CHIEF COMPLAINT: Exertional Angina

PRESENT ILLNESS: 68 y/o male with exertional chest pain and shortness of breath.
Both resovlve with rest and have been occurring for approx [**8-2**]
months. Underwent ETT which was positive. Then had cardiac cath
which revealed severe two-vessel disease. Referred for surgical
revascularization.

MEDICAL HISTORY: Hypertension, Hypercholesterolemia, Benign Prostatic
Hypertrophy, Hiatal Hernia, s/p bilat hernia repair, s/p T&A as
child, s/p r eye catarac surgery w/ lens implant

MEDICATION ON ADMISSION: Atenolol 50mg qd, Lisinopril/HCTZ 10/12.5mg qd, Doxazosin 1mg
qd, Pravachol 80mg qd, Aspirin 325mg qd, Plavix 75 mg qd
(stopped 3 days proior to admission), Prilosec 20mg qd

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: VS: 72 20 134/80 5'9" 200#
Gen: Well-appearing male in NAD
Skin: W/D -lesions
Neck: Supple, FROM, -JVD
Chest: CATB -w/r/r
Heart: RRR -c/r/m/g
Abd: Soft, NT/ND +BS
Ext: Warm, well-perfused, -c/c/e
Neuro: A&O x 3, MAE, non-focal

FAMILY HISTORY: Father died of MI at 97.

SOCIAL HISTORY: Quit smoking 20 yrs ago. 2 ETOH drinks/day.
Coronary atherosclerosis of native coronary artery,Cardiac complications, not elsewhere classified,Atrial fibrillation,Unspecified essential hypertension,Pure hypercholesterolemia,Diaphragmatic hernia without mention of obstruction or gangrene,Hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (LUTS)
Crnry athrscl natve vssl,Surg compl-heart,Atrial fibrillation,Hypertension NOS,Pure hypercholesterolem,Diaphragmatic hernia,BPH w/o urinary obs/LUTS
Admission Date:  [**2153-4-2**]              Discharge Date:   [**2153-4-8**]

Date of Birth:  [**2084-7-22**]             Sex:   M

Service: CARDIOTHORACIC

Allergies:
Patient recorded as having No Known Allergies to Drugs

Attending:[**First Name3 (LF) 1283**]
Chief Complaint:
Exertional Angina

Major Surgical or Invasive Procedure:
[**2153-4-2**]  Coronary Artery Bypass Graft x 4 (LIMA to LAD, SVG to
Diag, SVG to OM, SVG to PDA)

History of Present Illness:
68 y/o male with exertional chest pain and shortness of breath.
Both resovlve with rest and have been occurring for approx [**8-2**]
months. Underwent ETT which was positive. Then had cardiac cath
which revealed severe two-vessel disease. Referred for surgical
revascularization.

Past Medical History:
Hypertension, Hypercholesterolemia, Benign Prostatic
Hypertrophy, Hiatal Hernia, s/p bilat hernia repair, s/p T&A as
child, s/p r eye catarac surgery w/ lens implant

Social History:
Quit smoking 20 yrs ago. 2 ETOH drinks/day.

Family History:
Father died of MI at 97.

Physical Exam:
VS: 72 20 134/80 5'9" 200#
Gen: Well-appearing male in NAD
Skin: W/D -lesions
Neck: Supple, FROM, -JVD
Chest: CATB -w/r/r
Heart: RRR -c/r/m/g
Abd: Soft, NT/ND +BS
Ext: Warm, well-perfused, -c/c/e
Neuro: A&O x 3, MAE, non-focal

Pertinent Results:
[**2153-4-2**] Echo: PRE-BYPASS: Overall left ventricular systolic
function is normal (LVEF>55%). Regional left ventricular wall
motion is normal. Right ventricular chamber size and free wall
motion are normal. No spontaneous echo contrast is seen in the
left atrial appendage. No atrial septal defect is seen by 2D or
color Doppler. There are simple atheroma in the aortic arch and
descending aorta. The aortic valve leaflets (3) are mildly
thickened. No aortic regurgitation is seen. No aortic stenosis
is seen. The mitral valve appears structurally normal with
trivial mitral regurgitation. There is no pericardial effusion.
POST-BYPASS: Preserved [**Hospital1 **]-ventricular systolic function. No
evidence of aortic dissection post de-canulation. Rest of the
study is unchanged from pre-bypass.

[**2153-4-2**] 11:50AM BLOOD WBC-15.2*# RBC-3.37*# Hgb-10.2*#
Hct-29.8*# MCV-88 MCH-30.1 MCHC-34.1 RDW-15.1 Plt Ct-131*
[**2153-4-2**] 11:50AM BLOOD PT-15.3* PTT-32.5 INR(PT)-1.4*
[**2153-4-2**] 12:42PM BLOOD UreaN-26* Creat-1.0 K-4.0 Cl-111* HCO3-24

[**Last Name (NamePattern4) 4125**]ospital Course:
Mr. [**Known lastname 20180**] was a same day admit after undergoing all
pre-operative work-up as an outpatient. On admit day he was
brought to the operating room where he underwent a coronary
artery bypass graft x 4. Please see operative report for
surgical details. Following surgery he was transferred to the
CSRU for invasive monitoring in stable condition. Later on op
day he was weaned from sedation, awoke neurologically intact and
extubated. On post-op day one he was transferred to the SDU for
further care. He was started on beta blockers and diuretics and
gently diuresed towards his pre-op weight. His chest tubes were
removed on POD#2. On POD#3, he converted to atrial fibrillation
with rapid ventricular response. He was cardioverted on POD#5
with success and started on amiodarone. On POD#6, his external
pacing wires were removed without incident. He was discharged
home on POD#7 with visiting nurses services. He is to follow up
in clinic with Dr. [**Last Name (Prefixes) **].

Medications on Admission:
Atenolol 50mg qd, Lisinopril/HCTZ 10/12.5mg qd, Doxazosin 1mg
qd, Pravachol 80mg qd, Aspirin 325mg qd, Plavix 75 mg qd
(stopped 3 days proior to admission), Prilosec 20mg qd

Discharge Medications:
1. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2
times a day).
Disp:*60 Capsule(s)* Refills:*1*
2. Pravastatin 20 mg Tablet Sig: Four (4) Tablet PO DAILY
(Daily).
Disp:*120 Tablet(s)* Refills:*1*
3. Hydromorphone 2 mg Tablet Sig: 1-2 Tablets PO Q3-4H (Every 3
to 4 Hours) as needed.
Disp:*40 Tablet(s)* Refills:*0*
4. Furosemide 20 mg Tablet Sig: One (1) Tablet PO Q12H (every 12
hours) for 7 days.
Disp:*14 Tablet(s)* Refills:*0*
5. Metoprolol Tartrate 50 mg Tablet Sig: One (1) Tablet PO BID
(2 times a day).
Disp:*60 Tablet(s)* Refills:*2*
6. Amiodarone 200 mg Tablet Sig: One (1) Tablet PO TID (3 times
a day): Take 1 tablet three times a day for 4 days, take 2
tablets once a day for 2 weeks, and then take 1 tablet once a
day for 2 weeks. .
Disp:*54 Tablet(s)* Refills:*0*
7. Aspirin 325 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*


Discharge Disposition:
Home With Service

Facility:
[**Company 1519**]

Discharge Diagnosis:
Coronary Artery Disease s/p Coronary Artery Bypass Graft x 4
PMH: Hypertension, Hypercholesterolemia, Benign Prostatic
Hypertrophy, Hiatal Hernia, s/p bilat hernia repair, s/p T&A as
child, s/p r eye catarac surgery w/ lens implant

Discharge Condition:
Good

Discharge Instructions:
Call with fever, redness or drainage from incision or weight
gain more than 2 pounds in one day or five in one week.
Shower, no baths, no lotions, creams or powders to incisions.
No lifting greater than 10 pounds for 10 weeks. No driving for
one month.

[**Last Name (NamePattern4) 2138**]p Instructions:
Dr. [**Last Name (Prefixes) **] in 4 weeks
Dr. [**Last Name (STitle) 1295**] in [**1-27**] weeks
Dr. [**First Name (STitle) **] in [**12-26**] weeks


Completed by:[**2153-4-8**]
{'Coronary atherosclerosis of native coronary artery,Cardiac complications, not elsewhere classified,Atrial fibrillation,Unspecified essential hypertension,Pure hypercholesterolemia,Diaphragmatic hernia without mention of obstruction or gangrene,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: Exertional Angina

PRESENT ILLNESS: 68 y/o male with exertional chest pain and shortness of breath.
Both resovlve with rest and have been occurring for approx [**8-2**]
months. Underwent ETT which was positive. Then had cardiac cath
which revealed severe two-vessel disease. Referred for surgical
revascularization.

MEDICAL HISTORY: Hypertension, Hypercholesterolemia, Benign Prostatic
Hypertrophy, Hiatal Hernia, s/p bilat hernia repair, s/p T&A as
child, s/p r eye catarac surgery w/ lens implant

MEDICATION ON ADMISSION: Atenolol 50mg qd, Lisinopril/HCTZ 10/12.5mg qd, Doxazosin 1mg
qd, Pravachol 80mg qd, Aspirin 325mg qd, Plavix 75 mg qd
(stopped 3 days proior to admission), Prilosec 20mg qd

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: VS: 72 20 134/80 5'9" 200#
Gen: Well-appearing male in NAD
Skin: W/D -lesions
Neck: Supple, FROM, -JVD
Chest: CATB -w/r/r
Heart: RRR -c/r/m/g
Abd: Soft, NT/ND +BS
Ext: Warm, well-perfused, -c/c/e
Neuro: A&O x 3, MAE, non-focal

FAMILY HISTORY: Father died of MI at 97.

SOCIAL HISTORY: Quit smoking 20 yrs ago. 2 ETOH drinks/day. 

### Response:
{'Coronary atherosclerosis of native coronary artery,Cardiac complications, not elsewhere classified,Atrial fibrillation,Unspecified essential hypertension,Pure hypercholesterolemia,Diaphragmatic hernia without mention of obstruction or gangrene,Hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (LUTS)'}
