CHIEF COMPLAINT: known heart murmur with mild shortness of breath and chest
tightness

PRESENT ILLNESS: Mr. [**Known lastname 11270**] is a 51 yo gentleman with a [**4-4**] month h/o shortness
of breath and chest tightness>  He was found to have aortic
stenosis on echocardiogram.

MEDICAL HISTORY: aortic stenosis
Type 2 DM
HTN
hypercholesterolemia
s/p L fem bypass [**2095**]
s/p MVA with multiple orthopedic injuries
nephrolitihiasis

MEDICATION ON ADMISSION: Norvasc 10mg qd
Accupril 40mg qd
Crestor 10mg qd
Celebrex qd
gulcatrol 5mg qd

ALLERGIES: Zestril

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: 
Aortic valve disorders,Cardiac complications, not elsewhere classified,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Unspecified essential hypertension,Pure hypercholesterolemia,Personal history of urinary calculi,Atrial fibrillation,Dysthymic disorder
Aortic valve disorder,Surg compl-heart,DMII wo cmp nt st uncntr,Hypertension NOS,Pure hypercholesterolem,Prsnl hst urnr dsrd calc,Atrial fibrillation,Dysthymic disorder
Admission Date:  [**2119-2-20**]              Discharge Date:   [**2119-3-1**]

Date of Birth:  [**2067-8-18**]             Sex:   M

Service: CARDIOTHORACIC

Allergies:
Zestril

Attending:[**First Name3 (LF) 1283**]
Chief Complaint:
known heart murmur with mild shortness of breath and chest
tightness

Major Surgical or Invasive Procedure:
s/p aortic valve replacement(23mm St. [**Male First Name (un) 923**] mechanical)


History of Present Illness:
Mr. [**Known lastname 11270**] is a 51 yo gentleman with a [**4-4**] month h/o shortness
of breath and chest tightness>  He was found to have aortic
stenosis on echocardiogram.

Past Medical History:
aortic stenosis
Type 2 DM
HTN
hypercholesterolemia
s/p L fem bypass [**2095**]
s/p MVA with multiple orthopedic injuries
nephrolitihiasis


Pertinent Results:
[**2119-2-28**] 06:50AM BLOOD WBC-10.7 RBC-3.45* Hgb-10.0* Hct-31.2*
MCV-91 MCH-29.1 MCHC-32.2 RDW-14.6 Plt Ct-352
[**2119-3-1**] 06:15AM BLOOD PT-18.1* PTT-60.1* INR(PT)-2.1
[**2119-2-28**] 06:50AM BLOOD Plt Ct-352
[**2119-2-28**] 06:50AM BLOOD Glucose-127* UreaN-13 Creat-0.8 Na-140
K-4.9 Cl-103 HCO3-27 AnGap-15

Brief Hospital Course:
Mr. [**Known lastname 11270**] was admitted to [**Hospital1 18**] on [**2119-2-20**] and taken to the
operating room with Dr.[**Last Name (STitle) **] for an AVR with a [**Street Address(2) 11688**].
[**Male First Name (un) 923**] mechanical valve.  He tolerated the procedure well and was
transferred to the ICU in stable condition.  He was weaned and
extubated from mechanical ventilation on his first post
operative night.  Post operatively the patient had a period of
junctional rhythm which resolved by POD#2 and the patient was
started on a beta blocker without difficulty.  On POD#1 he was
noted to have some mild abdominal distention which resolved with
Reglan.  On POD#3 he began complaining of difficulty breathing
which he thought was due to anxiety. His CXR was unremarkable
and it was felt that his respiratory issues were truly anxiety.
He was started on Ativan, which he was taking at home, and a PCA
for pain control, but the patient continued to have episodes of
panic attacks.  A psychiatry consult was obtained and
recommended continuing the Ativan and adding trazodone and
Zyprexa which were added with good control of anxiety, an
subsequently changed to Remeron.  The psychiatry service
discussed their findings with the patient's PCP and recommended
follow up for the patient.  The team also counseled the patient
on minimizing his alcohol consumption.  During this time the
patient also developed atrial fibrillation and an EP consult was
obtained due to his prior junctional rhythm.  It was recommended
to control the atrial fibrillation with Lopressor and no
amiodarone.  The patient had been started on anticoagulation for
his mechanical valve.  He continued to progress well with
physical therapy, no further episodes of atrial fibrillation
were noted, and by POD#9, his INR was 2.1 and he was cleared for
discharge to home.

Medications on Admission:
Norvasc 10mg qd
Accupril 40mg qd
Crestor 10mg qd
Celebrex qd
gulcatrol 5mg qd

Discharge Medications:
1. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2
times a day).
Disp:*60 Capsule(s)* Refills:*0*
2. 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*
3. Rosuvastatin Calcium 10 mg Tablet Sig: One (1) Tablet PO
DAILY (Daily).
Disp:*30 Tablet(s)* Refills:*2*
4. Glipizide 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).
Disp:*30 Tablet(s)* Refills:*2*
5. Ibuprofen 600 mg Tablet Sig: One (1) Tablet PO Q8H (every 8
hours) as needed for pain.
Disp:*100 Tablet(s)* Refills:*0*
6. Hydromorphone HCl 2 mg Tablet Sig: 1-2 Tablets PO Q4H (every
4 hours) as needed.
Disp:*50 Tablet(s)* Refills:*0*
7. Quinapril HCl 20 mg Tablet Sig: One (1) Tablet PO once a day.
Disp:*30 Tablet(s)* Refills:*2*
8. Metoprolol Tartrate 50 mg Tablet Sig: One (1) Tablet PO BID
(2 times a day).
Disp:*60 Tablet(s)* Refills:*2*
9. Mirtazapine 7.5 mg Tablet Sig: One (1) Tablet PO HS (at
bedtime).
Disp:*30 Tablet(s)* Refills:*0*
10. Lorazepam 0.5 mg Tablet Sig: One (1) Tablet PO BID (2 times
a day) as needed.
Disp:*20 Tablet(s)* Refills:*0*
11. Coumadin 5 mg Tablet Sig: as directed Tablet PO once a day:
take 10mg [**3-1**] then per Dr.[**Name (NI) 42076**] office.
Disp:*60 Tablet(s)* Refills:*2*


Discharge Disposition:
Home With Service

Facility:
[**Hospital1 1474**] VNA

Discharge Diagnosis:
Type 2 DM
HTN
aortic stenosis
s/p AVR
dyslipidemia
anxiety/depression
post operative atrial fibrillation


Discharge Condition:
good

Discharge Instructions:
you may take a shower and wash your incisions with mild soap and
water
do not swim or take a bath for 1 month
do not drive for 1 month
do not apply lotions, creams, ointments or powders to your
incisions
do not lift anything heavier than 10 pounds for 1 month
do not drink alcohol while taking pain mediciations

Followup Instructions:
follow up with Dr.[**Name (NI) 42076**] office by phone [**3-2**] for coumadin
dosing
follow up with Dr. [**Last Name (STitle) **] in [**1-1**] weeks
follow up with Dr. [**Last Name (STitle) **] in [**1-1**] weeks
follow up with Dr. [**Last Name (STitle) **] in [**3-3**] weeks



Completed by:[**2119-3-1**]
{'Aortic valve disorders,Cardiac complications, not elsewhere classified,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Unspecified essential hypertension,Pure hypercholesterolemia,Personal history of urinary calculi,Atrial fibrillation,Dysthymic disorder'}


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: known heart murmur with mild shortness of breath and chest
tightness

PRESENT ILLNESS: Mr. [**Known lastname 11270**] is a 51 yo gentleman with a [**4-4**] month h/o shortness
of breath and chest tightness>  He was found to have aortic
stenosis on echocardiogram.

MEDICAL HISTORY: aortic stenosis
Type 2 DM
HTN
hypercholesterolemia
s/p L fem bypass [**2095**]
s/p MVA with multiple orthopedic injuries
nephrolitihiasis

MEDICATION ON ADMISSION: Norvasc 10mg qd
Accupril 40mg qd
Crestor 10mg qd
Celebrex qd
gulcatrol 5mg qd

ALLERGIES: Zestril

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY:  

### Response:
{'Aortic valve disorders,Cardiac complications, not elsewhere classified,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Unspecified essential hypertension,Pure hypercholesterolemia,Personal history of urinary calculi,Atrial fibrillation,Dysthymic disorder'}
