CHIEF COMPLAINT: 

PRESENT ILLNESS: This is a 76-year-old patient
who was referred to [**Hospital6 256**] for
cardiac catheterization due to a history of worsening angina
and a history of positive exercise treadmill test.  Cardiac
catheterization showed three-vessel coronary artery disease
and a normal left ventricular function.  The patient was
admitted to [**Hospital6 256**] on [**8-19**]
for surgery with Dr. [**Last Name (STitle) **].

MEDICAL HISTORY: 1.  Hypertension.  2.  Elevated
cholesterol.  3.  Coronary artery disease.  4.  History of
Parkinson's disease.  5.  Status post tonsillectomy.

MEDICATION ON ADMISSION: 

ALLERGIES: NO KNOWN DRUG ALLERGIES.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: 
Coronary atherosclerosis of native coronary artery,Other and unspecified angina pectoris,Retention of urine, unspecified,Tachycardia, unspecified,Paralysis agitans,Delirium due to conditions classified elsewhere,Unspecified essential hypertension,Pure hypercholesterolemia
Crnry athrscl natve vssl,Angina pectoris NEC/NOS,Retention urine NOS,Tachycardia NOS,Paralysis agitans,Delirium d/t other cond,Hypertension NOS,Pure hypercholesterolem
Admission Date:  [**2177-8-19**]       Discharge Date:  [**2177-8-25**]

Date of Birth:   [**2101-6-24**]       Sex:  M

Service:  CARDIAC SURGERY

HISTORY OF PRESENT ILLNESS:  This is a 76-year-old patient
who was referred to [**Hospital6 256**] for
cardiac catheterization due to a history of worsening angina
and a history of positive exercise treadmill test.  Cardiac
catheterization showed three-vessel coronary artery disease
and a normal left ventricular function.  The patient was
admitted to [**Hospital6 256**] on [**8-19**]
for surgery with Dr. [**Last Name (STitle) **].

PAST MEDICAL HISTORY:  1.  Hypertension.  2.  Elevated
cholesterol.  3.  Coronary artery disease.  4.  History of
Parkinson's disease.  5.  Status post tonsillectomy.

ALLERGIES:  NO KNOWN DRUG ALLERGIES.

PREOPERATIVE MEDICATIONS:  Aspirin 325 mg p.o. q.d.,
Lopressor 50 mg p.o. b.i.d., Lipitor 10 mg p.o. q.d.,
Cogentin 1 mg p.o. q.i.d.

PREOPERATIVE PHYSICAL EXAMINATION:  General:  The patient is
a 76-year-old gentleman in no apparent distress.  He was
alert and oriented times three.  Neurological:  Grossly
intact.  Chest:  Clear to auscultation bilaterally.
Cardiovascular:  Regular, rate and rhythm.  S1 and S2.
Within normal limits.  Electrocardiogram normal sinus rhythm.

LABORATORY DATA:  CBC with a white blood cell count of 6.8,
hematocrit 39.1, platelet count 185,000; sodium 141,
potassium 4.4, chloride 102, bicarb 30, BUN 27, creatinine
1.0.

HOSPITAL COURSE:  The patient was taken to the Operating Room
on [**2177-8-19**], by Dr. [**Last Name (STitle) **], for a coronary artery
bypass grafting times four, LIMA to diagonal, saphenous vein
graft to left anterior descending, saphenous vein graft to
OM1, saphenous vein graft to posterior descending artery;
please see operative note of that day for further details.

The patient was transferred to the Intensive Care Unit in
stable condition.  In the Intensive Care Unit, the patient
required FFP, Protamine, and blood transfusions for elevated
chest tube drainage which subsequently resolved.  The patient
was weaned from mechanical ventilation that evening and
extubated without problem.  The patient remained

hemodynamically stable.  The patient was transferred out of
the Intensive Care Unit on postoperative day #1 in stable
condition.

The patient's chest tubes and pacing wires were removed on
postoperative day #3.  The patient remained tachycardiac on
increasing doses of Lopressor.  The patient was noted to have
a hematocrit of 23.9 which had been stable.  The patient was
given a blood transfusion for tachycardia and orthostasis.
Repeat hematocrit after transfusion was 25.3.  The patient
experienced some confusion on postoperative day #4 which
resolved spontaneously.  The patient's Foley catheter was
removed on the evening of postoperative day #4.  The patient
had a postvoid residual checked which was greater than 300
cc.  The Foley catheter was inserted at that time.  The Foley
catheter was subsequently removed several hours later, and
the patient once again was unable to void, and a Foley was
reinserted.  Urinalysis on that day was negative for signs of
infection.

On postoperative day #5, the patient was also noted to have
left upper extremity IV site that was erythematous and
indurated.  The patient was placed on intravenous Kefzol.
Ultrasound was obtained to rule out deep venous thrombosis.
Ultrasound was positive for basilic vein thrombosis, negative
for deep venous thrombosis.  The patient was continued on
antibiotics, and it was determined that there was no need for
anticoagulation at that time.

The patient is ambulating with Physical Therapy 340 feet on
postoperative day #6 with several rest periods.  The patient
was screened for [**Hospital 3058**] rehabilitation placement and was
accepted and was cleared for discharge on [**2177-8-25**].

CONDITION ON DISCHARGE:  Vital signs:  T-max 100.7??????, pulse 98
in sinus rhythm, blood pressure 125/84, respirations 20, room
air oxygen saturation 94%.  General:  The patient was alert
and oriented times three with a right upper extremity tremor,
worsening with activity, which the patient reported was the
same as preoperatively secondary to Parkinson's disease.
Cardiovascular:  Regular, rate and rhythm.  Without rub or
murmur.  Respiratory:  Lungs clear to auscultation
bilaterally.  No wheezes, rhonchi, or rales.  GI:  Positive
bowel sounds.  Soft, nontender, nondistended.  The patient is
tolerating a regular diet without nausea or vomiting.  GU:
The patient had a Foley catheter in place, draining clear,
yellow urine.  Chest:  Sternal incision with staples intact
without erythema or drainage.  Sternum is stable.
Extremities:  Right lower extremity saphenectomy site clean
and dry without erythema or drainage.  Left upper extremity
basilic vein with a palpable cord.  No erythema.  No purulent
drainage.

DISCHARGE LABORATORY VALUES:  Urinalysis from [**8-24**] was
negative.  Electrolytes from [**8-21**] revealed a sodium of
137, potassium 4.2, chloride 101, bicarbonate 24, BUN 24,
creatinine 1.1, glucose 106.  CBC from [**8-23**] with a white
blood cell count of 11.2, hematocrit 25.3, platelet count
111,000.

DISPOSITION:  The patient is to be discharged to
rehabilitation in stable condition.

DISCHARGE DIAGNOSIS:
1.  Status post coronary artery bypass grafting.
2.  Hypertension.
3.  Elevated cholesterol.
4.  Benign prostatic hypertrophy with urinary retention.
5.  History of Parkinson's disease.
6.  Left basilic vein thrombosis.
7.  Status post tonsillectomy.

DISCHARGE MEDICATIONS:  Lopressor 100 mg p.o. b.i.d.,
Cogentin 2 mg p.o. b.i.d., Lasix 20 mg p.o. b.i.d. x 7 days,
KCl 20 mEq p.o. b.i.d. x 7 days, Colace 100 mg p.o. b.i.d.,
Aspirin 81 mg p.o. q.d., Lipitor 10 mg p.o. q.h.s., Keflex
500 mg p.o. q.i.d. x 7 days, Ibuprofen 600 mg p.o. q.4-6
hours p.r.n.

DISCHARGE INSTRUCTIONS:  The patient is to be discharged to
rehabilitation with Foley catheter in place.  The patient is
to make an appointment with his urologist, Dr. [**Last Name (STitle) 35380**], in
[**Location (un) 620**], phone [**Telephone/Fax (1) 35381**], upon discharge from
rehabilitation for monitoring and management of benign
prostatic hypertrophy and Foley catheter.





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

Dictated By:[**Last Name (NamePattern1) 35382**]
MEDQUIST36

D:  [**2177-8-25**]  12:27
T:  [**2177-8-25**]  13:20
JOB#:  [**Job Number 35383**]
{'Coronary atherosclerosis of native coronary artery,Other and unspecified angina pectoris,Retention of urine, unspecified,Tachycardia, unspecified,Paralysis agitans,Delirium due to conditions classified elsewhere,Unspecified essential hypertension,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: 

PRESENT ILLNESS: This is a 76-year-old patient
who was referred to [**Hospital6 256**] for
cardiac catheterization due to a history of worsening angina
and a history of positive exercise treadmill test.  Cardiac
catheterization showed three-vessel coronary artery disease
and a normal left ventricular function.  The patient was
admitted to [**Hospital6 256**] on [**8-19**]
for surgery with Dr. [**Last Name (STitle) **].

MEDICAL HISTORY: 1.  Hypertension.  2.  Elevated
cholesterol.  3.  Coronary artery disease.  4.  History of
Parkinson's disease.  5.  Status post tonsillectomy.

MEDICATION ON ADMISSION: 

ALLERGIES: NO KNOWN DRUG ALLERGIES.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY:  

### Response:
{'Coronary atherosclerosis of native coronary artery,Other and unspecified angina pectoris,Retention of urine, unspecified,Tachycardia, unspecified,Paralysis agitans,Delirium due to conditions classified elsewhere,Unspecified essential hypertension,Pure hypercholesterolemia'}
