CHIEF COMPLAINT: recent mild angina with exertion

PRESENT ILLNESS: 61 yo African-American male had abnormal EKG found as part of
pre-op eval. for ventral hernia repair. Had subsequent abnormal
stress test and pefusion imaging showed EF 38% with perfusion
defects. Echo prior to scheduled cath showed mild LVH, inferior
HK, EF 40%, mild MR, mild LAE. Cath at [**Hospital1 **] today showed
80% LM lesion with normal LAD, CX, RCA. Severe systolic HTN also
noted. Transferred in urgently for cabg with Dr. [**Last Name (STitle) 1290**].

MEDICAL HISTORY: ventral hernia
HTN
elev. chol.
right facial droop with metal plate secondary to GSW to face
right nephrectomy

MEDICATION ON ADMISSION: bisoprolol 5 mg daily
crestor 20 mg daily
HCTZ 25 mg daily
lisinopril 40 mg daily

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: Not done, taken to OR direct from ambulance transfer.

FAMILY HISTORY: not given

SOCIAL HISTORY: current smoker
Coronary atherosclerosis of native coronary artery,Unspecified essential hypertension,Pure hypercholesterolemia,Ventral, unspecified, hernia without mention of obstruction or gangrene
Crnry athrscl natve vssl,Hypertension NOS,Pure hypercholesterolem,Ventral hernia NOS
Admission Date:  [**2123-7-13**]              Discharge Date:   [**2123-7-17**]

Date of Birth:  [**2062-3-17**]             Sex:   M

Service: CARDIOTHORACIC

Allergies:
Patient recorded as having No Known Allergies to Drugs

Attending:[**First Name3 (LF) 1283**]
Chief Complaint:
recent mild angina with exertion

Major Surgical or Invasive Procedure:
emergency CABG X 3 ([**2123-7-13**])(LIMA to LAD, SVG to ramus, SVG to
OM)


History of Present Illness:
61 yo African-American male had abnormal EKG found as part of
pre-op eval. for ventral hernia repair. Had subsequent abnormal
stress test and pefusion imaging showed EF 38% with perfusion
defects. Echo prior to scheduled cath showed mild LVH, inferior
HK, EF 40%, mild MR, mild LAE. Cath at [**Hospital1 **] today showed
80% LM lesion with normal LAD, CX, RCA. Severe systolic HTN also
noted. Transferred in urgently for cabg with Dr. [**Last Name (STitle) 1290**].

Past Medical History:
ventral hernia
HTN
elev. chol.
right facial droop with metal plate secondary to GSW to face
right nephrectomy

Social History:
current smoker

Family History:
not given

Physical Exam:
Not done, taken to OR direct from ambulance transfer.

Pertinent Results:
[**2123-7-14**] 02:06AM BLOOD WBC-9.4 RBC-3.61* Hgb-10.4* Hct-29.9*
MCV-83 MCH-28.8 MCHC-34.8 RDW-14.3 Plt Ct-154
[**2123-7-17**] 05:14AM BLOOD Hct-25.2*
[**2123-7-14**] 02:06AM BLOOD Plt Ct-154
[**2123-7-13**] 08:05PM BLOOD PT-13.6* PTT-33.3 INR(PT)-1.2*
[**2123-7-17**] 05:14AM BLOOD UreaN-25* Creat-1.0 K-3.9
[**2123-7-15**] 02:02PM BLOOD Mg-2.1

FINAL REPORT


TWO VIEW CHEST, [**2123-7-17**]

COMPARISON: [**2123-7-14**].

INDICATION: Status post coronary bypass surgery.

There has been removal of a Swan-Ganz catheter and placement of
a right
internal jugular vascular catheter, with the tip terminating in
the proximal
right atrium just below the junction with the superior vena
cava. Cardiac and
mediastinal contours are stable in the postoperative period.
Previously
reported interstitial edema has resolved. There has been
interval improvement
in left basilar atelectasis. Right basilar atelectasis has
slightly worsened.
Bilateral pleural effusions are unchanged.

IMPRESSION:
1. Vascular catheter tip terminates in proximal right atrium.
2. Bibasilar minor atelectasis, worse on the right and improved
on the left.
Persistent pleural effusions.
DR. [**First Name11 (Name Pattern1) **] [**Initial (NamePattern1) **] [**Last Name (NamePattern4) 5785**]


Approved: SAT [**2123-7-17**] 8:20 PM
Procedure Date:[**2123-7-17**]

PRE-CPB: The left atrium is mildly dilated. No spontaneous echo
contrast is seen in the body of the left atrium. No spontaneous
echo contrast or thrombus is seen in the body of the left atrium
or left atrial appendage. No mass/thrombus is seen in the left
atrium or left atrial appendage. No atrial septal defect is seen
by 2D or color Doppler. There is mild symmetric left ventricular
hypertrophy with normal cavity size. There is mild symmetric
left ventricular hypertrophy. The left ventricular cavity size
is normal. No left ventricular aneurysm is seen. There is mild
regional left ventricular systolic dysfunction. Overall left
ventricular systolic function is mildly depressed. There is no
ventricular septal defect. Resting regional wall motion
abnormalities include mild inferior hypokinesis. Right
ventricular chamber size and free wall motion are normal. The
right ventricular cavity is mildly dilated. There are simple
atheroma in the aortic root. There are simple atheroma in the
ascending aorta. There are simple atheroma in the aortic arch.
There are simple atheroma in the descending thoracic aorta.
There are three aortic valve leaflets. The aortic valve leaflets
are mildly thickened. No masses or vegetations are seen on the
aortic valve. There is no aortic valve stenosis. Trace aortic
regurgitation is seen. The mitral valve leaflets are mildly
thickened. No mass or vegetation is seen on the mitral valve.
Trivial mitral regurgitation is seen. There is no pericardial
effusion.
POST-CPB: Preserved LV systolic function on phenylephrine. LVEF
now 50%. Trace MR, AI as described. Normal aortic contours.
I certify that I was present for this procedure in compliance
with HCFA regulations.

Electronically signed by [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 5209**], MD, Interpreting
physician





Brief Hospital Course:
Admitted directly to OR from ambulance transfer and underwent
cabg x3 with Dr. [**Last Name (STitle) 1290**] on [**7-13**]. Transferred to the CSRU in
stable condition on phenylephrine and propofol drips. Extubated
early the next morning and chest tubes removed. Gentle diuresis
and beta blockade started, and he was transferred to the floor
to begin increasing his activity level.Foley removed on POD #2
and had scattered rales with temp 101.2. Afebrile the next day
and pacing wires removed without incident. He made excellent
progress and was discharged to home with VNA services on POD #4.
He is to follow up with providers as per discharge instructions.

Medications on Admission:
bisoprolol 5 mg daily
crestor 20 mg daily
HCTZ 25 mg daily
lisinopril 40 mg daily

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. 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*
3. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2
times a day).
Disp:*60 Capsule(s)* Refills:*2*
4. Ranitidine HCl 150 mg Tablet Sig: One (1) Tablet PO BID (2
times a day).
Disp:*60 Tablet(s)* Refills:*2*
5. 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*
6. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO
every 4-6 hours as needed for pain.
Disp:*50 Tablet(s)* Refills:*0*
7. Rosuvastatin 20 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
Disp:*30 Tablet(s)* Refills:*2*
8. Furosemide 20 mg Tablet Sig: One (1) Tablet PO BID (2 times a
day) for 7 days.
Disp:*14 Tablet(s)* Refills:*0*


Discharge Disposition:
Home With Service

Facility:
VNA carenetwork

Discharge Diagnosis:
CAD
HTN
ventral hernia
right nephrectomy
s/p right facial plating


Discharge Condition:
good


Discharge Instructions:
may shower, no bathing or swimming for 1 month
no creams, lotions or powders to any incisions
no driving for 1 month
no lifting > 10 # for 10 weeks

[**Last Name (NamePattern4) **] Instructions:
with Dr. [**First Name (STitle) **] in [**2-19**] weeks
with Dr. [**Last Name (STitle) 6254**] in [**2-19**] weeks
with Dr. [**Last Name (STitle) **] [**Last Name (Prefixes) 53724**] in 4 weeks



Completed by:[**2123-7-29**]
{'Coronary atherosclerosis of native coronary artery,Unspecified essential hypertension,Pure hypercholesterolemia,Ventral, unspecified, hernia without mention of obstruction or gangrene'}


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: recent mild angina with exertion

PRESENT ILLNESS: 61 yo African-American male had abnormal EKG found as part of
pre-op eval. for ventral hernia repair. Had subsequent abnormal
stress test and pefusion imaging showed EF 38% with perfusion
defects. Echo prior to scheduled cath showed mild LVH, inferior
HK, EF 40%, mild MR, mild LAE. Cath at [**Hospital1 **] today showed
80% LM lesion with normal LAD, CX, RCA. Severe systolic HTN also
noted. Transferred in urgently for cabg with Dr. [**Last Name (STitle) 1290**].

MEDICAL HISTORY: ventral hernia
HTN
elev. chol.
right facial droop with metal plate secondary to GSW to face
right nephrectomy

MEDICATION ON ADMISSION: bisoprolol 5 mg daily
crestor 20 mg daily
HCTZ 25 mg daily
lisinopril 40 mg daily

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: Not done, taken to OR direct from ambulance transfer.

FAMILY HISTORY: not given

SOCIAL HISTORY: current smoker 

### Response:
{'Coronary atherosclerosis of native coronary artery,Unspecified essential hypertension,Pure hypercholesterolemia,Ventral, unspecified, hernia without mention of obstruction or gangrene'}
