CHIEF COMPLAINT: shortness of breath

PRESENT ILLNESS: Mr. [**Known lastname **] is a 74 year old gentleman who recently presented to
the emergency department via EMS for chest pain, nausea, and
shortness of breath.  Therefore, he was urgently catheterized
and found to have severe 3 vessel disease.  He aslo ruled in for
an ST elevation MI.

MEDICAL HISTORY: DM2
HTN
vocal Cord CA diagnosed [**2140**]- SCC- s/p surgery
hyperchol
GERD
colonic polyps in [**2140**]

MEDICATION ON ADMISSION: glyburide 5 [**Hospital1 **]
meclizine 25 [**Hospital1 **]
protonix 40 [**Hospital1 **]
actos 45
flomax 0.4

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: On discharge Mr. [**Known lastname **] was found to be awake, alert, and
oriented times three. His lungs were clear to auscultation
bilaterally.  His heart was of irregular rhythm.  His sternum
was stable and his skin was clean, dry, and intact.  His abdomen
was soft, non-tender, and non-distended with positive bowel
sounds.  He was found to have trace lower extremity edema
bilaterally.

FAMILY HISTORY: Denies CAD or lung CA

SOCIAL HISTORY: Lives in [**Location 2312**] w/ wife. [**Name (NI) 3003**] tobacco -100 pack-years. No
ETOH. Retired [**Last Name (un) **] in [**Country 532**].
Acute myocardial infarction of other inferior wall, initial episode of care,Cardiogenic shock,Cardiac complications, not elsewhere classified,Primary pulmonary hypertension,Coronary atherosclerosis of native coronary artery,Atrial fibrillation,Mitral valve disorders,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (LUTS),Esophageal reflux,Personal history of malignant neoplasm of larynx
AMI inferior wall, init,Cardiogenic shock,Surg compl-heart,Prim pulm hypertension,Crnry athrscl natve vssl,Atrial fibrillation,Mitral valve disorder,DMII wo cmp nt st uncntr,BPH w/o urinary obs/LUTS,Esophageal reflux,Hx-laryngeal malignancy
Admission Date:  [**2145-12-8**]              Discharge Date:   [**2145-12-17**]

Date of Birth:  [**2071-2-2**]             Sex:   M

Service: CARDIOTHORACIC

Allergies:
Patient recorded as having No Known Allergies to Drugs

Attending:[**First Name3 (LF) 922**]
Chief Complaint:
shortness of breath

Major Surgical or Invasive Procedure:
[**11-30**] CABGx3 (LIMA to LAD, SVG to OM, PLVC)


History of Present Illness:
Mr. [**Known lastname **] is a 74 year old gentleman who recently presented to
the emergency department via EMS for chest pain, nausea, and
shortness of breath.  Therefore, he was urgently catheterized
and found to have severe 3 vessel disease.  He aslo ruled in for
an ST elevation MI.

Past Medical History:
DM2
HTN
vocal Cord CA diagnosed [**2140**]- SCC- s/p surgery
hyperchol
GERD
colonic polyps in [**2140**]

Social History:
Lives in [**Location 2312**] w/ wife. [**Name (NI) 3003**] tobacco -100 pack-years. No
ETOH. Retired [**Last Name (un) **] in [**Country 532**].


Family History:
Denies CAD or lung CA

Physical Exam:
On discharge Mr. [**Known lastname **] was found to be awake, alert, and
oriented times three. His lungs were clear to auscultation
bilaterally.  His heart was of irregular rhythm.  His sternum
was stable and his skin was clean, dry, and intact.  His abdomen
was soft, non-tender, and non-distended with positive bowel
sounds.  He was found to have trace lower extremity edema
bilaterally.

Pertinent Results:
[**2145-12-17**] 04:30AM BLOOD WBC-7.9 RBC-3.36* Hgb-10.6* Hct-31.0*
MCV-92 MCH-31.5 MCHC-34.1 RDW-14.0 Plt Ct-385
[**2145-12-17**] 04:30AM BLOOD PT-27.1* INR(PT)-2.7*
[**2145-12-17**] 04:30AM BLOOD Glucose-112* UreaN-18 Creat-1.0 Na-138
K-4.1 Cl-102 HCO3-31 AnGap-9
[**2145-12-15**] 12:53AM BLOOD ALT-21 AST-19 LD(LDH)-302* AlkPhos-60
Amylase-99 TotBili-0.7

Brief Hospital Course:
Upon cardiac catheterization on [**2145-12-8**], Mr. [**Known lastname **] was found
to have an LMCA 20% diffuse, proximal LAD long 80%, diffuse 40%
LCx proximal, 50% OM1, and RCA mid 40% and 90% distal.  After
allowing for a plavix washout, Mr. [**Known lastname **] was taken to the OR
and underwent a coronary artery bypass graft times three (LIMA
to LAD, SVG to OM1, SVG to PLB).  He tolerated the procedure
well and was able to be transferred in critical but stable
condition to the surgical intensive care unit.  He was given
Vancomycin perioperatively for 48 hours because of his
pre-operative inpatient status. In the unit he was found to be
in atrial fibrillation for which he was started on amiodarone.
His chest tubes and wires were removed.  He was started on
coumadin for his atrial fibrillation and quickly became
supertherapeutic.  His INR was allowed to drift down and he was
restarted on low dose coumadin.  He experienced some confusion
which improved with Haldol.  By post operative day 6 he was
transferred to the floor.  He was seen in consultation by the
physical therapy service.  He was ready for discharge to rehab
on post-operative day 7.

Medications on Admission:
glyburide 5 [**Hospital1 **]
meclizine 25 [**Hospital1 **]
protonix 40 [**Hospital1 **]
actos 45
flomax 0.4

Discharge Medications:
1. Metoprolol Tartrate 50 mg Tablet Sig: One (1) Tablet PO TID
(3 times a day).
Disp:*90 Tablet(s)* Refills:*0*
2. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2
times a day).
Disp:*60 Capsule(s)* Refills:*0*
3. 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*
4. Atorvastatin 10 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
Disp:*30 Tablet(s)* Refills:*0*
5. Tamsulosin 0.4 mg Capsule, Sust. Release 24 hr Sig: One (1)
Capsule, Sust. Release 24 hr PO HS (at bedtime).
6. Pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One
(1) Tablet, Delayed Release (E.C.) PO twice a day.
7. Amiodarone 200 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
Disp:*30 Tablet(s)* Refills:*0*
8. Digoxin 125 mcg Tablet Sig: One (1) Tablet PO DAILY (Daily).
Disp:*30 Tablet(s)* Refills:*0*
9. Meclizine 25 mg Tablet Sig: One (1) Tablet PO twice a day.
10. Acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO Q4H
(every 4 hours) as needed.
Disp:*30 Tablet(s)* Refills:*0*
11. Coumadin 2 mg Tablet Sig: One (1) Tablet PO once a day: take
one tablet (2mg) daily or as directed to obtain a goal INR of
[**12-18**].5 for atrial fibrillation.
Disp:*30 Tablet(s)* Refills:*0*
12. Pioglitazone 45 mg Tablet Sig: One (1) Tablet PO once a day.

13. Glyburide 5 mg Tablet Sig: One (1) Tablet PO twice a day.


Discharge Disposition:
Extended Care

Facility:
[**Location (un) 582**] of [**Location (un) 583**]

Discharge Diagnosis:
Coronary artery disease
Diabetes
Head and neck cancer
BPH
GERD
Colon adenomas
PVD
s/p cholectomy
s/p recent hemorrhoidectomy
s/p left hemilaryngectomy


Discharge Condition:
good


Discharge Instructions:
Follow medications on discharge instructions.
Do not drive for 4 weeks.
Do not lift more than 10 lbs. for 2 months.
Shower daily, let water flow over wounds, pat dry with a towel.
Do not use creams, lotions, or powders on wounds.
Call our office for temp>101.5, sternal drainage.

Followup Instructions:
Please see Dr. [**Last Name (NamePattern1) 54090**]in [**11-17**] weeks. ([**Telephone/Fax (1) 1921**].
Please see your cardiologist in [**11-17**] weeks.
Please see Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 914**] in [**2-20**] weeks. ([**Telephone/Fax (1) 11763**].



Completed by:[**2145-12-17**]

Name:  [**Known lastname 15187**],[**Known firstname 15188**]                    Unit No:   [**Numeric Identifier 15189**]

Admission Date:  [**2145-12-8**]              Discharge Date:   [**2145-12-17**]

Date of Birth:  [**2071-2-2**]             Sex:   M

Service: CARDIOTHORACIC

Allergies:
Patient recorded as having No Known Allergies to Drugs

Attending:[**First Name3 (LF) 1543**]
Addendum:
The [**Location (un) 176**] at [**Hospital 177**] rehab was called after Mr. [**Known lastname 15190**]
discharge to request that digoxin be discontinued.

Chief Complaint:
chest pain

Major Surgical or Invasive Procedure:
[**11-30**] CABGx3 (LIMA to LAD, SVG to OM, PLVC)


Discharge Disposition:
Extended Care

Facility:
[**Location (un) 176**] of [**Location (un) 177**]

                             [**First Name11 (Name Pattern1) 33**] [**Last Name (NamePattern4) 1544**] MD [**MD Number(2) 1545**]

Completed by:[**2145-12-17**]
{'Acute myocardial infarction of other inferior wall, initial episode of care,Cardiogenic shock,Cardiac complications, not elsewhere classified,Primary pulmonary hypertension,Coronary atherosclerosis of native coronary artery,Atrial fibrillation,Mitral valve disorders,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (LUTS),Esophageal reflux,Personal history of malignant neoplasm of larynx'}


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: shortness of breath

PRESENT ILLNESS: Mr. [**Known lastname **] is a 74 year old gentleman who recently presented to
the emergency department via EMS for chest pain, nausea, and
shortness of breath.  Therefore, he was urgently catheterized
and found to have severe 3 vessel disease.  He aslo ruled in for
an ST elevation MI.

MEDICAL HISTORY: DM2
HTN
vocal Cord CA diagnosed [**2140**]- SCC- s/p surgery
hyperchol
GERD
colonic polyps in [**2140**]

MEDICATION ON ADMISSION: glyburide 5 [**Hospital1 **]
meclizine 25 [**Hospital1 **]
protonix 40 [**Hospital1 **]
actos 45
flomax 0.4

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: On discharge Mr. [**Known lastname **] was found to be awake, alert, and
oriented times three. His lungs were clear to auscultation
bilaterally.  His heart was of irregular rhythm.  His sternum
was stable and his skin was clean, dry, and intact.  His abdomen
was soft, non-tender, and non-distended with positive bowel
sounds.  He was found to have trace lower extremity edema
bilaterally.

FAMILY HISTORY: Denies CAD or lung CA

SOCIAL HISTORY: Lives in [**Location 2312**] w/ wife. [**Name (NI) 3003**] tobacco -100 pack-years. No
ETOH. Retired [**Last Name (un) **] in [**Country 532**]. 

### Response:
{'Acute myocardial infarction of other inferior wall, initial episode of care,Cardiogenic shock,Cardiac complications, not elsewhere classified,Primary pulmonary hypertension,Coronary atherosclerosis of native coronary artery,Atrial fibrillation,Mitral valve disorders,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (LUTS),Esophageal reflux,Personal history of malignant neoplasm of larynx'}
