angiography performed at the
same time showed a 70% stenosis of the left main coronary
artery.  In addition, there was 70% of the proximal left
anterior descending artery and an ostial 95% stenosis.  Also
there was a 70% stenosis of the distal right coronary artery.
The patient was consequently referred to Cardiac Surgery for
a possible surgical intervention.  There is no history of
diabetes, no history of congestive heart failure, no history
of stroke.

MEDICAL HISTORY: 1.  History of angina
2.  History of leg trauma

MEDICATION ON ADMISSION: 

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: The patient is a tobacco user.  The
patient's occupation is a construction worker.
Coronary atherosclerosis of native coronary artery,Other and unspecified angina pectoris
Crnry athrscl natve vssl,Angina pectoris NEC/NOS
Admission Date:  [**2125-10-2**]       Discharge Date:  [**2125-10-5**]

Date of Birth:   [**2071-6-23**]       Sex:  M

Service:  CARDIAC SURGERY

HISTORY OF PRESENT ILLNESS:  The patient is a 54-year-old
male with a prior history significant for anginal symptoms
which have gradually progressed.  There is also a family
history of coronary artery disease.  The patient consequently
had a cardiac catheterization performed at an outside
hospital in [**2125-9-18**].  The echocardiogram showed mild
anterobasal hypokinesis and moderate anterolateral
hypokinesis.  Estimated left ventricular ejection fraction
was approximately 50%.  Coronary angiography performed at the
same time showed a 70% stenosis of the left main coronary
artery.  In addition, there was 70% of the proximal left
anterior descending artery and an ostial 95% stenosis.  Also
there was a 70% stenosis of the distal right coronary artery.
The patient was consequently referred to Cardiac Surgery for
a possible surgical intervention.  There is no history of
diabetes, no history of congestive heart failure, no history
of stroke.

PAST MEDICAL HISTORY:
1.  History of angina
2.  History of leg trauma

MEDICATIONS:
1.  Aspirin 325 mg by mouth once daily
2.  Isosorbide

ALLERGIES:  No known drug allergies.

SOCIAL HISTORY:  The patient is a tobacco user.  The
patient's occupation is a construction worker.

PHYSICAL EXAMINATION:  Heart rate 70, blood pressure 120/80,
afebrile, oxygen saturation 97% on room air.  General
examination:  Middle-aged white male in no apparent distress.
Skin examination within normal limits.  Head, eyes, ears,
nose and throat examination within normal limits.  No jugular
venous distention, no bruits detected.  Chest examination
clear to auscultation bilaterally.  Heart examination:
Regular rate and rhythm, no murmurs, gallops or rubs.
Abdomen:  Soft, nontender, nondistended.  Extremities:  Warm,
well perfused, with good pulses.  Neurologically, grossly
intact.

LABORATORY DATA:  Preoperative chest x-ray was within normal
limits, without any evidence of congestive heart failure or
cardiac enlargement.

HOSPITAL COURSE:  Given three vessel coronary artery disease,
the patient was referred for cardiac surgery.  It was thought
that a coronary artery bypass grafting would be appropriate
intervention.  On [**2125-10-2**], the patient underwent coronary
artery bypass grafting x 4, specifically left internal
mammary artery to proximal left anterior descending,
saphenous vein graft to distal left anterior descending,
saphenous vein graft to obtuse marginal, saphenous vein graft
to posterior descending artery.  The patient tolerated the
procedure well.  There were no complications.  Please refer
to the full operative report for further details.

The patient was transferred to the Intensive Care Unit in
fair condition.  The patient remained intubated.  His blood
pressure and heart rate were in normal range.  He was in
sinus rhythm.  Postoperatively, the patient's hematocrit was
32.5, platelet count 181, white blood cell count 11.4.
Sodium 139, potassium 4.5, BUN 14, creatinine 0.9.  Calcium
8.3, magnesium 1.9.

The patient was extubated on the same day.  There were no
complications.  The patient's blood gas remained stable.
Postoperative echocardiogram showed an ejection fraction of
40%, with mild global left ventricular systolic dysfunction,
with focally involving anterior and anterolateral
hypokinesis.

On postoperative day one, the patient remained stable in the
Intensive Care Unit.  Pulmonary toilet was initiated
postoperatively.  The patient was started on Lopressor and
Plavix.  He maintained good urine output.  His pain was well
controlled.

Physical Therapy was consulted, who followed the patient
during his hospitalization.  The patient was transferred to
the regular floor on postoperative day two, in stable
condition.  His chest tubes were removed.  His urine catheter
was removed.  The sternal incision appeared clean, dry and
intact.  The pacing wires were removed as well.

The patient continued to show significant improvement.  He
was cleared to go home by Physical Therapy.  He maintained
good oxygen levels on room air.  He remained in sinus rhythm.

The patient was discharged to home on [**2125-10-5**].

CONDITION ON DISCHARGE:  Good.

DISCHARGE DESTINATION:  Home.

DISCHARGE DIAGNOSIS:
1.  Coronary artery disease status post coronary artery
bypass grafting x 4

DISCHARGE MEDICATIONS:
1.  Lopressor 25 mg by mouth twice a day
2.  Lasix 20 mg by mouth twice a day for seven days
3.  Potassium chloride 20 mEq by mouth twice a day for seven
days
4.  Enteric-coated aspirin 325 mg by mouth once daily
5.  Colace 100 mg by mouth twice a day as needed for
constipation
6.  Percocet one to two tablets by mouth every four to six
hours as needed for pain
7.  Plavix 75 mg by mouth once daily

DISCHARGE INSTRUCTIONS:
1.  The patient is to follow up with his surgeon, Dr. [**First Name4 (NamePattern1) **]
[**Last Name (NamePattern1) **], in approximately four weeks.
2.  The patient is to follow up with his primary care
physician in approximately one to two weeks.
3.  The patient is to follow up with his cardiologist in
approximately three to four weeks, preferably before seeing
Dr. [**Last Name (STitle) **].




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

Dictated By:[**Last Name (NamePattern1) 10097**]
MEDQUIST36

D:  [**2125-10-7**]  22:03
T:  [**2125-10-8**]  00:30
JOB#:  [**Job Number 45055**]
{'Coronary atherosclerosis of native coronary artery,Other and unspecified angina pectoris'}


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: The patient is a 54-year-old
male with a prior history significant for anginal symptoms
which have gradually progressed.  There is also a family
history of coronary artery disease.  The patient consequently
had a cardiac catheterization performed at an outside
hospital in [**2125-9-18**].  The echocardiogram showed mild
anterobasal hypokinesis and moderate anterolateral
hypokinesis.  Estimated left ventricular ejection fraction
was approximately 50%.  Coronary angiography performed at the
same time showed a 70% stenosis of the left main coronary
artery.  In addition, there was 70% of the proximal left
anterior descending artery and an ostial 95% stenosis.  Also
there was a 70% stenosis of the distal right coronary artery.
The patient was consequently referred to Cardiac Surgery for
a possible surgical intervention.  There is no history of
diabetes, no history of congestive heart failure, no history
of stroke.

MEDICAL HISTORY: 1.  History of angina
2.  History of leg trauma

MEDICATION ON ADMISSION: 

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: The patient is a tobacco user.  The
patient's occupation is a construction worker. 

### Response:
{'Coronary atherosclerosis of native coronary artery,Other and unspecified angina pectoris'}
