CHIEF COMPLAINT: 

PRESENT ILLNESS: This is a 57-year-old male with
known CAD, coronary artery disease who is status post PTCA/MI
in [**2165**] who was doing well until he presented to an outside
hospital with substernal chest pain, which had awoken him
from sleep.  It was nonradiating.  The patient complained of
associated weakness, dizziness, diaphoresis and some
shortness of breath.  However, there was no nausea or
vomiting.  He also complained of a pain in his back.  An EKG
revealed ST elevation in leads II, III and aVF.  The patient
was started on heparin and a lidocaine drip, P and K at half
the dose and a 2B3A inhibitor, a baby aspirin and Lopressor
25 mg and was transferred to [**Hospital1 188**] for cardiac catheterization.  When he arrived at [**Hospital1 1444**] he did have a sudden onset of
SVT, supraventricular tachycardia, for which he was given
lidocaine.  The patient arrived to the [**Hospital1 190**] catheterization laboratory at 6 in the
morning.  His chest pain had resolved and he was
hemodynamically stable.

MEDICAL HISTORY: CAD status post MI in [**2165**] and
hyperlipidemia.

MEDICATION ON ADMISSION: He was on Lopressor 25 mg p.o.
b.i.d.  He was started on Lopressor on [**7-10**] after the
MI.  On [**7-11**] an ACE inhibitor, lisinopril was added at
5 mg q.d.  The dose was titrated up on the 2nd to 10 mg q.d.

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: Not significant.

SOCIAL HISTORY: No alcohol.  The patient reports having quit
smoking and no IV or street drug abuse.
Acute myocardial infarction of other inferior wall, initial episode of care,Hematoma complicating a procedure,Coronary atherosclerosis of native coronary artery,Unspecified essential hypertension,Other and unspecified hyperlipidemia,Old myocardial infarction,Percutaneous transluminal coronary angioplasty status
AMI inferior wall, init,Hematoma complic proc,Crnry athrscl natve vssl,Hypertension NOS,Hyperlipidemia NEC/NOS,Old myocardial infarct,Status-post ptca
Admission Date:  [**2172-7-10**]     Discharge Date:  [**2172-7-12**]

Date of Birth:   [**2115-4-30**]     Sex:  M

Service:  CU

HISTORY OF PRESENT ILLNESS:  This is a 57-year-old male with
known CAD, coronary artery disease who is status post PTCA/MI
in [**2165**] who was doing well until he presented to an outside
hospital with substernal chest pain, which had awoken him
from sleep.  It was nonradiating.  The patient complained of
associated weakness, dizziness, diaphoresis and some
shortness of breath.  However, there was no nausea or
vomiting.  He also complained of a pain in his back.  An EKG
revealed ST elevation in leads II, III and aVF.  The patient
was started on heparin and a lidocaine drip, P and K at half
the dose and a 2B3A inhibitor, a baby aspirin and Lopressor
25 mg and was transferred to [**Hospital1 188**] for cardiac catheterization.  When he arrived at [**Hospital1 1444**] he did have a sudden onset of
SVT, supraventricular tachycardia, for which he was given
lidocaine.  The patient arrived to the [**Hospital1 190**] catheterization laboratory at 6 in the
morning.  His chest pain had resolved and he was
hemodynamically stable.

MEDICATIONS ON ADMISSION:  He was on Lopressor 25 mg p.o.
b.i.d.  He was started on Lopressor on [**7-10**] after the
MI.  On [**7-11**] an ACE inhibitor, lisinopril was added at
5 mg q.d.  The dose was titrated up on the 2nd to 10 mg q.d.

ALLERGIES:  No known drug allergies.

PAST MEDICAL HISTORY:  CAD status post MI in [**2165**] and
hyperlipidemia.

FAMILY HISTORY:  Not significant.

SOCIAL HISTORY:  No alcohol.  The patient reports having quit
smoking and no IV or street drug abuse.

PHYSICAL EXAMINATION ON ADMISSION:  Blood pressure 110/60,
heart rate 78, respiratory rate 16.  General:  Alert and
oriented, lying flat in bed, in no apparent distress.  HEENT:
Sclerae were anicteric, mucous membranes were moist.  There
was no JVD or JVP appreciated.  Cardiovascular:  Regular rate
and rhythm.  Normal S1 and S2.  No murmurs, rubs or gallops.
Respiratory:  Clear to auscultation bilaterally without
crackles.  Abdomen:  Soft.  Nontender.  Nondistended.
Extremities:  Warm.  His hands were cool without edema.  His
pulses radial and DP were 2+ bilaterally.  The right cardiac
catheterization site, there was a small, soft hematoma.  No
bruit was heard.

LABORATORY DATA:  Significant laboratory from the outside
hospital revealed his hematocrit was 35.1.  Electrolytes were
fine.  CPK 176, MB 4.9, troponin I 0.37.

The catheterization at [**Hospital1 69**]
on the first showed 60% mid LAD lesion, 70% at the origin of
LAD.  The left circumflex had mild, diffuse disease.  The RCA
had 90% mid, 70% distal stenosis.  Hepacoat stents were
placed in the proximal, mid and distal RCA.  Wedge pressure
was 16.  His RA pressure was 12.  An LV ventriculogram showed
60% with normal systolic function.

HOSPITAL COURSE:  The patient was admitted to the CCU.
Cardiac wise he was continued on the aspirin, Plavix,
Lopressor 25 b.i.d.  CKs were serially checked and they began
to trend down.  On the day of discharge his CK was 648.  The
patient had no further episodes of chest pain or EKG changes
during his hospital course.  He was on telemetry and
throughout his hospital stay he was in normal sinus rhythm.
There were no other ectopies.  The patient's LV function was
60%.  The LV had a 60% ejection fraction.  He was continued
on IV fluids at 150 cc per hour to maintain his preload,
given his territory of his myocardial infarction.

For his right groin hematoma, the Integrilin was stopped at
1800 hours on [**7-11**].  The patient showed no further
signs of bleeding.  The right groin hematoma was serially
followed.  It was stable throughout his hospital course and
was beginning to decrease.  There were no bruits auscultated
throughout his hospital course.

Hyperlipidemia.  He was started on Lipitor 20 mg q.d.  On
discharge he was given a prescription for Lescol XL 80 mg
q.d.  The patient was noted to have an elevated LDL during
his hospital course.

The patient was seen by physical therapy and they recommended
that he have outpatient cardiac rehabilitation for a week
post MI.

DISCHARGE INSTRUCTIONS:  The patient was discharged home on
[**7-12**] with the following instructions.  If you
experience any chest pain, nausea, vomiting or shortness of
breath, please [**Name8 (MD) 138**] M.D. or return to the ER.  Take all
medications as instructed.  Do not continue Plavix unless
instructed by a cardiologist.

FINAL DIAGNOSES:
1.  Myocardial infarction, non ST elevation myocardial
infarction, status post cardiac catheterization.
2. Coronary artery disease, status post myocardial infarction
in [**2165**] and [**2171**].
3.  Hyperlipidemia.

RECOMMENDED FOLLOWUP:  He is to follow up with his PCP, [**Last Name (NamePattern4) **].
[**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **] within the next week.  He is to be referred to a
cardiologist per Dr. [**Last Name (STitle) **] and he can schedule.  If he does
not follow up with his cardiologist, he should schedule an
appointment with Dr. [**Last Name (STitle) **], cardiology at [**Hospital1 346**] as necessary.  He is to follow up
and have an outpatient PMIBI to evaluate his 60% LAD stenosis
and see if there is reversible ischemia.

MAJOR SURGICAL OR INVASIVE PROCEDURES DURING THE HOSPITAL
COURSE:  Cardiac catheterization.

DISCHARGE CONDITION:  Stable.

DISCHARGE MEDICATIONS:  Aspirin 325 mg p.o. q.d., Clopidagrel
75 mg p.o. q.d., metoprolol 25 mg p.o. b.i.d., Lescol XL 80
mg p.o. q.d., lisinopril 10 mg p.o. q.d.

The patient is also to follow up with physical therapy for
outpatient cardiac rehabilitation in four weeks.



                          [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 3184**], M.D.  [**MD Number(1) 5211**]

Dictated By:[**Name8 (MD) 8736**]

MEDQUIST36

D:  [**2172-7-12**]  12:30
T:  [**2172-7-19**]  11:36
JOB#:  [**Job Number 51316**]

cc:[**Last Name (NamePattern4) 51317**]
{'Acute myocardial infarction of other inferior wall, initial episode of care,Hematoma complicating a procedure,Coronary atherosclerosis of native coronary artery,Unspecified essential hypertension,Other and unspecified hyperlipidemia,Old myocardial infarction,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: 

PRESENT ILLNESS: This is a 57-year-old male with
known CAD, coronary artery disease who is status post PTCA/MI
in [**2165**] who was doing well until he presented to an outside
hospital with substernal chest pain, which had awoken him
from sleep.  It was nonradiating.  The patient complained of
associated weakness, dizziness, diaphoresis and some
shortness of breath.  However, there was no nausea or
vomiting.  He also complained of a pain in his back.  An EKG
revealed ST elevation in leads II, III and aVF.  The patient
was started on heparin and a lidocaine drip, P and K at half
the dose and a 2B3A inhibitor, a baby aspirin and Lopressor
25 mg and was transferred to [**Hospital1 188**] for cardiac catheterization.  When he arrived at [**Hospital1 1444**] he did have a sudden onset of
SVT, supraventricular tachycardia, for which he was given
lidocaine.  The patient arrived to the [**Hospital1 190**] catheterization laboratory at 6 in the
morning.  His chest pain had resolved and he was
hemodynamically stable.

MEDICAL HISTORY: CAD status post MI in [**2165**] and
hyperlipidemia.

MEDICATION ON ADMISSION: He was on Lopressor 25 mg p.o.
b.i.d.  He was started on Lopressor on [**7-10**] after the
MI.  On [**7-11**] an ACE inhibitor, lisinopril was added at
5 mg q.d.  The dose was titrated up on the 2nd to 10 mg q.d.

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: Not significant.

SOCIAL HISTORY: No alcohol.  The patient reports having quit
smoking and no IV or street drug abuse. 

### Response:
{'Acute myocardial infarction of other inferior wall, initial episode of care,Hematoma complicating a procedure,Coronary atherosclerosis of native coronary artery,Unspecified essential hypertension,Other and unspecified hyperlipidemia,Old myocardial infarction,Percutaneous transluminal coronary angioplasty status'}
