CHIEF COMPLAINT: Chest pain

PRESENT ILLNESS: Mr. [**Known lastname **] is a 35 y/o male with h/o CAD s/p multiple stents this
year c/b restensosis. He continued to have recurrent angina and
underwent cardiac cath at OSH which revealed progression of LAD
disease. Coronary disease was not amenable to PCI and was
transferred to [**Hospital1 18**] for surgical revascularization.

MEDICAL HISTORY: Coronary Artery Disease s/p stent to prox and mid LAD c/b
subacute stent thrombosis s/p thrombectomy of LAD and stent
[**2140-4-7**], s/p DES to prox LAD [**2140-6-3**], h/o
retroperitoneal/extraperitoneal bleed, Hypertension

MEDICATION ON ADMISSION: At transfer: Plavix 75mg qd, Aspirin 325mg qd, Zocor 40mg qd,
Lisinopril 5mg qd, Toprol XL 100mg qd, Heparin gtt.

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: VS: 66 20 176/98 5'9" 195#
Gen: WDWN male in NAD
HEENT: EOMI, PERRL, NC/AT
Neck: Supple, FROM, -JVD, -bruit
Chest: CTAB -w/r/r
Heart: RRR -c/r/m/g
Abd: Soft, NT/ND, +BS
Ext: Warm, well-perfused, -edema, -varicosities
Neuro: A&O x 3, MAE, non-focal

FAMILY HISTORY: Father with stents at age 65.

SOCIAL HISTORY: Biochemist. Denies tobacco and ETOH use.
Coronary atherosclerosis of native coronary artery,Other and unspecified angina pectoris,Percutaneous transluminal coronary angioplasty status,Unspecified essential hypertension
Crnry athrscl natve vssl,Angina pectoris NEC/NOS,Status-post ptca,Hypertension NOS
Admission Date:  [**2140-6-29**]              Discharge Date:   [**2140-7-4**]

Date of Birth:  [**2104-7-3**]             Sex:   M

Service: CARDIOTHORACIC

Allergies:
Patient recorded as having No Known Allergies to Drugs

Attending:[**First Name3 (LF) 165**]
Chief Complaint:
Chest pain

Major Surgical or Invasive Procedure:
[**2140-6-30**] Off-Pump Coronary Artery Bypass Graft x 2 (LIMA to LAD, L
radial to diag)

History of Present Illness:
Mr. [**Known lastname **] is a 35 y/o male with h/o CAD s/p multiple stents this
year c/b restensosis. He continued to have recurrent angina and
underwent cardiac cath at OSH which revealed progression of LAD
disease. Coronary disease was not amenable to PCI and was
transferred to [**Hospital1 18**] for surgical revascularization.

Past Medical History:
Coronary Artery Disease s/p stent to prox and mid LAD c/b
subacute stent thrombosis s/p thrombectomy of LAD and stent
[**2140-4-7**], s/p DES to prox LAD [**2140-6-3**], h/o
retroperitoneal/extraperitoneal bleed, Hypertension

Social History:
Biochemist. Denies tobacco and ETOH use.

Family History:
Father with stents at age 65.

Physical Exam:
VS: 66 20 176/98 5'9" 195#
Gen: WDWN male in NAD
HEENT: EOMI, PERRL, NC/AT
Neck: Supple, FROM, -JVD, -bruit
Chest: CTAB -w/r/r
Heart: RRR -c/r/m/g
Abd: Soft, NT/ND, +BS
Ext: Warm, well-perfused, -edema, -varicosities
Neuro: A&O x 3, MAE, non-focal

Pertinent Results:
[**6-30**] Echo: The left atrium is normal in size. No spontaneous echo
contrast or thrombus is seen in the body of the left atrium/left
atrial appendage or the body of the right atrium/right atrial
appendage. No spontaneous echo contrast or thrombus is seen in
the body of the right atrium or the right atrial appendage. No
atrial septal defect is seen by 2D or color Doppler. Left
ventricular wall thickness, cavity size, and systolic function
are normal (LVEF>55%). There is mild symmetric left ventricular
hypertrophy. Right ventricular chamber size and free wall motion
are normal. The ascending, transverse and descending thoracic
aorta are normal in diameter and free of atherosclerotic plaque.
The aortic valve leaflets (3) appear structurally normal with
good leaflet excursion and no aortic regurgitation. The mitral
valve appears structurally normal with trivial mitral
regurgitation. There is no pericardial effusion. Post off pump:
Preserved biventricular systolic function. Overall LVEF 55%.
Aortic contour is intact
[**7-4**] CXR: The patient is status post recent median sternotomy
and coronary bypass surgery. Cardiomediastinal contours are
stable in the post-operative period. Minor basilar atelectasis
and small pleural effusions are present. No pneumothorax is
evident.

[**2140-6-29**] 12:45PM BLOOD WBC-6.6 RBC-4.77 Hgb-13.7* Hct-37.8*
MCV-79* MCH-28.8 MCHC-36.4* RDW-13.9 Plt Ct-311
[**2140-7-4**] 09:15AM BLOOD WBC-10.0 RBC-3.28* Hgb-9.3* Hct-26.7*
MCV-82 MCH-28.4 MCHC-34.8 RDW-14.4 Plt Ct-371#
[**2140-6-29**] 12:45PM BLOOD PT-11.7 PTT-23.2 INR(PT)-1.0
[**2140-7-2**] 01:24AM BLOOD PT-13.0 INR(PT)-1.1
[**2140-6-29**] 12:45PM BLOOD Glucose-109* UreaN-12 Creat-1.0 Na-140
K-4.4 Cl-103 HCO3-29 AnGap-12
[**2140-7-3**] 05:20AM BLOOD Glucose-126* UreaN-12 Creat-1.0 Na-142
K-4.0 Cl-105 HCO3-28 AnGap-13
[**2140-7-2**] 01:24AM BLOOD Phos-3.4 Mg-1.9

Brief Hospital Course:
As mentioned in the HPI, Mr. [**Known lastname **] was transferred from OSH for
surgical revascularization of his coronary disease. He underwent
usual pre-operative testing and was brought to the operating
room on [**6-30**] where he had a off-pump coronary artery bypass x 2.
Please see operative report for details. Following surgery he
was transferred to the CSRU for invasive monitoring in stable
condition. Later on op day he was weaned from sedation, awoke
neurologically intact and extubated. On post-op day one beta
blocker and diuretics were started and he was gently diuresed
towards his pre-op weight. On post-op day two his chest tubes
were removed and he was then transferred to the SDU for further
care. Epicardial pacing wires were removed the following day.
Physical therapy worked with pt. during post-op period for
strength and mobility. He continued to improve and was ready for
discharge home with services on post operative day 4.

Medications on Admission:
At transfer: Plavix 75mg qd, Aspirin 325mg qd, Zocor 40mg qd,
Lisinopril 5mg qd, Toprol XL 100mg qd, Heparin gtt.

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. Clopidogrel 75 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
Disp:*30 Tablet(s)* Refills:*0*
4. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO
Q4H (every 4 hours) as needed for pain.
Disp:*50 Tablet(s)* Refills:*0*
5. Metoprolol Tartrate 50 mg Tablet Sig: One (1) Tablet PO BID
(2 times a day).
Disp:*60 Tablet(s)* Refills:*0*
6. Simvastatin 40 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
Disp:*30 Tablet(s)* Refills:*0*
7. Ferrous Gluconate 300 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
Disp:*30 Tablet(s)* Refills:*0*
8. Ascorbic Acid 500 mg Tablet Sig: One (1) Tablet PO BID (2
times a day).
Disp:*60 Tablet(s)* Refills:*0*
9. Diltiazem HCl 240 mg Capsule, Sustained Release Sig: One (1)
Capsule, Sustained Release PO DAILY (Daily) for 3 months.
Disp:*30 Capsule, Sustained Release(s)* Refills:*2*
10. Chlorhexidine Gluconate 0.12 % Mouthwash Sig: Five (5) ML
Mucous membrane [**Hospital1 **] (2 times a day) for 1 weeks.
Disp:*70 ML(s)* Refills:*0*
11. Ranitidine HCl 150 mg Tablet Sig: One (1) Tablet PO once a
day for 1 months.
Disp:*30 Tablet(s)* Refills:*0*
12. Furosemide 20 mg Tablet Sig: One (1) Tablet PO once a day
for 10 days.
Disp:*10 Tablet(s)* Refills:*0*
13. Potassium Chloride 10 mEq Capsule, Sustained Release Sig:
Two (2) Capsule, Sustained Release PO once a day for 10 days.
Disp:*20 Capsule, Sustained Release(s)* Refills:*0*


Discharge Disposition:
Home With Service

Facility:
[**Hospital1 **]

Discharge Diagnosis:
Coronary Artery Disease s/p Off-Pump Coronary Artery Bypass
Graft x 2
PMH: s/p stent to prox and mid LAD c/b subacute stent thrombosis
s/p thrombectomy of LAD and stent [**2140-4-7**], s/p DES to prox LAD
[**2140-6-3**], h/o retroperitoneal/extraperitoneal bleed, Hypertension

Discharge Condition:
Good

Discharge Instructions:
Please shower daily including washing incisions, 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 [**Telephone/Fax (1) 170**]

Followup Instructions:
Please call to schedule all appointments
Dr. [**First Name (STitle) **] in 4 weeks  [**Telephone/Fax (1) 170**]
Dr. [**Last Name (STitle) 5874**] in [**12-26**] weeks
Dr. [**Last Name (STitle) 43672**] in [**11-24**] weeks [**Telephone/Fax (1) 6256**]
Wound check [**Hospital Ward Name **] 2 please schedule with RN [**Telephone/Fax (1) 3633**]


                             [**Name6 (MD) **] [**Name8 (MD) **] MD [**MD Number(2) 173**]

Completed by:[**2140-7-4**]
{'Coronary atherosclerosis of native coronary artery,Other and unspecified angina pectoris,Percutaneous transluminal coronary angioplasty status,Unspecified essential hypertension'}


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: Chest pain

PRESENT ILLNESS: Mr. [**Known lastname **] is a 35 y/o male with h/o CAD s/p multiple stents this
year c/b restensosis. He continued to have recurrent angina and
underwent cardiac cath at OSH which revealed progression of LAD
disease. Coronary disease was not amenable to PCI and was
transferred to [**Hospital1 18**] for surgical revascularization.

MEDICAL HISTORY: Coronary Artery Disease s/p stent to prox and mid LAD c/b
subacute stent thrombosis s/p thrombectomy of LAD and stent
[**2140-4-7**], s/p DES to prox LAD [**2140-6-3**], h/o
retroperitoneal/extraperitoneal bleed, Hypertension

MEDICATION ON ADMISSION: At transfer: Plavix 75mg qd, Aspirin 325mg qd, Zocor 40mg qd,
Lisinopril 5mg qd, Toprol XL 100mg qd, Heparin gtt.

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: VS: 66 20 176/98 5'9" 195#
Gen: WDWN male in NAD
HEENT: EOMI, PERRL, NC/AT
Neck: Supple, FROM, -JVD, -bruit
Chest: CTAB -w/r/r
Heart: RRR -c/r/m/g
Abd: Soft, NT/ND, +BS
Ext: Warm, well-perfused, -edema, -varicosities
Neuro: A&O x 3, MAE, non-focal

FAMILY HISTORY: Father with stents at age 65.

SOCIAL HISTORY: Biochemist. Denies tobacco and ETOH use. 

### Response:
{'Coronary atherosclerosis of native coronary artery,Other and unspecified angina pectoris,Percutaneous transluminal coronary angioplasty status,Unspecified essential hypertension'}
