CHIEF COMPLAINT: Abnormal Stress Test

PRESENT ILLNESS: Pleasant 46 y/o male who was under evaluation for possible renal
transplant and during cardiac clearance pt had an abnormal ETT.
He was then referred for cardiac catheterization which revealed
3 vessel disease. Pt. was then referred for cardiac surgery.

MEDICAL HISTORY: End-Stage Renal Disease on Hemodialysis
Renal Artery Stenosis s/p Right Renal Artery Stenting [**12-19**]
Renal Osteodystrophy
Cardiomyopathy
Hypertension
Hypercholesterolemia
h/o Cellulitis left hip/LE

MEDICATION ON ADMISSION: 1. [**Date Range **] 81mg qd
2. IC Renal 1 tablet qd
3. Toprol 100mg qd
4. Diovan 160mg qd
5. Lipitor 20mg qd
6. TUMS 5 tablets qd

ALLERGIES: Ace Inhibitors

PHYSICAL EXAM: VS: 189/91 90 20 36.5 66in 76kg
General: WD/WN male in NAD
Neuro: A&O x 3, non-focal
HEENT: EOMI
Neck: FROM, NC/AT
Heart: RRR, -c/r/m/g
Lungs: CTAB. -w/r/r
Abd: Soft, NT/ND
Ext: warm, -c/c/e

FAMILY HISTORY: Brother died of an MI at age 37

SOCIAL HISTORY: Lives with significant other. Unemployed originally from [**Country **].
Coronary atherosclerosis of native coronary artery,Congestive heart failure, unspecified,Hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage V or end stage renal disease,Awaiting organ transplant status,Other primary cardiomyopathies,Pure hypercholesterolemia
Crnry athrscl natve vssl,CHF NOS,Hyp kid NOS w cr kid V,Await organ transplnt st,Prim cardiomyopathy NEC,Pure hypercholesterolem
Admission Date:  [**2107-9-15**]              Discharge Date:   [**2107-9-20**]

Date of Birth:  [**2061-1-7**]             Sex:   M

Service: CARDIOTHORACIC

Allergies:
Ace Inhibitors

Attending:[**First Name3 (LF) 1267**]
Chief Complaint:
Abnormal Stress Test

Major Surgical or Invasive Procedure:
s/p Coronary Artery Bypass Graft x 3 (LIMA->LAD, SVG->OM,
SVG->diag)

History of Present Illness:
Pleasant 46 y/o male who was under evaluation for possible renal
transplant and during cardiac clearance pt had an abnormal ETT.
He was then referred for cardiac catheterization which revealed
3 vessel disease. Pt. was then referred for cardiac surgery.

Past Medical History:
End-Stage Renal Disease on Hemodialysis
Renal Artery Stenosis s/p Right Renal Artery Stenting [**12-19**]
Renal Osteodystrophy
Cardiomyopathy
Hypertension
Hypercholesterolemia
h/o Cellulitis left hip/LE

Social History:
Lives with significant other. Unemployed originally from [**Country **].

Family History:
Brother died of an MI at age 37

Physical Exam:
VS: 189/91 90 20 36.5 66in 76kg
General: WD/WN male in NAD
Neuro: A&O x 3, non-focal
HEENT: EOMI
Neck: FROM, NC/AT
Heart: RRR, -c/r/m/g
Lungs: CTAB. -w/r/r
Abd: Soft, NT/ND
Ext: warm, -c/c/e

Pertinent Results:
CXR [**2107-9-19**]: Improving Pneumothoraces with residual tiny
[**Hospital1 **]-apical pneumothoraces. Slight improvement in bibasilar
atelectasis and persistant pleural effusion.

[**2107-9-15**] 11:10AM BLOOD WBC-9.2 RBC-2.90* Hgb-9.6* Hct-27.8*
MCV-96 MCH-33.1* MCHC-34.4 RDW-14.4 Plt Ct-98*
[**2107-9-16**] 02:02AM BLOOD WBC-7.8 RBC-3.11* Hgb-10.2* Hct-29.2*
MCV-94 MCH-32.9* MCHC-35.0 RDW-16.2* Plt Ct-107*
[**2107-9-19**] 08:25AM BLOOD WBC-1.2*# RBC-2.86* Hgb-9.3* Hct-27.5*
MCV-96 MCH-32.5* MCHC-33.8 RDW-14.7 Plt Ct-135*
[**2107-9-19**] 04:58PM BLOOD WBC-5.5#
[**2107-9-15**] 11:10AM BLOOD PT-18.7* PTT-44.6* INR(PT)-2.5
[**2107-9-16**] 02:02AM BLOOD PT-14.0* PTT-35.4* INR(PT)-1.3
[**2107-9-15**] 11:33AM BLOOD UreaN-42* Creat-6.4*# Cl-107 HCO3-25
[**2107-9-19**] 08:25AM BLOOD Glucose-140* UreaN-69* Creat-9.9* Na-134
K-3.8 Cl-95* HCO3-26 AnGap-17
[**2107-9-19**] 08:25AM BLOOD Albumin-3.2* Calcium-8.4 Phos-3.7 Mg-2.5

Brief Hospital Course:
Pt. was a same day admit and on [**2107-9-15**] pt was brought directly
to the OR and underwent a Coronary Artery Bypass Graft x 3.
Please see op note for surgical details. Pt. tolerated the
procedure well and had total bypass time of 64 minutes and
cross-clamp time of 55 minutes. He was transferred to the CSRU
in stable condition on a Neo-Synephrine gtt. That evening pt was
weaned from sedation and mechanical ventilation and was
extubated. Pt. was alert, awake and moving all extremities. By
POD #1 Neo was weaned off, but was receiving a Nitro gtt (which
was later weaned off on this day). He had hemodialysis and was
then transferred to telemetry floor. Renal was consulted for
further management of pt's ESRD. B-blockers were initiated. On
POD #3 chest tubes were removed. On POD #4 pt was again dialyzed
and had his epicardial pacing wires removed. Pt. was stable and
improving well. Continued PT and improved with ambulation. On
POD #5 pt was doing well, hemodynamically stable and cleared
level 5. He was thus discharged home with VNA services and the
appropriate follow-up appointments.

Medications on Admission:
1. [**Date Range **] 81mg qd
2. IC Renal 1 tablet qd
3. Toprol 100mg qd
4. Diovan 160mg qd
5. Lipitor 20mg qd
6. TUMS 5 tablets qd

Discharge Medications:
1. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2
times a day).
Disp:*60 Capsule(s)* Refills:*2*
2. Atorvastatin 20 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
Disp:*30 Tablet(s)* Refills:*0*
3. 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*
4. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO
Q4H (every 4 hours) as needed for pain.
Disp:*60 Tablet(s)* Refills:*0*
5. Calcium Carbonate 500 mg Tablet, Chewable Sig: One (1)
Tablet, Chewable PO TID (3 times a day).
Disp:*90 Tablet, Chewable(s)* Refills:*0*
6. Metoprolol Tartrate 25 mg Tablet Sig: 1.5 Tablets PO BID (2
times a day).
Disp:*90 Tablet(s)* Refills:*2*

Discharge Disposition:
Home With Service

Facility:
[**Hospital 119**] Homecare

Discharge Diagnosis:
Coronary Artery Disease s/p Myocardial Infarction s/p Coronary
Artery Bypass Graft x 3
End-Stage Renal Disease on Hemodialysis
Renal Artery Stenosis
Hypertension
Hypercholesterolemia

Discharge Condition:
Good.

Discharge Instructions:
Follow medications on discharge instructions.
You should not lift more than 10 lbs for 3 months.
You should not drive for 4 weeks.
You should shower daily, let water flow over wounds, pat dry
with a towel.
Do not use creams, lotions, or powders on wounds.
Call our office for sternal drainage, temp>101.5

Followup Instructions:
Make an appointment with Dr. [**Last Name (STitle) **] for 4 weeks.
Make an appointment with your caridologist to 2-3 weeks.
Please follow-up with your PCP next week.


Completed by:[**2107-10-5**]
{'Coronary atherosclerosis of native coronary artery,Congestive heart failure, unspecified,Hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage V or end stage renal disease,Awaiting organ transplant status,Other primary cardiomyopathies,Pure hypercholesterolemia'}


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: Abnormal Stress Test

PRESENT ILLNESS: Pleasant 46 y/o male who was under evaluation for possible renal
transplant and during cardiac clearance pt had an abnormal ETT.
He was then referred for cardiac catheterization which revealed
3 vessel disease. Pt. was then referred for cardiac surgery.

MEDICAL HISTORY: End-Stage Renal Disease on Hemodialysis
Renal Artery Stenosis s/p Right Renal Artery Stenting [**12-19**]
Renal Osteodystrophy
Cardiomyopathy
Hypertension
Hypercholesterolemia
h/o Cellulitis left hip/LE

MEDICATION ON ADMISSION: 1. [**Date Range **] 81mg qd
2. IC Renal 1 tablet qd
3. Toprol 100mg qd
4. Diovan 160mg qd
5. Lipitor 20mg qd
6. TUMS 5 tablets qd

ALLERGIES: Ace Inhibitors

PHYSICAL EXAM: VS: 189/91 90 20 36.5 66in 76kg
General: WD/WN male in NAD
Neuro: A&O x 3, non-focal
HEENT: EOMI
Neck: FROM, NC/AT
Heart: RRR, -c/r/m/g
Lungs: CTAB. -w/r/r
Abd: Soft, NT/ND
Ext: warm, -c/c/e

FAMILY HISTORY: Brother died of an MI at age 37

SOCIAL HISTORY: Lives with significant other. Unemployed originally from [**Country **]. 

### Response:
{'Coronary atherosclerosis of native coronary artery,Congestive heart failure, unspecified,Hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage V or end stage renal disease,Awaiting organ transplant status,Other primary cardiomyopathies,Pure hypercholesterolemia'}
