CHIEF COMPLAINT: Chest pain

PRESENT ILLNESS: 60 yo M with h/o HTN, HLD, and ?ischemic colitis presenting with
progressive chest pain.  He was found to have an acute
myocardial infarction.  He was taken to the cath lab where he
was found to have multi-vessel Coronary Artery Disease.  Cardiac
surgery was consulted for surgical revasculariztion.

MEDICAL HISTORY: Coronary Artery Disease
-Myocardial infarction
-Hypertension
-hypercholesterolemia
-CRI creat 1.4 on admission
-Ischemic colitis
-CT scan revealed emphysema

MEDICATION ON ADMISSION: HOME MEDICATIONS:
- Nebivolol 20 mg daily
- Ramapril 20 mg daily
- Simvastatin 10 mg daily
- Omeprazole 20 mg daily

ALLERGIES: Sulfa(Sulfonamide Antibiotics) / Valium

PHYSICAL EXAM: ADMISSION PHYSICAL EXAMINATION:
VS: T 98.7 BP 116/67 HR 76 RR 18 O2 sat 97% on 3L
GENERAL: NAD. Oriented x3. Mood, affect appropriate.
HEENT: NCAT. Sclera anicteric. PERRL, EOMI. Conjunctiva were
pink, no pallor or cyanosis of the oral mucosa.
NECK: Supple, JVP unable to be appreciated given body habitus.
CARDIAC: PMI located in 5th intercostal space, midclavicular
line. RR, normal S1, S2. soft systolic murmur ([**3-8**]). No thrills,
lifts. No S3 or S4.
LUNGS: No chest wall deformities, scoliosis or kyphosis. Resp
were unlabored, no accessory muscle use. CTAB, no crackles,
wheezes or rhonchi.
ABDOMEN: Soft, NTND. No HSM or tenderness. NABS.
EXTREMITIES: No clubbing/cyanosis.  1+ b/l pedal edeam.
SKIN: No stasis dermatitis, ulcers, scars, or xanthomas.
NEURO: AAOx3, CNII-XII intact, sensation grossly intact
PULSES:  Right: DP 2+ PT 2+  Left: DP 2+ PT 2+
.
Transfer to CT surgery exam:
GENERAL: Awake, alert and oriented x3. Mood, affect appropriate.
 Interactive, comfortable and in NAD
HEENT: NCAT. Sclera anicteric. PERRL, EOMI. Conjunctiva were
pink, no pallor or cyanosis of the oral mucosa.
NECK: Supple, JVP low
CARDIAC: PMI located in 5th intercostal space, midclavicular
line. RR, S1, S2 clear and of good quality, HRs in 50s. soft
systolic murmur ([**3-8**]). No thrills, lifts. No S3 or S4.
LUNGS: No chest wall deformities, scoliosis or kyphosis. Resp
were unlabored, no accessory muscle use, moving air well and
symmetrically. CTAB, no crackles, wheezes or rhonchi.  No faint
expiratory wheezes on this mornings exam.
ABDOMEN: Distended but Soft, NT, voluntary guarding but no
rebound. No HSM or tenderness. NABS.
EXTREMITIES: No clubbing/cyanosis. trace b/l pedal edema.
SKIN: No stasis dermatitis, ulcers, scars, or xanthomas.
NEURO: AAOx3, CNII-XII intact, sensation grossly intact
PULSES:  Right: DP 2+ PT 2+  Left: DP 2+ PT 2+

FAMILY HISTORY: Pt reports his mother died of a heart attack and his twin
brother recently require a stent placement.  His older son has
[**Name (NI) 4522**] disease.

SOCIAL HISTORY: Pt is a former Police officer and paramedic.  He lives with his
wife [**Name (NI) **] and they have three children.
- Tobacco history:  Former smoker, quit 2.5 years prior.  40
packyears.
- ETOH: Denies
- Illicit drugs: Denies
Subendocardial infarction, initial episode of care,Acute kidney failure with lesion of tubular necrosis,Unspecified vascular insufficiency of intestine,Body Mass Index 40.0-44.9, adult,Hyposmolality and/or hyponatremia,Hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage I through stage IV, or unspecified,Other emphysema,Coronary atherosclerosis of native coronary artery,Chronic kidney disease, unspecified,Other and unspecified hyperlipidemia,Myalgia and myositis, unspecified,Anemia, unspecified,Asthma, unspecified type, unspecified,Diaphragmatic hernia without mention of obstruction or gangrene,Personal history of tobacco use,Abnormal weight gain
Subendo infarct, initial,Ac kidny fail, tubr necr,Vasc insuff intest NOS,BMI 40.0-44.9, adult,Hyposmolality,Hy kid NOS w cr kid I-IV,Emphysema NEC,Crnry athrscl natve vssl,Chronic kidney dis NOS,Hyperlipidemia NEC/NOS,Myalgia and myositis NOS,Anemia NOS,Asthma NOS,Diaphragmatic hernia,History of tobacco use,Abnormal weight gain
Admission Date:  [**2162-5-23**]              Discharge Date:   [**2162-6-3**]

Date of Birth:  [**2102-4-19**]             Sex:   M

Service: CARDIOTHORACIC

Allergies:
Sulfa(Sulfonamide Antibiotics) / Valium

Attending:[**First Name3 (LF) 165**]
Chief Complaint:
Chest pain

Major Surgical or Invasive Procedure:
[**2162-5-23**] - Cardiac catheterization
[**2162-5-27**] - Urgent off-pump coronary artery bypass graft x3:  Left
internal mammary artery to left anterior descending artery and
saphenous vein grafts to diagonal and left radial artery graft
to the ramus artery.

History of Present Illness:
60 yo M with h/o HTN, HLD, and ?ischemic colitis presenting with
progressive chest pain.  He was found to have an acute
myocardial infarction.  He was taken to the cath lab where he
was found to have multi-vessel Coronary Artery Disease.  Cardiac
surgery was consulted for surgical revasculariztion.

Past Medical History:
Coronary Artery Disease
-Myocardial infarction
-Hypertension
-hypercholesterolemia
-CRI creat 1.4 on admission
-Ischemic colitis
-CT scan revealed emphysema


Social History:
Pt is a former Police officer and paramedic.  He lives with his
wife [**Name (NI) **] and they have three children.
- Tobacco history:  Former smoker, quit 2.5 years prior.  40
packyears.
- ETOH: Denies
- Illicit drugs: Denies

Family History:
Pt reports his mother died of a heart attack and his twin
brother recently require a stent placement.  His older son has
[**Name (NI) 4522**] disease.

Physical Exam:
ADMISSION PHYSICAL EXAMINATION:
VS: T 98.7 BP 116/67 HR 76 RR 18 O2 sat 97% on 3L
GENERAL: NAD. Oriented x3. Mood, affect appropriate.
HEENT: NCAT. Sclera anicteric. PERRL, EOMI. Conjunctiva were
pink, no pallor or cyanosis of the oral mucosa.
NECK: Supple, JVP unable to be appreciated given body habitus.
CARDIAC: PMI located in 5th intercostal space, midclavicular
line. RR, normal S1, S2. soft systolic murmur ([**3-8**]). No thrills,
lifts. No S3 or S4.
LUNGS: No chest wall deformities, scoliosis or kyphosis. Resp
were unlabored, no accessory muscle use. CTAB, no crackles,
wheezes or rhonchi.
ABDOMEN: Soft, NTND. No HSM or tenderness. NABS.
EXTREMITIES: No clubbing/cyanosis.  1+ b/l pedal edeam.
SKIN: No stasis dermatitis, ulcers, scars, or xanthomas.
NEURO: AAOx3, CNII-XII intact, sensation grossly intact
PULSES:  Right: DP 2+ PT 2+  Left: DP 2+ PT 2+
.
Transfer to CT surgery exam:
GENERAL: Awake, alert and oriented x3. Mood, affect appropriate.
 Interactive, comfortable and in NAD
HEENT: NCAT. Sclera anicteric. PERRL, EOMI. Conjunctiva were
pink, no pallor or cyanosis of the oral mucosa.
NECK: Supple, JVP low
CARDIAC: PMI located in 5th intercostal space, midclavicular
line. RR, S1, S2 clear and of good quality, HRs in 50s. soft
systolic murmur ([**3-8**]). No thrills, lifts. No S3 or S4.
LUNGS: No chest wall deformities, scoliosis or kyphosis. Resp
were unlabored, no accessory muscle use, moving air well and
symmetrically. CTAB, no crackles, wheezes or rhonchi.  No faint
expiratory wheezes on this mornings exam.
ABDOMEN: Distended but Soft, NT, voluntary guarding but no
rebound. No HSM or tenderness. NABS.
EXTREMITIES: No clubbing/cyanosis. trace b/l pedal edema.
SKIN: No stasis dermatitis, ulcers, scars, or xanthomas.
NEURO: AAOx3, CNII-XII intact, sensation grossly intact
PULSES:  Right: DP 2+ PT 2+  Left: DP 2+ PT 2+

Pertinent Results:
DATA:
- ECG:  NSR at 77, normal axis, normal intervals, no STE/STD.
.
- ECHO:  Prelim - mild RV dilation, no focal wall motion
abnormalities
.
- CARDIAC CATH:
Interventional details

The LAD-diagonal branches can be approached with a simultaneous
V
stenting technique in the LAD and diagonal branch.  It appears
that both stents will be approximately 20 mm in length.  In
addition, the large ramus branch also has diffuse disease that
will require a long stent in the event of residual ischemia.

The patient's chest pain was improved - and we have the time to
discuss the options of CABG versus multivessel bifurcation
stenting with long DES.  The risk of stent thrombosis with two
long stents in this location is not negligible.

We will begin more aggressive beta blockage (his HR is in the
90s), administer IV eptifibatide x 18 hours, and titrate his IV
NTG for pain control.  We will hold his clopidogrel in the event
that surgery is selected.

Assessment & Recommendations
1.	Two vessel coronary artery disease (LAD, ramus)
2.	Consider CABG v. multivessel PCI
.
- CTA Chest ([**2162-5-23**]) -
IMPRESSION:
1. No evidence of acute aortic syndrome or pulmonary embolus.
2. Centrilobular emphysema predominantly in upper lobes. Right
middle lobe
and lingular atelectasis.
3. Small hiatal hernia.
.
-ECHO [**5-24**]
Conclusions
Left ventricular wall thickness, cavity size, and global
systolic function are normal (LVEF>55%). Due to suboptimal
technical quality, a focal wall motion abnormality cannot be
fully excluded. Right ventricular chamber size and free wall
motion are normal. There is an anterior space which most likely
represents a prominent fat pad.

IMPRESSION: Suboptimal image quality. Normal biventricular
cavity sizes with preserved global biventricular systolic
function. No pericardial effusion identified.
.
[**2162-5-27**] ECHO
The interatrial septum is [**Month/Day/Year 76472**]. A patent foramen ovale is
present. A left-to-right shunt across the interatrial septum is
seen at rest. There is mild symmetric left ventricular
hypertrophy. Overall left ventricular systolic function is
normal (LVEF>55%). Right ventricular chamber size and free wall
motion are normal. The diameters of aorta at the sinus,
ascending and arch levels are normal. The aortic valve leaflets
(3) appear structurally normal with good leaflet excursion.
There is no aortic valve stenosis. No aortic regurgitation is
seen. The mitral valve leaflets are structurally normal. Mild
(1+) mitral regurgitation is seen.

: Normal overall LV and RV systolic function with no regional
wall motion abnormalities. Mild MR. [**First Name (Titles) **] [**Last Name (Titles) **] with PFO and
left to right shunt.
Post OPCABG
Ventricular function is preserved.
Valve function similar to Pre CABG.
.
[**2162-5-27**] Intra-op TEE:
Conclusions
The interatrial septum is [**Month/Day/Year 76472**]. A patent foramen ovale is
present. A left-to-right shunt across the interatrial septum is
seen at rest. There is mild symmetric left ventricular
hypertrophy. Overall left ventricular systolic function is
normal (LVEF>55%). Right ventricular chamber size and free wall
motion are normal. The diameters of aorta at the sinus,
ascending and arch levels are normal. The aortic valve leaflets
(3) appear structurally normal with good leaflet excursion.
There is no aortic valve stenosis. No aortic regurgitation is
seen. The mitral valve leaflets are structurally normal. Mild
(1+) mitral regurgitation is seen.

: Normal overall LV and RV systolic function with no regional
wall motion abnormalities. Mild MR. [**First Name (Titles) **] [**Last Name (Titles) **] with PFO and
left to right shunt.
Post OPCABG
Ventricular function is preserved.
Valve function similar to Pre CABG.


Brief Hospital Course:
Mr. [**Known lastname 76473**] was admitted to the [**Hospital1 18**] on [**2162-5-23**] for further
management of his chest pain and myocardial infraction. He was
placed on heparin and plavix. Chest xray suggested a widened
mediastinum and thus a ct scan was obtained. This showed a small
hiatal hernia, emphysema and no aortic dissection or embolism. A
cardiac catheterization was performed which revealed severe two
vessel disease. Given the severity of his disease, the cardiac
surgical service was consulted. Mr. [**Known lastname 76473**] was worked-up in the
usual preoperative manner. [**First Name8 (NamePattern2) 6**] [**Doctor Last Name 6237**] test was performed which
showed the left radial artery to suitable for use as conduit.
Plavix was held. On [**2162-5-27**], Mr. [**Known lastname 76473**] was taken to the
operating room where he underwent off pump coronary artery
bypass grafting to three vessels. Please see operative note for
details. Postoperatively he was taken to the intensive care unit
for monitoring. He later awoke neurologically intact and was
extubated. Plavix and imdur were started for his off pump bypass
and his free radial graft respectively.  On postoperative day
one, he was transferred to the step down unit for further
recovery.  Beta blocker was initiated and the patient was gently
diuresed toward the preoperative weight.  Chest tubes and pacing
wires were discontinued without complication.  He developed
Acute Kidney Injury with rise in creatinine to 2.4.  Lisinopril
and Lasix were discontinued and creatinine would trend down.
Urine output remained stable.  Additionally, radial artery
harvest site and sternum developed serosanguinous drainage.
These sites were painted with chloraprep and dressings were
changed TID, drainage diminished.  The patient was evaluated by
the physical therapy service for assistance with strength and
mobility, and it was felt that the patient was safe to be
discharged to home with VNA and physical therapy services.  It
is now felt on [**2162-6-3**] that the patient is safe for discharge
on post-operative day #7.

[**6-1**]

By the time of discharge on POD **** the patient was ambulating
freely, the wound was healing and pain was controlled with oral
analgesics.  The patient was discharged ***** in good condition
with appropriate follow up instructions.


Medications on Admission:
HOME MEDICATIONS:
- Nebivolol 20 mg daily
- Ramapril 20 mg daily
- Simvastatin 10 mg daily
- Omeprazole 20 mg daily

Discharge Medications:
1. fluticasone-salmeterol 250-50 mcg/dose Disk with Device Sig:
One (1) Disk with Device Inhalation [**Hospital1 **] (2 times a day).
Disp:*60 Disk with Device(s)* Refills:*2*
2. isosorbide mononitrate 60 mg Tablet Extended Release 24 hr
Sig: One (1) Tablet Extended Release 24 hr PO DAILY (Daily).
Disp:*30 Tablet Extended Release 24 hr(s)* Refills:*2*
3. clopidogrel 75 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
Disp:*30 Tablet(s)* Refills:*2*
4. atorvastatin 80 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
Disp:*30 Tablet(s)* Refills:*2*
5. docusate sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2
times a day) as needed for constipation.
Disp:*30 Capsule(s)* Refills:*0*
6. 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:*2*
7. mesalamine 250 mg Capsule, Extended Release Sig: Four (4)
Capsule, Extended Release PO QID (4 times a day).
Disp:*240 Capsule, Extended Release(s)* Refills:*0*
8. omeprazole 20 mg Capsule, Delayed Release(E.C.) Sig: Two (2)
Capsule, Delayed Release(E.C.) PO DAILY (Daily).
Disp:*60 Capsule, Delayed Release(E.C.)(s)* Refills:*2*
9. metoprolol tartrate 25 mg Tablet Sig: Three (3) Tablet PO BID
(2 times a day).
Disp:*180 Tablet(s)* Refills:*2*
10. oxycodone 5 mg Tablet Sig: One (1) Tablet PO Q4H (every 4
hours) as needed for pain mild .
Disp:*60 Tablet(s)* Refills:*0*
11. furosemide 20 mg Tablet Sig: One (1) Tablet PO DAILY (Daily)
for 7 days.
Disp:*7 Tablet(s)* Refills:*0*
12. potassium chloride 10 mEq Tablet Extended Release Sig: One
(1) Tablet Extended Release PO once a day for 7 days.
Disp:*7 Tablet Extended Release(s)* Refills:*0*
13. acetaminophen 500 mg Tablet Sig: Two (2) Tablet PO Q6H
(every 6 hours) as needed for pain.
Disp:*60 Tablet(s)* Refills:*0*


Discharge Disposition:
Home With Service

Facility:
[**Company 1519**]

Discharge Diagnosis:
Coronary Artery Disease
-Myocardial infarction
-Hypertension
-hypercholesterolemia
-CRI creat 1.4 on admission
-Ischemic colitis
-CT scan revealed emphysema


Discharge Condition:
Alert and oriented x3 nonfocal
Ambulating with steady gait
Incisional pain managed with oxycodone and tylenol
Incisions:
Sternal - healing well, mild erythema at distal pole of sternal
incision and along left radial harvest site incision.
Leg Right - healing well, no erythema or drainage.
Edema: trace


Discharge Instructions:
1) Please shower daily including washing incisions gently with
mild soap, no baths or swimming until cleared by surgeon. Look
at your incisions daily for redness or drainage.
2) Please NO lotions, cream, powder, or ointments to incisions.
3) Each morning you should weigh yourself and then in the
evening take your temperature, these should be written down on
the chart provided.
4) No driving for approximately one month and while taking
narcotics. Driving will be discussed at follow up appointment
with surgeon when you will likely be cleared to drive.
5) No lifting more than 10 pounds for 10 weeks
6) Please call with any questions or concerns [**Telephone/Fax (1) 170**]

**Please call cardiac surgery office with any questions or
concerns [**Telephone/Fax (1) 170**]. Answering service will contact on call
person during off hours**


Followup Instructions:
You are scheduled for the following appointments
WOUND CARE Phone:[**Telephone/Fax (1) 170**] Date/Time:[**2162-6-8**] 10:00 in the
[**Hospital **] Medical office building, [**Doctor First Name **] [**Hospital Unit Name **]
Surgeon: Dr. [**First Name (STitle) **] on [**2162-6-29**] 1:30, [**Telephone/Fax (1) 170**] in the [**Hospital **]
Medical office building, [**Doctor First Name **] [**Hospital Unit Name **]

Cardiologist: Dr. [**Last Name (STitle) 11493**] [**2162-6-14**] 2:15p

Please call to schedule appointments with your
Primary Care Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 71168**] [**Telephone/Fax (1) 33146**] in [**5-6**] weeks

**Please call cardiac surgery office with any questions or
concerns [**Telephone/Fax (1) 170**]. Answering service will contact on call
person during off hours**


                             [**Name6 (MD) **] [**Name8 (MD) **] MD [**MD Number(2) 173**]

Completed by:[**2162-6-3**]
{'Subendocardial infarction, initial episode of care,Acute kidney failure with lesion of tubular necrosis,Unspecified vascular insufficiency of intestine,Body Mass Index 40.0-44.9, adult,Hyposmolality and/or hyponatremia,Hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage I through stage IV, or unspecified,Other emphysema,Coronary atherosclerosis of native coronary artery,Chronic kidney disease, unspecified,Other and unspecified hyperlipidemia,Myalgia and myositis, unspecified,Anemia, unspecified,Asthma, unspecified type, unspecified,Diaphragmatic hernia without mention of obstruction or gangrene,Personal history of tobacco use,Abnormal weight gain'}


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: 60 yo M with h/o HTN, HLD, and ?ischemic colitis presenting with
progressive chest pain.  He was found to have an acute
myocardial infarction.  He was taken to the cath lab where he
was found to have multi-vessel Coronary Artery Disease.  Cardiac
surgery was consulted for surgical revasculariztion.

MEDICAL HISTORY: Coronary Artery Disease
-Myocardial infarction
-Hypertension
-hypercholesterolemia
-CRI creat 1.4 on admission
-Ischemic colitis
-CT scan revealed emphysema

MEDICATION ON ADMISSION: HOME MEDICATIONS:
- Nebivolol 20 mg daily
- Ramapril 20 mg daily
- Simvastatin 10 mg daily
- Omeprazole 20 mg daily

ALLERGIES: Sulfa(Sulfonamide Antibiotics) / Valium

PHYSICAL EXAM: ADMISSION PHYSICAL EXAMINATION:
VS: T 98.7 BP 116/67 HR 76 RR 18 O2 sat 97% on 3L
GENERAL: NAD. Oriented x3. Mood, affect appropriate.
HEENT: NCAT. Sclera anicteric. PERRL, EOMI. Conjunctiva were
pink, no pallor or cyanosis of the oral mucosa.
NECK: Supple, JVP unable to be appreciated given body habitus.
CARDIAC: PMI located in 5th intercostal space, midclavicular
line. RR, normal S1, S2. soft systolic murmur ([**3-8**]). No thrills,
lifts. No S3 or S4.
LUNGS: No chest wall deformities, scoliosis or kyphosis. Resp
were unlabored, no accessory muscle use. CTAB, no crackles,
wheezes or rhonchi.
ABDOMEN: Soft, NTND. No HSM or tenderness. NABS.
EXTREMITIES: No clubbing/cyanosis.  1+ b/l pedal edeam.
SKIN: No stasis dermatitis, ulcers, scars, or xanthomas.
NEURO: AAOx3, CNII-XII intact, sensation grossly intact
PULSES:  Right: DP 2+ PT 2+  Left: DP 2+ PT 2+
.
Transfer to CT surgery exam:
GENERAL: Awake, alert and oriented x3. Mood, affect appropriate.
 Interactive, comfortable and in NAD
HEENT: NCAT. Sclera anicteric. PERRL, EOMI. Conjunctiva were
pink, no pallor or cyanosis of the oral mucosa.
NECK: Supple, JVP low
CARDIAC: PMI located in 5th intercostal space, midclavicular
line. RR, S1, S2 clear and of good quality, HRs in 50s. soft
systolic murmur ([**3-8**]). No thrills, lifts. No S3 or S4.
LUNGS: No chest wall deformities, scoliosis or kyphosis. Resp
were unlabored, no accessory muscle use, moving air well and
symmetrically. CTAB, no crackles, wheezes or rhonchi.  No faint
expiratory wheezes on this mornings exam.
ABDOMEN: Distended but Soft, NT, voluntary guarding but no
rebound. No HSM or tenderness. NABS.
EXTREMITIES: No clubbing/cyanosis. trace b/l pedal edema.
SKIN: No stasis dermatitis, ulcers, scars, or xanthomas.
NEURO: AAOx3, CNII-XII intact, sensation grossly intact
PULSES:  Right: DP 2+ PT 2+  Left: DP 2+ PT 2+

FAMILY HISTORY: Pt reports his mother died of a heart attack and his twin
brother recently require a stent placement.  His older son has
[**Name (NI) 4522**] disease.

SOCIAL HISTORY: Pt is a former Police officer and paramedic.  He lives with his
wife [**Name (NI) **] and they have three children.
- Tobacco history:  Former smoker, quit 2.5 years prior.  40
packyears.
- ETOH: Denies
- Illicit drugs: Denies 

### Response:
{'Subendocardial infarction, initial episode of care,Acute kidney failure with lesion of tubular necrosis,Unspecified vascular insufficiency of intestine,Body Mass Index 40.0-44.9, adult,Hyposmolality and/or hyponatremia,Hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage I through stage IV, or unspecified,Other emphysema,Coronary atherosclerosis of native coronary artery,Chronic kidney disease, unspecified,Other and unspecified hyperlipidemia,Myalgia and myositis, unspecified,Anemia, unspecified,Asthma, unspecified type, unspecified,Diaphragmatic hernia without mention of obstruction or gangrene,Personal history of tobacco use,Abnormal weight gain'}
