CHIEF COMPLAINT: DOE

PRESENT ILLNESS: 50 year old male with 3 years of increasing dyspnea on exertion
but denies syncope, chest pain, palpitations.  Under went
cardiac catherization at outside hospital for cardiac workup
which revealed RCA lesion.  Referred for preoperative evaluation

MEDICAL HISTORY: Severe Aortic Stenosis
Coronary Artery Disease
Hyperlipidemia
s/p Appy '[**79**]
Hernia repair '[**97**]
Foot surgery '[**13**]

MEDICATION ON ADMISSION: None

ALLERGIES: Gentamicin

PHYSICAL EXAM: Admission
Vitals 105/80, 16, 100SR Wt 192#
NAD, A/O x3
3/6 SEM at LSB RRR
Lungs CTA but breath sounds distant
+bowel sounds, NT, ND
LE bil +2 edema
Pulses +2

FAMILY HISTORY: Father with CAD s/p CABG

SOCIAL HISTORY: Lives with Spouse
[**Name (NI) 1403**] as software systems analysis
Tobacco: [**12-13**] pack/day x 37 years, quit 2 weeks ago
ETOH: 1-2 drinks a week
Aortic valve disorders,Congestive heart failure, unspecified,Coronary atherosclerosis of native coronary artery,Dental caries, unspecified
Aortic valve disorder,CHF NOS,Crnry athrscl natve vssl,Dental caries NOS
Admission Date:  [**2124-11-17**]              Discharge Date:   [**2124-11-29**]

Date of Birth:  [**2074-5-3**]             Sex:   M

Service: CARDIOTHORACIC

Allergies:
Gentamicin

Attending:[**First Name3 (LF) 1505**]
Chief Complaint:
DOE

Major Surgical or Invasive Procedure:
[**2124-11-24**] AVR (#21 pericardial)/CABG x 1 (SVG->RCA)


History of Present Illness:
50 year old male with 3 years of increasing dyspnea on exertion
but denies syncope, chest pain, palpitations.  Under went
cardiac catherization at outside hospital for cardiac workup
which revealed RCA lesion.  Referred for preoperative evaluation

Past Medical History:
Severe Aortic Stenosis
Coronary Artery Disease
Hyperlipidemia
s/p Appy '[**79**]
Hernia repair '[**97**]
Foot surgery '[**13**]


Social History:
Lives with Spouse
[**Name (NI) 1403**] as software systems analysis
Tobacco: [**12-13**] pack/day x 37 years, quit 2 weeks ago
ETOH: 1-2 drinks a week

Family History:
Father with CAD s/p CABG

Physical Exam:
Admission
Vitals 105/80, 16, 100SR Wt 192#
NAD, A/O x3
3/6 SEM at LSB RRR
Lungs CTA but breath sounds distant
+bowel sounds, NT, ND
LE bil +2 edema
Pulses +2

Pertinent Results:
[**2124-11-28**] 07:20AM BLOOD WBC-8.8 RBC-4.58* Hgb-13.6* Hct-40.8
MCV-89 MCH-29.7 MCHC-33.3 RDW-15.6* Plt Ct-84*
[**2124-11-28**] 07:20AM BLOOD Plt Ct-84*
[**2124-11-27**] 01:45PM BLOOD Plt Ct-67*
[**2124-11-27**] 02:05AM BLOOD Plt Ct-54*

Brief Hospital Course:
Transferred in from [**Hospital3 **] for cardiac surgery
evaluation [**11-17**].  Underwent preoperative workup including dental
evaluation revealed one tooth that carried risk for bacteremia.
On [**11-21**] underwent tooth extraction. Carotid u/s showed < 40%
stenosis bilaterally. OR was delayed secondary to continued INR
of 1.4 despite vitamin K, he was seen by hematology who felt
that it was vitamin K deficiency. Then on [**11-24**] went to the
operating room for an AVR/CABG x 1. He was transferred to the
SICU in critical but stable condition. He was extubated on POD
#1. A HIT screen for sent for thrombocytopenia. His milrinone
was weaned to off on POD #3 and he was later transferred to the
floor.  On the floor his blood pressure regimen was maximized
and he was gently diuresed. He was seen in consultation by the
physical therapy service.  By POD #5 he was ready for discharge
in stable condition to home.

Medications on Admission:
None

Discharge Medications:
1. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2
times a day).
Disp:*60 Capsule(s)* Refills:*0*
2. 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*
3. Atorvastatin 10 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
Disp:*30 Tablet(s)* Refills:*0*
4. Pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One
(1) Tablet, Delayed Release (E.C.) PO Q24H (every 24 hours).
Disp:*30 Tablet, Delayed Release (E.C.)(s)* Refills:*0*
5. Carvedilol 12.5 mg Tablet Sig: One (1) Tablet PO BID (2 times
a day).
Disp:*60 Tablet(s)* Refills:*0*
6. Hydromorphone 2 mg Tablet Sig: One (1) Tablet PO Q3-4H (Every
3 to 4 Hours) as needed.
Disp:*40 Tablet(s)* Refills:*0*
7. Lisinopril 2.5 mg Tablet Sig: One (1) Tablet PO once a day.
Disp:*30 Tablet(s)* Refills:*0*
8. Furosemide 40 mg Tablet Sig: One (1) Tablet PO BID (2 times a
day) for 1 weeks: take 40mg twice a day for 1 week then decrease
to 40mg once daily and follow up with cardiologist.
Disp:*30 Tablet(s)* Refills:*0*


Discharge Disposition:
Home With Service

Facility:
[**Location (un) **] VNA

Discharge Diagnosis:
Aortic Stenosis
Coronary Artery Disease
Hyperlipidemia
Appy
hernia repair
foot surgery


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) **] in 4 weeks ([**Telephone/Fax (1) 170**]) please call for appointment

Dr [**Last Name (STitle) 52855**] in 1 week ([**Telephone/Fax (1) 54481**]) please call for
appointment
Dr [**Last Name (STitle) 5655**] in [**1-14**] weeks - please call for appointment
Wound check appointment [**Hospital Ward Name 121**] 2 as instructed by nurse
([**Telephone/Fax (1) 3633**])



Completed by:[**2124-11-29**]
{'Aortic valve disorders,Congestive heart failure, unspecified,Coronary atherosclerosis of native coronary artery,Dental caries, unspecified'}


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: DOE

PRESENT ILLNESS: 50 year old male with 3 years of increasing dyspnea on exertion
but denies syncope, chest pain, palpitations.  Under went
cardiac catherization at outside hospital for cardiac workup
which revealed RCA lesion.  Referred for preoperative evaluation

MEDICAL HISTORY: Severe Aortic Stenosis
Coronary Artery Disease
Hyperlipidemia
s/p Appy '[**79**]
Hernia repair '[**97**]
Foot surgery '[**13**]

MEDICATION ON ADMISSION: None

ALLERGIES: Gentamicin

PHYSICAL EXAM: Admission
Vitals 105/80, 16, 100SR Wt 192#
NAD, A/O x3
3/6 SEM at LSB RRR
Lungs CTA but breath sounds distant
+bowel sounds, NT, ND
LE bil +2 edema
Pulses +2

FAMILY HISTORY: Father with CAD s/p CABG

SOCIAL HISTORY: Lives with Spouse
[**Name (NI) 1403**] as software systems analysis
Tobacco: [**12-13**] pack/day x 37 years, quit 2 weeks ago
ETOH: 1-2 drinks a week 

### Response:
{'Aortic valve disorders,Congestive heart failure, unspecified,Coronary atherosclerosis of native coronary artery,Dental caries, unspecified'}
