CHIEF COMPLAINT: Asymptomatic

PRESENT ILLNESS: 53 year old man with CAD who sustained an MI in [**12-11**]. A cardiac
catheterization revealed severe three vessel disease and
stenting was performed to his circumflex artery. Given the
severity of his disease, the cardiac surgical service was
consulted. He is now admitted for surgical revascualrization

MEDICAL HISTORY: CAD: STEMI with total occlusion of LCx s/p thrombectomy and
placement bare-metal stent on [**2163-12-31**]; 3VD
Hypercholesterolemia
No HTN ("usually low")
Renal stones 10 yrs ago
Last colonoscopy 1.5 yrs ago (@ [**Hospital1 34**]: polyps, otherwise neg)
Left adrenal nodule
RLL Pulmonary nodule
? C. diff colitis
Sleep apnea
Colon polyps

MEDICATION ON ADMISSION: Aspirin 325mg QD
Plavix 75mg QD
Atenolol 25mg QD
Lipitor 80mg QD
Lisinopril 20mg QD

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: 60 SR  16 112/66  72" 206
GEN: NAD
HEENT: NCAT, PERRLA, EOMI, Anicteric sclera
NECK: Supple, No JVD
LUNGS: CTA
HEART: RRR, No M/R/G
ABD: Benign
EXT: Warm, well perfused, no C/C/E. [**12-6**]+ Pulses throughout. No
varicosities.
NEURO: Nonfocal. No carotid bruits

FAMILY HISTORY: father died of MI at age 57; grandfather with [**Name2 (NI) **] in 50's.

SOCIAL HISTORY: smokes [**12-6**] PPD since age 15.
drinks 6 beers 1 night/week.
no drugs.
works as chief probation officer
Coronary atherosclerosis of native coronary artery,Subendocardial infarction, subsequent episode of care,Pure hypercholesterolemia,Other diseases of lung, not elsewhere classified,Unspecified sleep apnea,Calculus of kidney,Percutaneous transluminal coronary angioplasty status
Crnry athrscl natve vssl,Subendo infarct, subseq,Pure hypercholesterolem,Other lung disease NEC,Sleep apnea NOS,Calculus of kidney,Status-post ptca
Admission Date:  [**2164-2-16**]              Discharge Date:   [**2164-2-21**]

Date of Birth:  [**2110-8-27**]             Sex:   M

Service: CARDIOTHORACIC

Allergies:
Patient recorded as having No Known Allergies to Drugs

Attending:[**First Name3 (LF) 922**]
Chief Complaint:
Asymptomatic

Major Surgical or Invasive Procedure:
[**2164-2-16**] - CABGx5(LIMA->LAD, SVG->Diag, OM1, OM2, RCA)


History of Present Illness:
53 year old man with CAD who sustained an MI in [**12-11**]. A cardiac
catheterization revealed severe three vessel disease and
stenting was performed to his circumflex artery. Given the
severity of his disease, the cardiac surgical service was
consulted. He is now admitted for surgical revascualrization

Past Medical History:
CAD: STEMI with total occlusion of LCx s/p thrombectomy and
placement bare-metal stent on [**2163-12-31**]; 3VD
Hypercholesterolemia
No HTN ("usually low")
Renal stones 10 yrs ago
Last colonoscopy 1.5 yrs ago (@ [**Hospital1 34**]: polyps, otherwise neg)
Left adrenal nodule
RLL Pulmonary nodule
? C. diff colitis
Sleep apnea
Colon polyps

Social History:
smokes [**12-6**] PPD since age 15.
drinks 6 beers 1 night/week.
no drugs.
works as chief probation officer


Family History:
father died of MI at age 57; grandfather with [**Name2 (NI) **] in 50's.

Physical Exam:
60 SR  16 112/66  72" 206
GEN: NAD
HEENT: NCAT, PERRLA, EOMI, Anicteric sclera
NECK: Supple, No JVD
LUNGS: CTA
HEART: RRR, No M/R/G
ABD: Benign
EXT: Warm, well perfused, no C/C/E. [**12-6**]+ Pulses throughout. No
varicosities.
NEURO: Nonfocal. No carotid bruits

Pertinent Results:
[**2164-2-20**] 07:15AM BLOOD WBC-7.8 RBC-3.42* Hgb-11.1* Hct-31.4*
MCV-92 MCH-32.3* MCHC-35.2* RDW-13.0 Plt Ct-237#
[**2164-2-20**] 07:15AM BLOOD Plt Ct-237#
[**2164-2-20**] 07:15AM BLOOD Glucose-103 UreaN-12 Creat-0.8 Na-141
K-4.2 Cl-103 HCO3-32 AnGap-10

[**2164-2-16**] - ECHO
Prebypass
1. No atrial septal defect is seen by 2D or color Doppler.
2. Regional left ventricular wall motion is normal. Overall left
ventricular systolic function is normal (LVEF>55%).
3.Right ventricular chamber size and free wall motion are
normal.
4.There are simple atheroma in the descending thoracic aorta.
5.The aortic valve leaflets (3) are mildly thickened but aortic
stenosis is not present. Trace aortic regurgitation is seen.
6.The mitral valve leaflets are mildly thickened. Mild (1+)
mitral
regurgitation is seen.

Post Bypass
1.Patient is being AV paced and receiving an infusion of
phenylephrine.
2. Biventricular systolic function is unchanged.
3. Trace to mild mitral regurgitation present.
4. Aorta intact post decannulation.

Brief Hospital Course:
Mr. [**Known lastname 70972**] was admitted to the [**Hospital1 18**] on [**2164-2-16**] for surgical
management of his coronary artery disease. He was taken directly
to the operating room where he underwent coronary artery bypass
grafting to five vessels. Postoperatively he was taken to the
intensive care unit for monitoring. By postoperative day one,
Mr. [**Known lastname 70972**] had awoke neurologically intact and was extubated. He
was then transferred to the step down unit for further recovery.
He was gently diuresed towards his preoperative weight. The
physical therapy service was consulted for assistance with his
postoperative strength and mobility. His plavix was resumed
given his previous stent placement. An orthopedic consult was
obtained for right shoulder and neck pain. Radiographic studies
were negative for any vertebral abnormalities. Ibuprofen was
started with some relief of his symptoms. He will have an MRI as
an outpatient and will follow-up with the orthopedic service as
an outpatient. Mr. [**Known lastname 70972**] continued to make steady progress and
was discharged home on postoperative day five. He will follow-up
with Dr. [**Last Name (STitle) 914**], his cardiologist and his primary care
physician as an outpatient.

Medications on Admission:
Aspirin 325mg QD
Plavix 75mg QD
Atenolol 25mg QD
Lipitor 80mg QD
Lisinopril 20mg QD

Discharge Medications:
1. Potassium Chloride 10 mEq Capsule, Sustained Release Sig: Two
(2) Capsule, Sustained Release PO Q12H (every 12 hours) for 7
days.
Disp:*28 Capsule, Sustained Release(s)* Refills:*0*
2. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2
times a day).
Disp:*60 Capsule(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:*0*
4. Atorvastatin 80 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
Disp:*30 Tablet(s)* Refills:*0*
5. Ibuprofen 600 mg Tablet Sig: One (1) Tablet PO Q8H (every 8
hours) for 1 weeks.
Disp:*21 Tablet(s)* Refills:*0*
6. Metoprolol Tartrate 25 mg Tablet Sig: One (1) Tablet PO BID
(2 times a day).
Disp:*60 Tablet(s)* Refills:*0*
7. Furosemide 40 mg Tablet Sig: One (1) Tablet PO BID (2 times a
day) for 7 days.
Disp:*14 Tablet(s)* Refills:*0*
8. Hydromorphone 2 mg Tablet Sig: 1-2 Tablets PO every 4-6 hours
as needed.
Disp:*50 Tablet(s)* Refills:*0*
9. Clopidogrel 75 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily): please continue as directed by dr [**Last Name (STitle) **].
Disp:*30 Tablet(s)* Refills:*0*


Discharge Disposition:
Home With Service

Facility:
[**Hospital3 **] VNA

Discharge Diagnosis:
Coronary Artery Disease s/p CABG
Myocardial Infarction s/p stent
Hypertension
Elevated Cholesterol
Renal calculi


Discharge Condition:
Good.


Discharge Instructions:
[**Month (only) 116**] shower, no baths or swimming
Monitor wounds for infection - redness, drainage, or increased
pain
Report any fever greater than 101
Report any weight gain of greater than 2 pounds in 24 hours or 5
pounds in a week
No creams, lotions, powders, or ointments to incisions
No driving for approximately one month
No lifting more than 10 pounds for 10 weeks
Please call with any questions or concerns


Followup Instructions:
Dr [**Last Name (STitle) 914**] in 4 weeks ([**Telephone/Fax (1) 170**]) please call for appointment

Dr [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 36589**] in 1 week ([**Telephone/Fax (1) 70973**]) please call for
appointment
Dr [**Last Name (STitle) **] in [**1-7**] weeks - please call for appointment
Orthopedics - Dr [**First Name (STitle) **] [**Name (STitle) 2719**] ([**Telephone/Fax (1) 1228**]) in 1 week after MRI
- please call for appointment
MRI shoulder with results to Dr [**Last Name (STitle) 2719**] - please call to
schedule [**Telephone/Fax (1) 327**]
Wound check appointment [**Hospital Ward Name 121**] 2 as instructed by nurse
([**Telephone/Fax (1) 3633**])



Completed by:[**2164-2-21**]
{'Coronary atherosclerosis of native coronary artery,Subendocardial infarction, subsequent episode of care,Pure hypercholesterolemia,Other diseases of lung, not elsewhere classified,Unspecified sleep apnea,Calculus of kidney,Percutaneous transluminal coronary angioplasty status'}


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: Asymptomatic

PRESENT ILLNESS: 53 year old man with CAD who sustained an MI in [**12-11**]. A cardiac
catheterization revealed severe three vessel disease and
stenting was performed to his circumflex artery. Given the
severity of his disease, the cardiac surgical service was
consulted. He is now admitted for surgical revascualrization

MEDICAL HISTORY: CAD: STEMI with total occlusion of LCx s/p thrombectomy and
placement bare-metal stent on [**2163-12-31**]; 3VD
Hypercholesterolemia
No HTN ("usually low")
Renal stones 10 yrs ago
Last colonoscopy 1.5 yrs ago (@ [**Hospital1 34**]: polyps, otherwise neg)
Left adrenal nodule
RLL Pulmonary nodule
? C. diff colitis
Sleep apnea
Colon polyps

MEDICATION ON ADMISSION: Aspirin 325mg QD
Plavix 75mg QD
Atenolol 25mg QD
Lipitor 80mg QD
Lisinopril 20mg QD

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: 60 SR  16 112/66  72" 206
GEN: NAD
HEENT: NCAT, PERRLA, EOMI, Anicteric sclera
NECK: Supple, No JVD
LUNGS: CTA
HEART: RRR, No M/R/G
ABD: Benign
EXT: Warm, well perfused, no C/C/E. [**12-6**]+ Pulses throughout. No
varicosities.
NEURO: Nonfocal. No carotid bruits

FAMILY HISTORY: father died of MI at age 57; grandfather with [**Name2 (NI) **] in 50's.

SOCIAL HISTORY: smokes [**12-6**] PPD since age 15.
drinks 6 beers 1 night/week.
no drugs.
works as chief probation officer 

### Response:
{'Coronary atherosclerosis of native coronary artery,Subendocardial infarction, subsequent episode of care,Pure hypercholesterolemia,Other diseases of lung, not elsewhere classified,Unspecified sleep apnea,Calculus of kidney,Percutaneous transluminal coronary angioplasty status'}
