CHIEF COMPLAINT: Increased dizziness, presyncope, exertional angina

PRESENT ILLNESS: 63 y/o male with known aortic stenosis and single-vessel RCA
disease which was stented in [**9-9**]. Recent increase in symptoms.
Underwent cardiac cath which revealed bicupsod AV with severe
AS. Referred for surgical eval.

MEDICAL HISTORY: Aortic stenosis s/p Aortic Valve Replacement
Coronary Artery Disease s/p PCI
Hypertension
Benign Prostatic Hypertrophy
Osteoarthritis
Hemorrhoids
Remote Bilat. ankle fx
s/p Tonsillectomy
s/p R. Femoral Pseudoaneurysm repair

MEDICATION ON ADMISSION: Terazosin 10mg qd, Aspirin 325mg qd, Lopid 300mg [**Hospital1 **], MVI,
Albuterol PRN, Tylenol 1300mg [**Hospital1 **], Amox prn pre dental

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: VS:
General: NAD, fit male
HEENT: EOMI, PERRL, Non-icteric
Neck: Supple, FROM, -JVD
Chest: CTAB -w/r/r
Heart: RRR 4/6 SEM which radiates to neck
Abd: Soft, NT/ND +BS
Ext: Warm, well-perfused, trace edema, well healed r. fem scar,
-varicosities
Neuro: MAE, [**6-9**] strengths, Non-focal

FAMILY HISTORY: Noncontributory

SOCIAL HISTORY: Quit smoking [**2168**] after 20 pk/yrs. Drinks 1 beer/day
Aortic valve disorders,Congestive heart failure, unspecified,Coronary atherosclerosis of native coronary artery,Unspecified essential hypertension,Pure hypercholesterolemia,Intestinal disaccharidase deficiencies and disaccharide malabsorption,Esophageal reflux,Osteoarthrosis, unspecified whether generalized or localized, pelvic region and thigh,Hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (LUTS),Percutaneous transluminal coronary angioplasty status
Aortic valve disorder,CHF NOS,Crnry athrscl natve vssl,Hypertension NOS,Pure hypercholesterolem,Disaccharidase def/malab,Esophageal reflux,Osteoarthros NOS-pelvis,BPH w/o urinary obs/LUTS,Status-post ptca
Admission Date:  [**2192-2-9**]              Discharge Date:   [**2192-2-12**]

Date of Birth:  [**2128-5-26**]             Sex:   M

Service: CARDIOTHORACIC

Allergies:
Patient recorded as having No Known Allergies to Drugs

Attending:[**First Name3 (LF) 1267**]
Chief Complaint:
Increased dizziness, presyncope, exertional angina

Major Surgical or Invasive Procedure:
Aortic valve replacement with 21 mm [**Company 1543**] Mosaic valve

History of Present Illness:
63 y/o male with known aortic stenosis and single-vessel RCA
disease which was stented in [**9-9**]. Recent increase in symptoms.
Underwent cardiac cath which revealed bicupsod AV with severe
AS. Referred for surgical eval.

Past Medical History:
Aortic stenosis s/p Aortic Valve Replacement
Coronary Artery Disease s/p PCI
Hypertension
Benign Prostatic Hypertrophy
Osteoarthritis
Hemorrhoids
Remote Bilat. ankle fx
s/p Tonsillectomy
s/p R. Femoral Pseudoaneurysm repair

Social History:
Quit smoking [**2168**] after 20 pk/yrs. Drinks 1 beer/day

Family History:
Noncontributory

Physical Exam:
VS:
General: NAD, fit male
HEENT: EOMI, PERRL, Non-icteric
Neck: Supple, FROM, -JVD
Chest: CTAB -w/r/r
Heart: RRR 4/6 SEM which radiates to neck
Abd: Soft, NT/ND +BS
Ext: Warm, well-perfused, trace edema, well healed r. fem scar,
-varicosities
Neuro: MAE, [**6-9**] strengths, Non-focal

Pertinent Results:
[**2192-2-9**] Echo: PRE-BYPASS: Left ventricular wall thicknesses and
cavity size are normal. Right ventricular chamber size and free
wall motion are normal. There are three aortic valve leaflets.
The aortic valve leaflets are severely thickened/deformed. There
is severe aortic valve stenosis)area <0.8cm2). The mitral valve
leaflets are mildly thickened. Mild (1+)mitral regurgitation is
seen. There is no pericardial effusion. POST-BYPASS: preserved
biventricular function. Bioprosthesis is aortic position. Well
seated and mechamicqally stable. Trace AI. No other change
[**2192-2-12**] CXR: Median sternotomy wires are seen. There is
atelectasis at the lung bases, new since the previous study.
There are no signs of focal consolidation or overt pulmonary
edema. Cardiac silhouette is upper limits of normal.
[**2192-2-9**] 11:30AM BLOOD WBC-15.4*# RBC-3.67* Hgb-11.7* Hct-33.4*
MCV-91 MC-31.9 MCHC-35.1* RDW-13.7 Plt Ct-147*
[**2192-2-12**] 05:25AM BLOOD WBC-8.2 RBC-3.00* Hgb-9.7* Hct-27.1*
MCV-90 MCH-32.2* MCHC-35.7* RDW-13.7 Plt Ct-105*
[**2192-2-9**] 11:42AM BLOOD PT-13.6* PTT-33.5 INR(PT)-1.2*
[**2192-2-9**] 11:42AM BLOOD UreaN-12 Creat-0.7 Cl-112* HCO3-24
[**2192-2-12**] 05:25AM BLOOD Glucose-100 UreaN-20 Creat-0.8 Na-136
K-4.3 Cl-100 HCO3-27 AnGap-13

Brief Hospital Course:
Mr. [**Known lastname 1968**] was a same day admit and was brought directly to the
OR where he underwent an Aortic Valve Replacement. Please see
surgical report for details. He tolerated the procedure well and
was transferred to the CSRU for invasive monitoring in stable
condition. Later on op day he was weaned from sedation, awoke
neurologically intact and was extubated. On post-op day one he
was doing well and was started on beta blockers and diuretics.
He was diuresed towards his pre-op weight. Also on this day his
chest tubes were removed and he was transferred to the telemetry
floor. Epicardial pacing wires were removed on post-op day two.
Physical therapy worked with patient for strength and stability.
He improved rather fast with no post-op complications and on
post-op day three he was discharged home with VNA services.

Medications on Admission:
Terazosin 10mg qd, Aspirin 325mg qd, Lopid 300mg [**Hospital1 **], MVI,
Albuterol PRN, Tylenol 1300mg [**Hospital1 **], Amox prn pre dental

Discharge Medications:
1. Metoprolol Tartrate 25 mg Tablet Sig: One (1) Tablet PO BID
(2 times a day).
Disp:*60 Tablet(s)* Refills:*2*
2. Furosemide 20 mg Tablet Sig: One (1) Tablet PO Q12H (every 12
hours).
For 7 days
3. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2
times a day).
Disp:*60 Capsule(s)* Refills:*2*
4. 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*
5. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO
Q4H (every 4 hours) as needed for pain.
Disp:*60 Tablet(s)* Refills:*0*
Potassium Chloride 20 meq po BID for 7days
Gemfibrozil 600mg take half tablet twice daily
Terazosin 10mg qhs

Discharge Disposition:
Home With Service

Facility:
TBA

Discharge Diagnosis:
Aortic stenosis s/p Aortic Valve Replacement
Coronary Artery Disease s/p PCI
Hypertension
Benign Prostatic Hypertrophy
Osteoarthritis
Hemorrhoids
Remote Bilat. ankle fx
s/p Tonsillectomy
s/p R. Femoral Pseudoaneurysm repair

Discharge Condition:
Good

Discharge Instructions:
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
No lifting more than 5 pounds
Please call with any questions or concerns

Followup Instructions:
Dr. [**Last Name (STitle) **] in 2 weeks ([**Telephone/Fax (1) 170**]) please call for
appointment
Dr [**Last Name (STitle) **] in 1 week call for appt
Dr [**Last Name (STitle) **] in 2 weeks call for appt


Completed by:[**2192-3-2**]
{'Aortic valve disorders,Congestive heart failure, unspecified,Coronary atherosclerosis of native coronary artery,Unspecified essential hypertension,Pure hypercholesterolemia,Intestinal disaccharidase deficiencies and disaccharide malabsorption,Esophageal reflux,Osteoarthrosis, unspecified whether generalized or localized, pelvic region and thigh,Hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (LUTS),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: Increased dizziness, presyncope, exertional angina

PRESENT ILLNESS: 63 y/o male with known aortic stenosis and single-vessel RCA
disease which was stented in [**9-9**]. Recent increase in symptoms.
Underwent cardiac cath which revealed bicupsod AV with severe
AS. Referred for surgical eval.

MEDICAL HISTORY: Aortic stenosis s/p Aortic Valve Replacement
Coronary Artery Disease s/p PCI
Hypertension
Benign Prostatic Hypertrophy
Osteoarthritis
Hemorrhoids
Remote Bilat. ankle fx
s/p Tonsillectomy
s/p R. Femoral Pseudoaneurysm repair

MEDICATION ON ADMISSION: Terazosin 10mg qd, Aspirin 325mg qd, Lopid 300mg [**Hospital1 **], MVI,
Albuterol PRN, Tylenol 1300mg [**Hospital1 **], Amox prn pre dental

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: VS:
General: NAD, fit male
HEENT: EOMI, PERRL, Non-icteric
Neck: Supple, FROM, -JVD
Chest: CTAB -w/r/r
Heart: RRR 4/6 SEM which radiates to neck
Abd: Soft, NT/ND +BS
Ext: Warm, well-perfused, trace edema, well healed r. fem scar,
-varicosities
Neuro: MAE, [**6-9**] strengths, Non-focal

FAMILY HISTORY: Noncontributory

SOCIAL HISTORY: Quit smoking [**2168**] after 20 pk/yrs. Drinks 1 beer/day 

### Response:
{'Aortic valve disorders,Congestive heart failure, unspecified,Coronary atherosclerosis of native coronary artery,Unspecified essential hypertension,Pure hypercholesterolemia,Intestinal disaccharidase deficiencies and disaccharide malabsorption,Esophageal reflux,Osteoarthrosis, unspecified whether generalized or localized, pelvic region and thigh,Hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (LUTS),Percutaneous transluminal coronary angioplasty status'}
