CHIEF COMPLAINT: 

PRESENT ILLNESS: Briefly, this is a 61 year old
gentleman with no significant past medical history.  He
presented to an outside hospital with shortness of breath and
substernal chest pain, times six days.  He was transferred to
[**Hospital1 69**] for coronary artery
bypass graft and also for respiratory failure.  He had
undergone a cardiac catheterization at the outside hospital,
which showed 70% right coronary artery lesion, 100% left
anterior descending lesion and 95% circumflex lesion.  He was
originally admitted to the CCU on the medical service and was
started on an IVP as well as multiple pressors. He required
intubation for respiratory difficulty.

MEDICAL HISTORY: Only significant for a family history
of coronary artery disease and history of tobacco.

MEDICATION ON ADMISSION: 

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: 
Subendocardial infarction, initial episode of care,Acute respiratory failure,Congestive heart failure, unspecified,Urinary tract infection, site not specified,Hypopotassemia,Coronary atherosclerosis of native coronary artery,Mitral valve disorders,Anemia, unspecified,Disorders of magnesium metabolism
Subendo infarct, initial,Acute respiratry failure,CHF NOS,Urin tract infection NOS,Hypopotassemia,Crnry athrscl natve vssl,Mitral valve disorder,Anemia NOS,Dis magnesium metabolism
Admission Date:  [**2184-4-23**]       Discharge Date:  [**2184-5-3**]

Date of Birth:   [**2123-2-22**]       Sex:  M

Service:  Cardiothoracic surgery.

HISTORY OF PRESENT ILLNESS:  Briefly, this is a 61 year old
gentleman with no significant past medical history.  He
presented to an outside hospital with shortness of breath and
substernal chest pain, times six days.  He was transferred to
[**Hospital1 69**] for coronary artery
bypass graft and also for respiratory failure.  He had
undergone a cardiac catheterization at the outside hospital,
which showed 70% right coronary artery lesion, 100% left
anterior descending lesion and 95% circumflex lesion.  He was
originally admitted to the CCU on the medical service and was
started on an IVP as well as multiple pressors. He required
intubation for respiratory difficulty.

PAST MEDICAL HISTORY:  Only significant for a family history
of coronary artery disease and history of tobacco.

ALLERGIES:  No known drug allergies.

MEDICATIONS:  He took no medications.  He did, however, smoke
one pack per day with occasional alcohol.

PHYSICAL EXAMINATION:  Upon admission here, he was afebrile.
His heart rate was 73.  Blood pressure was 88/50;
respiratory rate of 11; saturating 97%.  He was intubated and
sedated.  His cardiovascular is regular rate and rhythm with
a 2/6 systolic murmur at the apex. He had bilateral diffuse
crackles.  His abdomen was soft, nontender, nondistended.
Extremities had no edema.  Dopplerable dorsalis pedis and
posterior tibial pulses.  He had a right and left groin
sheath in.

LABORATORY DATA:  On admission, his white count was 9.2;
hematocrit was 39.7; platelet count of 302.  Chemistries:
137; 4.5; 101; 27; BUN of 11; creatinine of 0.9.  Blood sugar
of 115.  CK was 175.  MB was 4.3.  Troponin of 1.8.

The patient was admitted to the medical service on [**2184-4-23**]
for evaluation and management.  As stated previously, he
underwent a repeat cardiac catheterization here at [**Hospital1 1444**] that reconfirmed the presence
of three vessel disease and a repeat echo which again showed
similar results.

Cardiothoracic surgery was consulted at that time for
evaluation for emergent coronary artery bypass graft.  The
patient went to the operating room on [**2184-4-27**] where he
underwent a coronary artery bypass graft times three and a
mitral valve repair.  Please see the operative report for
further details.  The patient was transferred to the CSIU
postoperatively.   His ejection fraction postoperatively was
45%.  He was slowly weaned from his ventilator and ultimately
able to be extubated. He required pressors postoperatively
for blood pressure support.  He was fully weaned from his
Levophed and he was also given Amiodarone.  He was taken off
of his Levophed and started on Milrinone for blood pressure
support.  He was weaned off of his Amiodarone drip. He was
also given a course of Levofloxacin for a positive urinary
tract infection.  He continued to improve and was extubated
on postoperative day number one.  He was kept in the CSIU.

Physical therapy was consulted while he was in the CSIU and
they continued to follow him throughout his hospital course.
He was ultimately deemed capable of going home and being
improved from a physical therapy standpoint.  He was weaned
off of all pressors by postoperative day number three. He
continued do well.  His laboratory values were all within
normal limits.  He made excellent urine and was started on
Lasix for diuresis.   He was started on Captopril, Lopressor,
Plavix and Lasix for his cardiac medications.  His wires and
chest tubes were removed on postoperative day number four and
the patient was transferred out to the floor on postoperative
day number five. His Foley catheter was also removed after
arriving on the floor. He remained in sinus rhythm throughout
his hospital stay and continued to do well.

On [**2184-5-3**], the patient was cleared by physical therapy,
tolerating a regular diet and was discharged to home with VNA
services.

DISCHARGE MEDICATIONS:
1.  Lopressor 50 mg p.o. twice a day.
2.  Lasix 20 mg p.o. twice a day.
3.  Colace 100 mg p.o. twice a day.
4.  Aspirin 325 mg p.o. q. day.
5.  Percocet one to two tablets p.o. every four hours prn for
pain.
6.  Plavix 75 mg p.o. q. day.
7.  Lipitor 80 mg p.o. q. day.
8.  Potassium 20 meq p.o. twice a day.

FOLLOW-UP:  The patient was instructed to follow-up with his
primary care physician in one to two weeks.
Follow-up with cardiologist in three weeks.
Follow-up with the cardiothoracic service at [**Hospital3 1280**] in
four weeks.

DISPOSITION:  He was discharged to home in stable condition.

DISCHARGE DIAGNOSES:
1.  Coronary artery disease.
2.  Status post myocardial infarction.
3.  Status post cardiac catheterization.
4.  Status post IBP.
5.  Now status post coronary artery bypass graft times three.
6.  Mitral valve regurgitation.
7.  Now status post mitral valve repair.

SECONDARY DIAGNOSES:
1.  Urinary tract infection.
2.  Hypokalemia.
3.  Hypomagnesemia.

The patient is discharged to home in stable condition.



                            [**First Name11 (Name Pattern1) **] [**Initials (NamePattern4) **] [**Last Name (NamePattern4) **], M.D.  [**MD Number(1) 75**]

Dictated By:[**Last Name (NamePattern4) **]
MEDQUIST36

D:  [**2184-5-4**]  08:15
T:  [**2184-5-4**]  08:22
JOB#:  [**Job Number 55626**]
{'Subendocardial infarction, initial episode of care,Acute respiratory failure,Congestive heart failure, unspecified,Urinary tract infection, site not specified,Hypopotassemia,Coronary atherosclerosis of native coronary artery,Mitral valve disorders,Anemia, unspecified,Disorders of magnesium metabolism'}


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: Briefly, this is a 61 year old
gentleman with no significant past medical history.  He
presented to an outside hospital with shortness of breath and
substernal chest pain, times six days.  He was transferred to
[**Hospital1 69**] for coronary artery
bypass graft and also for respiratory failure.  He had
undergone a cardiac catheterization at the outside hospital,
which showed 70% right coronary artery lesion, 100% left
anterior descending lesion and 95% circumflex lesion.  He was
originally admitted to the CCU on the medical service and was
started on an IVP as well as multiple pressors. He required
intubation for respiratory difficulty.

MEDICAL HISTORY: Only significant for a family history
of coronary artery disease and history of tobacco.

MEDICATION ON ADMISSION: 

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY:  

### Response:
{'Subendocardial infarction, initial episode of care,Acute respiratory failure,Congestive heart failure, unspecified,Urinary tract infection, site not specified,Hypopotassemia,Coronary atherosclerosis of native coronary artery,Mitral valve disorders,Anemia, unspecified,Disorders of magnesium metabolism'}
