CHIEF COMPLAINT: Chief complaint was vague upper chest pain
with positive stress test.

PRESENT ILLNESS: Mr. [**Known lastname 35119**] is a
66-year-old male with a history of non-insulin-dependent
diabetes mellitus, portal vein thrombosis, with a known
abdominal aortic aneurysm, carotid disease, hypertension, and
coronary artery disease who presents following cardiac
catheterization suggesting the need for revascularization.

MEDICAL HISTORY: (Past medical history was notable for
the following)
1.  Coronary artery disease (as described above) with
non-Q-wave myocardial infarction in [**2194-6-15**] with right
coronary artery stent and stent placement in [**2194-7-16**]
to the middle and distal circumflex artery.
2.  Adult-onset diabetes mellitus.
3.  A 3.7-cm abdominal aortic aneurysm.
4.  Chronic renal insufficiency with a baseline creatinine
of 1.3.  A nonfunctioning right kidney secondary to a
ureteral pelvic obstruction.
5.  Status post left carotid endarterectomy.
6.  Peripheral vascular disease.
7.  Hypertension.

MEDICATION ON ADMISSION: 1.  Lisinopril 80 mg p.o. q.d.
2.  Atenolol 100 mg p.o. q.d.
3.  Lipitor 10 mg p.o. q.d.
4.  Prilosec 40 mg p.o.
5.  Glyburide 2.5 mg p.o. b.i.d.
6.  Flomax 0.4 mg p.o. q.h.s.
7.  External carotid artery.
8.  Hydrochlorothiazide 25 mg p.o. q.d.
9.  Vitamin E.

ALLERGIES: The patient has no known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: 
Coronary atherosclerosis of native coronary artery,Other complications due to other cardiac device, implant, and graft,Atrial fibrillation,Other and unspecified angina pectoris,Hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage I through stage IV, or unspecified,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Abdominal aneurysm without mention of rupture,Unspecified disorder of kidney and ureter,Examination of participant in clinical trial
Crnry athrscl natve vssl,Comp-oth cardiac device,Atrial fibrillation,Angina pectoris NEC/NOS,Hy kid NOS w cr kid I-IV,DMII wo cmp nt st uncntr,Abdom aortic aneurysm,Renal & ureteral dis NOS,Exam-clincal trial
Admission Date:  [**2195-5-24**]     Discharge Date:  [**2195-5-31**]

Date of Birth:   [**2129-3-13**]     Sex:  M

Service:  Cardiac Surgery

CHIEF COMPLAINT:  Chief complaint was vague upper chest pain
with positive stress test.

HISTORY OF PRESENT ILLNESS:  Mr. [**Known lastname 35119**] is a
66-year-old male with a history of non-insulin-dependent
diabetes mellitus, portal vein thrombosis, with a known
abdominal aortic aneurysm, carotid disease, hypertension, and
coronary artery disease who presents following cardiac
catheterization suggesting the need for revascularization.

He had a non-ST-elevation myocardial infarction in [**2194-4-15**].  Catheterization at that time demonstrated that he
required a stent in his right coronary artery.  During that
time, he was also found to have 50% stenosis of the left main
which was not hemodynamically significant by wire
transduction, mild diffuse disease of the left anterior
descending artery, and 40% stenosis at the ostium of the left
circumflex with an 80% middle circumflex lesion.

He had further interventions involving stents to both the
proximal and the middle left circumflex artery.  Since that
time, he has been relatively asymptomatic; however, he had a
positive stress test in [**2195-4-15**] in which he had
anterolateral electrocardiogram changes and reversible
ischemia involving the inferior wall, anterolateral wall, and
apex on nuclear imaging and was referred for catheterization.

The patient was admitted prior to procedure to the Cardiology
Service.

PAST MEDICAL HISTORY:  (Past medical history was notable for
the following)
1.  Coronary artery disease (as described above) with
non-Q-wave myocardial infarction in [**2194-6-15**] with right
coronary artery stent and stent placement in [**2194-7-16**]
to the middle and distal circumflex artery.
2.  Adult-onset diabetes mellitus.
3.  A 3.7-cm abdominal aortic aneurysm.
4.  Chronic renal insufficiency with a baseline creatinine
of 1.3.  A nonfunctioning right kidney secondary to a
ureteral pelvic obstruction.
5.  Status post left carotid endarterectomy.
6.  Peripheral vascular disease.
7.  Hypertension.

ALLERGIES:  The patient has no known drug allergies.

MEDICATIONS ON ADMISSION:
1.  Lisinopril 80 mg p.o. q.d.
2.  Atenolol 100 mg p.o. q.d.
3.  Lipitor 10 mg p.o. q.d.
4.  Prilosec 40 mg p.o.
5.  Glyburide 2.5 mg p.o. b.i.d.
6.  Flomax 0.4 mg p.o. q.h.s.
7.  External carotid artery.
8.  Hydrochlorothiazide 25 mg p.o. q.d.
9.  Vitamin E.

HOSPITAL COURSE:   The patient was admitted to the Cardiology
Service.  He had a catheterization that revealed 50% left
main disease, 80% in-stent restenosis of the left circumflex,
and 90% focal restenosis of the right coronary artery, with a
50% distal lesion.

The patient was referred to Cardiac Surgery for intervention.
On [**2195-5-26**], the patient was taken to the operating room
where he had a coronary artery bypass graft times three.  His
grafts were left internal mammary artery to left anterior
descending artery, saphenous vein graft to obtuse marginal,
and saphenous vein graft to PL.

The procedure itself was unremarkable.  Total cardiopulmonary
bypass time was 76 minutes with a cross-point time of 63
minutes.

Postoperatively, the patient was taken intubated to the
Coronary Care Unit.  He was atrially paced at this time and
was on a propofol drip.  That evening in the Intensive Care
Unit, he was extubated without incident.  The following day,
his chest tubes were discontinued, and he was stable enough
to be transferred to the floor.

Upon arrival on the floor, his Foley catheter was
discontinued.  He did have paroxysmal round of atrial
fibrillation that always lasted less than one minute and
broke spontaneously.  For this reason, he was started on
amiodarone, and his Lopressor was progressively increased.
The frequency of these incidents markedly diminished;
although, he did still have occasional ones on postoperative
days three and four.  However, by this time, he did become
mildly bradycardic, and his amiodarone dose was decreased.

The remainder of the patient's hospitalization was
unremarkable.  By the fifth postoperative day he was eating,
ambulating, and voiding, and walking independently in the
hallway, and ascending a flight of stairs without any
difficulty.

It should be noted that while he was ascending stairs with
Physical Therapy, he blood pressure did increase transiently
to approximately 180 systolic.  It then went back down.  This
was discussed amongst the team, and it was felt that the
patient would be safe to be discharged home, and he could
follow up in the next day or two with his primary care
physician to have his blood pressure rechecked.  He may need
to have some of his other antihypertensive agents started in
the more immediate postoperative period.

DISCHARGE STATUS:  The patient was discharged to home on
[**2195-5-31**] in the care of his family.

CONDITION AT DISCHARGE:  In stable condition.

DISCHARGE INSTRUCTIONS:  He was instructed to see his primary
care physician in the next one to two days to get his blood
pressure checked.  In addition, he was to see Dr. [**Last Name (STitle) **] in
approximately four weeks.

MEDICATIONS ON DISCHARGE: (The patient was discharged on the
following medications)
 1.  Enteric-coated aspirin 325 mg p.o. q.d.
 2.  Prilosec 40 mg p.o. q.d.
 3.  Lipitor 10 mg p.o. q.d.
 4.  Flomax 0.4 mg p.o. q.h.s.
 5.  Atenolol 50 mg p.o. b.i.d.
 6.  Amiodarone 200 mg p.o. b.i.d.
 7.  Lasix 20 mg p.o. b.i.d. (times seven days).
 8.  Potassium chloride 20 mEq p.o. b.i.d. (times seven
days).
 9.  Colace 100 mg p.o. b.i.d.
10.  Percocet 5/325 one to two tablets p.o. q.4-6h. p.r.n.

DISCHARGE DIAGNOSES:
1.  Coronary artery disease; status post coronary artery
bypass graft times three.
2.  Rapid atrial fibrillation; spontaneously converted.
3.  Non-insulin-dependent diabetes mellitus.
4.  Hypertension.
5.  Peripheral vascular disease.




                          [**First Name11 (Name Pattern1) 1112**] [**Last Name (NamePattern1) **], M.D.  [**MD Number(1) 3113**]

Dictated By:[**Last Name (NamePattern1) 9638**]

MEDQUIST36

D:  [**2195-5-31**]  14:39
T:  [**2195-6-4**]  09:20
JOB#:  [**Job Number 35120**]
{'Coronary atherosclerosis of native coronary artery,Other complications due to other cardiac device, implant, and graft,Atrial fibrillation,Other and unspecified angina pectoris,Hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage I through stage IV, or unspecified,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Abdominal aneurysm without mention of rupture,Unspecified disorder of kidney and ureter,Examination of participant in clinical trial'}


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: Chief complaint was vague upper chest pain
with positive stress test.

PRESENT ILLNESS: Mr. [**Known lastname 35119**] is a
66-year-old male with a history of non-insulin-dependent
diabetes mellitus, portal vein thrombosis, with a known
abdominal aortic aneurysm, carotid disease, hypertension, and
coronary artery disease who presents following cardiac
catheterization suggesting the need for revascularization.

MEDICAL HISTORY: (Past medical history was notable for
the following)
1.  Coronary artery disease (as described above) with
non-Q-wave myocardial infarction in [**2194-6-15**] with right
coronary artery stent and stent placement in [**2194-7-16**]
to the middle and distal circumflex artery.
2.  Adult-onset diabetes mellitus.
3.  A 3.7-cm abdominal aortic aneurysm.
4.  Chronic renal insufficiency with a baseline creatinine
of 1.3.  A nonfunctioning right kidney secondary to a
ureteral pelvic obstruction.
5.  Status post left carotid endarterectomy.
6.  Peripheral vascular disease.
7.  Hypertension.

MEDICATION ON ADMISSION: 1.  Lisinopril 80 mg p.o. q.d.
2.  Atenolol 100 mg p.o. q.d.
3.  Lipitor 10 mg p.o. q.d.
4.  Prilosec 40 mg p.o.
5.  Glyburide 2.5 mg p.o. b.i.d.
6.  Flomax 0.4 mg p.o. q.h.s.
7.  External carotid artery.
8.  Hydrochlorothiazide 25 mg p.o. q.d.
9.  Vitamin E.

ALLERGIES: The patient has no known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY:  

### Response:
{'Coronary atherosclerosis of native coronary artery,Other complications due to other cardiac device, implant, and graft,Atrial fibrillation,Other and unspecified angina pectoris,Hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage I through stage IV, or unspecified,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Abdominal aneurysm without mention of rupture,Unspecified disorder of kidney and ureter,Examination of participant in clinical trial'}
