CHIEF COMPLAINT: 

PRESENT ILLNESS: Mr. [**Known lastname 3924**] is a 68-year-old
patient of Dr. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **] who was referred for an
outpatient cardiac catheterization on [**8-14**] due to
progressive exertional angina and a positive cardiac MRI.  He
is a 68-year-old marathon runner who reported a three to four
month history of exertional angina who stated that he had
been having symptoms of mild back and substernal chest
discomfort that radiated down both arms when running or
walking quickly.  These symptoms always resolved with rest.
He stated that he had also been feeling the need to belch
frequently.  The patient apparently underwent a cardiac
catheterization in [**2177**] and was medically managed for his
coronary artery disease.  On [**2182-8-1**] the patient
had a cardiac MRI which revealed mild LV enlargement with an
ejection fraction of 43% and multiple WMA consistent with
multivessel disease.  He has not had any symptoms occurring
at rest or waking him from sleep.  The patient denied any
claudication, orthopnea, edema, paroxysmal nocturnal dyspnea
or lightheadedness.

MEDICAL HISTORY: 1.  Hypertension
2.  Hypercholesterolemia
3.  Coronary artery disease

MEDICATION ON ADMISSION: 

ALLERGIES: He has no known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: Father with angina in his 50s who died of a
myocardial infarction at the age of 68.

SOCIAL HISTORY: Two cigars per week smoking.
Coronary atherosclerosis of native coronary artery,Cardiac complications, not elsewhere classified,Unspecified disease of pericardium,Atrial fibrillation,Unspecified essential hypertension,Pure hypercholesterolemia,Family history of ischemic heart disease,Tobacco use disorder
Crnry athrscl natve vssl,Surg compl-heart,Pericardial disease NOS,Atrial fibrillation,Hypertension NOS,Pure hypercholesterolem,Fam hx-ischem heart dis,Tobacco use disorder
Admission Date:  [**2182-8-15**]       Discharge Date:  [**2182-8-20**]

Date of Birth:   [**2114-7-22**]       Sex:  M

Service:

ADMISSION DIAGNOSIS:  Coronary artery disease

HISTORY OF PRESENT ILLNESS:  Mr. [**Known lastname 3924**] is a 68-year-old
patient of Dr. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **] who was referred for an
outpatient cardiac catheterization on [**8-14**] due to
progressive exertional angina and a positive cardiac MRI.  He
is a 68-year-old marathon runner who reported a three to four
month history of exertional angina who stated that he had
been having symptoms of mild back and substernal chest
discomfort that radiated down both arms when running or
walking quickly.  These symptoms always resolved with rest.
He stated that he had also been feeling the need to belch
frequently.  The patient apparently underwent a cardiac
catheterization in [**2177**] and was medically managed for his
coronary artery disease.  On [**2182-8-1**] the patient
had a cardiac MRI which revealed mild LV enlargement with an
ejection fraction of 43% and multiple WMA consistent with
multivessel disease.  He has not had any symptoms occurring
at rest or waking him from sleep.  The patient denied any
claudication, orthopnea, edema, paroxysmal nocturnal dyspnea
or lightheadedness.

PAST MEDICAL HISTORY:
1.  Hypertension
2.  Hypercholesterolemia
3.  Coronary artery disease

SOCIAL HISTORY:  Two cigars per week smoking.

SURGICAL HISTORY:
1.  Left knee arthroscopy
2.  Appendectomy

FAMILY HISTORY:  Father with angina in his 50s who died of a
myocardial infarction at the age of 68.

ALLERGIES:  He has no known drug allergies.

ADMISSION MEDICATIONS:
1.  Aspirin 81 mg p.o. q.d.
2.  Lipitor 10 mg p.o. q.d.
3.  Cozaar 50 mg p.o. q.d.
4.  Atenolol 25 mg p.o. q.d.
5.  Multivitamin

He was seen and underwent a cardiac catheterization at the
[**Hospital6 256**] on [**8-15**] which
demonstrated an ejection fraction of 40%, apical akinesis,
anterolateral and inferior hypokinesis on this right dominant
system with left main 80% distal disease involving the
bifurcation.  LAD was occluded after the first diagonal.  The
left circumflex showed mild disease.  The mild disease of the
OM1 and AV branch.  The RCA showed 40% mid and 19% distal
disease before the bifurcation.  Secondary to these findings
the patient was referred to Dr. [**Last Name (STitle) 70**] for coronary artery
bypass grafting.

HOSPITAL COURSE:  The patient was admitted to the [**Hospital6 1760**] after cardiac catheterization
and was taken to the Operating Room on [**8-16**] where
he underwent a coronary artery bypass grafting x4 as follows:
left internal mammary artery to LAD, saphenous vein graft to
OM with a jump graft to a diagonal and saphenous vein graft
to our PDA.  His postoperative ejection fraction was 50%.
The procedure was performed by Dr. [**Last Name (STitle) 70**], assisted by Dr.
[**Last Name (STitle) 25067**], as well as Dr. [**Last Name (STitle) **].  Postoperatively, the
patient went to the cardiothoracic surgery recovery unit.  He
required some Neo-Synephrine to maintain his blood pressure
as well as some fluids and he did very well.  He did,
however, have a significant rub noted on auscultation.  He
had some episodes of atrial fibrillation for which amiodarone
was added.

On postoperative day #1, serial electrocardiograms were
performed which demonstrated mild ST segment elevations in
leads V2 and V3 with tapering of the T-waves.  Given concern
that these may have represented ischemia, a bedside
transthoracic echocardiogram was obtained which showed good
LV contractile function of the anterior wall, basal, anterior
septum inferior and lateral walls.  The apex and distal
anterior septum were not well seen.  There was no evidence of
tamponade based on this and overall the ejection fraction was
mildly depressed.  The echocardiogram was not consistent with
any new wall motion abnormalities and the patient was
diagnosed as having postoperative pericarditis.

He was kept in the cardiothoracic surgery recovery room until
postoperative day #2, when he was transferred to the floor.
His chest tubes were removed without complications.  The
patient ambulated early and was transfused 1 unit of packed
red blood cells during his postoperative course.

By postoperative day #4, he was without complaints, able to
ambulate upstairs.  He was afebrile and hemodynamically
stable.  His rhythm was regular.  His sternum was stable and
dry and his extremities demonstrated minimal edema.  His
hematocrit was 27.5 and he was doing well enough that it was
felt that he was stable for discharge.  The patient was
tolerating a regular diet.

DISCHARGE MEDICATION:
1.  Lopressor 25 mg p.o. b.i.d.
2.  Lasix 20 mg p.o. b.i.d. for 7 days
3.  Potassium chloride 20 milliequivalents p.o. b.i.d. for 7
days
4.  Colace 100 mg p.o. b.i.d.
5.  Protonix 40 mg p.o. q.d.
6.  Aspirin 81 mg p.o. q.d.
7.  Motrin 400 mg q6h prn
8.  Amiodarone 400 mg p.o. t.i.d. for 2 days, then 400 mg
p.o. b.i.d. for 2 days, then 400 mg p.o. q.d.
9.  Percocet 1 to 2 p.o. q 4 to 6 hours prn

DISCHARGE DIAGNOSES:
1.  Coronary artery disease with angina, status post coronary
artery bypass grafting x4
2.  Hypertension
3.  Hypercholesterolemia

DISCHARGE INSTRUCTIONS:  He was instructed to follow up with
Dr. [**Last Name (STitle) 70**] in two to four weeks.




                          DR.[**Last Name (STitle) **],[**First Name3 (LF) **] R. 02-358

Dictated By:[**Name8 (MD) 4720**]
MEDQUIST36

D:  [**2182-8-20**]  11:57
T:  [**2182-8-20**]  12:07
JOB#:  [**Job Number 20702**]
{'Coronary atherosclerosis of native coronary artery,Cardiac complications, not elsewhere classified,Unspecified disease of pericardium,Atrial fibrillation,Unspecified essential hypertension,Pure hypercholesterolemia,Family history of ischemic heart disease,Tobacco use disorder'}


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: Mr. [**Known lastname 3924**] is a 68-year-old
patient of Dr. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **] who was referred for an
outpatient cardiac catheterization on [**8-14**] due to
progressive exertional angina and a positive cardiac MRI.  He
is a 68-year-old marathon runner who reported a three to four
month history of exertional angina who stated that he had
been having symptoms of mild back and substernal chest
discomfort that radiated down both arms when running or
walking quickly.  These symptoms always resolved with rest.
He stated that he had also been feeling the need to belch
frequently.  The patient apparently underwent a cardiac
catheterization in [**2177**] and was medically managed for his
coronary artery disease.  On [**2182-8-1**] the patient
had a cardiac MRI which revealed mild LV enlargement with an
ejection fraction of 43% and multiple WMA consistent with
multivessel disease.  He has not had any symptoms occurring
at rest or waking him from sleep.  The patient denied any
claudication, orthopnea, edema, paroxysmal nocturnal dyspnea
or lightheadedness.

MEDICAL HISTORY: 1.  Hypertension
2.  Hypercholesterolemia
3.  Coronary artery disease

MEDICATION ON ADMISSION: 

ALLERGIES: He has no known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: Father with angina in his 50s who died of a
myocardial infarction at the age of 68.

SOCIAL HISTORY: Two cigars per week smoking. 

### Response:
{'Coronary atherosclerosis of native coronary artery,Cardiac complications, not elsewhere classified,Unspecified disease of pericardium,Atrial fibrillation,Unspecified essential hypertension,Pure hypercholesterolemia,Family history of ischemic heart disease,Tobacco use disorder'}
