CHIEF COMPLAINT: Chest pain

PRESENT ILLNESS: The patient is a 72-year-old
female who was recently discharged from [**Hospital6 649**] from the vascular surgery service on [**2110-2-27**]
during which she was being worked up for left calf
claudication and a non healing ulcer.  The angiography had
revealed left superficial femoral artery stenosis at the
adductor canal and during the work up for surgical treatment,
the stress test was found to be positive.  The cardiac
catheterization was performed on [**2110-2-26**] which revealed
severe two vessel disease.  The LAD had moderate diffuse
disease with 80% stenosis in the proximal portion.  The RCA
had an 80% mid lesion and a 90% distal followed by serial
severe lesions distally and it was noted that she had severe
left ventricular diastolic dysfunction.  She was evaluated by
the cardiothoracic surgery service and it was deemed that she
would coronary artery bypass graft prior to having her SFA
bypass by the vascular surgery service.  She was discharged
home and was to return to [**Hospital6 2018**] on the day of admission to have coronary artery bypass
graft.

MEDICAL HISTORY: 1.  Diabetes mellitus type II
2.  Hypertension
3.  Hypercholesterolemia
4.  Glaucoma

MEDICATION ON ADMISSION: 

ALLERGIES: CODEINE

PHYSICAL EXAM: GENERAL:  The patient is an obese white female in no acute
distress.
VITAL SIGNS:  Her pulse is 98, blood pressure 181/64,
temperature 99.6??????.
HEAD, EARS, EYES, NOSE AND THROAT:  She is alert and oriented
x3.  She has no jugular venous distention, no carotid bruits.
LUNGS:  Clear to auscultation bilaterally.
HEART:  Regular rate and rhythm with no murmurs.
ABDOMEN:  Obese, soft and nontender.
EXTREMITIES:  She has a left lower leg ulcer with Doppler
signals in the distal pulses.

FAMILY HISTORY: 

SOCIAL HISTORY: 
Coronary atherosclerosis of native coronary artery,Intermediate coronary syndrome,Atherosclerosis of native arteries of the extremities with ulceration,Heart disease, unspecified,Unspecified essential hypertension,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Pure hypercholesterolemia,Unspecified disorder of iris and ciliary body,Obesity, unspecified
Crnry athrscl natve vssl,Intermed coronary synd,Ath ext ntv art ulcrtion,Heart disease NOS,Hypertension NOS,DMII wo cmp nt st uncntr,Pure hypercholesterolem,Iris/ciliary dis NOS,Obesity NOS
Admission Date:  [**2110-3-3**]       Discharge Date:  [**2110-3-7**]

Date of Birth:   [**2037-11-16**]       Sex:  F

Service:  CARDIAC SURGERY

CHIEF COMPLAINT:  Chest pain

HISTORY OF PRESENT ILLNESS:  The patient is a 72-year-old
female who was recently discharged from [**Hospital6 649**] from the vascular surgery service on [**2110-2-27**]
during which she was being worked up for left calf
claudication and a non healing ulcer.  The angiography had
revealed left superficial femoral artery stenosis at the
adductor canal and during the work up for surgical treatment,
the stress test was found to be positive.  The cardiac
catheterization was performed on [**2110-2-26**] which revealed
severe two vessel disease.  The LAD had moderate diffuse
disease with 80% stenosis in the proximal portion.  The RCA
had an 80% mid lesion and a 90% distal followed by serial
severe lesions distally and it was noted that she had severe
left ventricular diastolic dysfunction.  She was evaluated by
the cardiothoracic surgery service and it was deemed that she
would coronary artery bypass graft prior to having her SFA
bypass by the vascular surgery service.  She was discharged
home and was to return to [**Hospital6 2018**] on the day of admission to have coronary artery bypass
graft.

PAST MEDICAL HISTORY:
1.  Diabetes mellitus type II
2.  Hypertension
3.  Hypercholesterolemia
4.  Glaucoma

PAST SURGICAL HISTORY:
1.  Right mastectomy in [**2096**]

ADMISSION MEDICATIONS:
1.  Glucophage 850 mg po tid
2.  Avandia 4 mg po bid
3.  Glucotrol XL 10 mg po bid
4.  Zestril 10 mg po qd
5.  Lipitor 40 mg po qd
6.  Xalatan eyedrops
7.  Resqula eyedrops
8.  Patanol eyedrops
9.  Cosopt eyedrops
10. [**Doctor First Name **] 60 mg po bid
11. Sucralfate 1 gm q day

ALLERGIES:  CODEINE

PHYSICAL EXAM:
GENERAL:  The patient is an obese white female in no acute
distress.
VITAL SIGNS:  Her pulse is 98, blood pressure 181/64,
temperature 99.6??????.
HEAD, EARS, EYES, NOSE AND THROAT:  She is alert and oriented
x3.  She has no jugular venous distention, no carotid bruits.
LUNGS:  Clear to auscultation bilaterally.
HEART:  Regular rate and rhythm with no murmurs.
ABDOMEN:  Obese, soft and nontender.
EXTREMITIES:  She has a left lower leg ulcer with Doppler
signals in the distal pulses.

IMAGING:  Electrocardiogram shows normal sinus rhythm with a
rate of 69, no evidence of ischemia and a left shift.

ADMISSION LABS:  White count of 6.6, hematocrit of 33.1,
platelets 250.  PT 12.2, PTT 26.6, INR 1.1.  Her sodium is
143, potassium is 3.7, chloride of 106, bicarbonate of 29,
BUN of 10, creatinine of 0.6, glucose of 111.  Calcium was
8.9, magnesium 1.5, phosphorous 3.1.

HOSPITAL COURSE:  The patient on the day of admission went to
the Operating Room where she underwent a coronary artery
bypass graft x2.  The grafts were left internal mammary
artery to the diagonal, saphenous vein graft to the right
PDA.  She tolerated this procedure well.  She was transferred
to the Cardiac Intensive Care Unit on a drip of propofol at
20 mcg per kg per minute and Neo at 0.3 mcg per kg per
minute.

In the first postoperative day, the patient was weaned to be
extubated.  Her drips were weaned.  She remained
hemodynamically stable through the first postoperative night.
On postoperative day #1, she was transferred to the floor in
stable condition.  On the floor, she remained hemodynamically
stable.  She was started on her Lopressor which was
appropriately adjusted for a heart rate around 80.  Her chest
tubes were discontinued on postoperative day #2.  Her pacer
wires were discontinued on postoperative day #3.  Physical
therapy evaluated the patient and deemed her appropriate for
a short stay in rehabilitation.  She is tolerating a regular
diet.  She is placed on her preoperative hypoglycemic agents.
Her blood sugars have remained in good control.  She is
stable and ready to be discharged.

DISCHARGE DIAGNOSES:
1.  Coronary artery disease, status post coronary artery
bypass graft x2
2.  Diabetes mellitus
3.  Hypertension
4.  Hypercholesterolemia
5.  Glaucoma

DISCHARGE MEDICATIONS:
1.  Lasix 20 mg po bid x7 days
2.  Potassium chloride 20 milliequivalents po bid x7 days
3.  Colace 100 mg po bid
4.  Zantac 150 mg po bid
5.  ASAC 325 mg po qd
6.  MVI po qd
7.  Zinc 240 po qd
8.  Vitamin C 500 mg po bid
9.  Santyl ointment on the left leg [**Hospital1 **] per application
10. Glucophage 850 mg po tid
11. Lipitor 40 mg po qd
12. Glucotrol XL 10 mg po bid
13. Avandia 4 mg po bid
14. Patanol eyedrops [**Hospital1 **]
15. Cosopt eyedrops [**Hospital1 **]
16. Resqula eyedrops [**Hospital1 **]
17. Lopressor 50 mg po bid
18. Xalatan eyedrops q hs
19. Dilaudid 2 to 4 mg po q4h prn
20. Insulin sliding scale

DISCHARGE CONDITION:  Stable

FOLLOW UP:  She will follow up with Dr. [**Last Name (STitle) 1537**] in four weeks.
She will follow up with Dr. [**First Name (STitle) **] in two to three weeks.




                            [**First Name11 (Name Pattern1) 275**] [**Last Name (NamePattern4) 1539**], M.D.  [**MD Number(1) 1540**]

Dictated By:[**Last Name (NamePattern1) 3835**]
MEDQUIST36

D:  [**2110-3-7**]  08:38
T:  [**2110-3-7**]  08:57
JOB#:  [**Job Number 38570**]
{'Coronary atherosclerosis of native coronary artery,Intermediate coronary syndrome,Atherosclerosis of native arteries of the extremities with ulceration,Heart disease, unspecified,Unspecified essential hypertension,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Pure hypercholesterolemia,Unspecified disorder of iris and ciliary body,Obesity, 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: Chest pain

PRESENT ILLNESS: The patient is a 72-year-old
female who was recently discharged from [**Hospital6 649**] from the vascular surgery service on [**2110-2-27**]
during which she was being worked up for left calf
claudication and a non healing ulcer.  The angiography had
revealed left superficial femoral artery stenosis at the
adductor canal and during the work up for surgical treatment,
the stress test was found to be positive.  The cardiac
catheterization was performed on [**2110-2-26**] which revealed
severe two vessel disease.  The LAD had moderate diffuse
disease with 80% stenosis in the proximal portion.  The RCA
had an 80% mid lesion and a 90% distal followed by serial
severe lesions distally and it was noted that she had severe
left ventricular diastolic dysfunction.  She was evaluated by
the cardiothoracic surgery service and it was deemed that she
would coronary artery bypass graft prior to having her SFA
bypass by the vascular surgery service.  She was discharged
home and was to return to [**Hospital6 2018**] on the day of admission to have coronary artery bypass
graft.

MEDICAL HISTORY: 1.  Diabetes mellitus type II
2.  Hypertension
3.  Hypercholesterolemia
4.  Glaucoma

MEDICATION ON ADMISSION: 

ALLERGIES: CODEINE

PHYSICAL EXAM: GENERAL:  The patient is an obese white female in no acute
distress.
VITAL SIGNS:  Her pulse is 98, blood pressure 181/64,
temperature 99.6??????.
HEAD, EARS, EYES, NOSE AND THROAT:  She is alert and oriented
x3.  She has no jugular venous distention, no carotid bruits.
LUNGS:  Clear to auscultation bilaterally.
HEART:  Regular rate and rhythm with no murmurs.
ABDOMEN:  Obese, soft and nontender.
EXTREMITIES:  She has a left lower leg ulcer with Doppler
signals in the distal pulses.

FAMILY HISTORY: 

SOCIAL HISTORY:  

### Response:
{'Coronary atherosclerosis of native coronary artery,Intermediate coronary syndrome,Atherosclerosis of native arteries of the extremities with ulceration,Heart disease, unspecified,Unspecified essential hypertension,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Pure hypercholesterolemia,Unspecified disorder of iris and ciliary body,Obesity, unspecified'}
