CHIEF COMPLAINT: Dyspnea on exertion, fatigue

PRESENT ILLNESS: 56 year old female s/p CABG'[**35**] presented with shortness of
breath secondary to Mitral Regurgitation. She was evaluated for
redo sternotomy/ Mitral valve repair with Dr.[**Last Name (STitle) **].

MEDICAL HISTORY: s/p OPCABG x1 '[**35**] (LIma-LAD)
s/p right femoral pseudoaneurysm repair '[**35**]
CAD
HTN
hypercholesterolemia
anemia
asthma
allergic rhinitis
depression
osteoarthritis
uterine myomectomy
knee surgery

MEDICATION ON ADMISSION: Lipitor 80(1)
Lasix 20(1)
Lisinopril 40(2)
Toprol XL 200(1)
asa 325(1)

ALLERGIES: Nifedipine / Iodine; Iodine Containing / Dicloxacillin /
Azithromycin / Penicillins

PHYSICAL EXAM: General: NAD
VSS
Skin: well healed sternotmy scar
HEENT:AT/NC, carotids:2+
CHEST: CTA (B)
CVS:RRR +sem
ABD:benign
EXT: NO cyanosis/clubbing/edema

FAMILY HISTORY: noncontributory

SOCIAL HISTORY: works as a project manager
denies tobacco
lives with mother
[**Name (NI) **]. ETOH
Congestive heart failure, unspecified,Mitral valve disorders,Aortocoronary bypass status,Unspecified essential hypertension,Pure hypercholesterolemia,Asthma, unspecified type, unspecified,Depressive disorder, not elsewhere classified,Anemia, unspecified
CHF NOS,Mitral valve disorder,Aortocoronary bypass,Hypertension NOS,Pure hypercholesterolem,Asthma NOS,Depressive disorder NEC,Anemia NOS
Admission Date:  [**2144-1-15**]              Discharge Date:   [**2144-1-19**]

Date of Birth:  [**2087-5-17**]             Sex:   F

Service: CARDIOTHORACIC

Allergies:
Nifedipine / Iodine; Iodine Containing / Dicloxacillin /
Azithromycin / Penicillins

Attending:[**First Name3 (LF) 1505**]
Chief Complaint:
Dyspnea on exertion, fatigue

Major Surgical or Invasive Procedure:
s/p redo sternotomy, MVrepair (#28mm Rigid saddle ring)


History of Present Illness:
56 year old female s/p CABG'[**35**] presented with shortness of
breath secondary to Mitral Regurgitation. She was evaluated for
redo sternotomy/ Mitral valve repair with Dr.[**Last Name (STitle) **].

Past Medical History:
s/p OPCABG x1 '[**35**] (LIma-LAD)
s/p right femoral pseudoaneurysm repair '[**35**]
CAD
HTN
hypercholesterolemia
anemia
asthma
allergic rhinitis
depression
osteoarthritis
uterine myomectomy
knee surgery

Social History:
works as a project manager
denies tobacco
lives with mother
[**Name (NI) **]. ETOH

Family History:
noncontributory

Physical Exam:
General: NAD
VSS
Skin: well healed sternotmy scar
HEENT:AT/NC, carotids:2+
CHEST: CTA (B)
CVS:RRR +sem
ABD:benign
EXT: NO cyanosis/clubbing/edema


Pertinent Results:
[**2144-1-15**] 02:02PM BLOOD WBC-11.5* RBC-2.67*# Hgb-7.9*# Hct-22.6*#
MCV-84 MCH-29.5 MCHC-35.0 RDW-14.7 Plt Ct-139*#
[**2144-1-17**] 06:45AM BLOOD WBC-13.9* RBC-3.31* Hgb-10.1* Hct-28.6*
MCV-87 MCH-30.6 MCHC-35.3* RDW-14.9 Plt Ct-107*
[**2144-1-15**] 02:02PM BLOOD PT-16.5* PTT-31.1 INR(PT)-1.5*
[**2144-1-16**] 03:35AM BLOOD PT-13.9* PTT-29.4 INR(PT)-1.2*
[**2144-1-17**] 06:45AM BLOOD Glucose-129* UreaN-12 Creat-1.0 Na-136
K-5.5* Cl-104 HCO3-26 AnGap-12
    [**Known lastname **],[**Known firstname **] [**Age over 90 105868**] F  56  [**2087-5-17**]

Radiology Report CHEST PORT. LINE PLACEMENT Study Date of
[**2144-1-15**] 4:58 PM


[**Last Name (LF) **],[**First Name3 (LF) **] R. CSURG CSRU [**2144-1-15**] SCHED
CHEST PORT. LINE PLACEMENT   Clip # [**Clip Number (Radiology) 105869**]
Reason: Pleural effusion, pulmonary edema, tamponade,
pneumothorax.



[**Hospital 93**] MEDICAL CONDITION:
   56 year old woman with redo MVR
REASON FOR THIS EXAMINATION:
   Pleural effusion, pulmonary edema, tamponade, pneumothorax.
[**First Name8 (NamePattern2) **] [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 14777**]
   [**Numeric Identifier 72690**] with issues. Pt will be in CSRU in 120 mins.



Final Report
REASON FOR EXAM: Assess line placement. Patient S/P redo MVR.

Comparison is made with preop evaluation, [**1-9**].

ET tube is 3.9 cm above the carina. NG tube tip is out of view
below the
diaphragm. Swan-Ganz catheter tip is in the right pulmonary
artery. Sternal
wires are aligned. Mediastinal and chest tubes are in place.
There is no
pneumothorax. There is no overt CHF. There is no evidence of
pneumothorax.
Bibasilar opacities are likely atelectasis. MVR is in place.

jr

DR. [**First Name (STitle) 3901**] [**Initials (NamePattern4) **] [**Last Name (NamePattern4) 3902**]
DR. [**First Name11 (Name Pattern1) **] [**Initial (NamePattern1) **] [**Last Name (NamePattern4) 3891**]
Approved: [**First Name8 (NamePattern2) **] [**2144-1-16**] 9:23 PM

  Imaging Lab



Brief Hospital Course:
[**1-15**] Ms.[**Known lastname **] was taken to the operating room and underwent
redosternotomy Mitral valve repair with a # 28mm Rigid saddle
ring. Please refer to Dr[**Last Name (STitle) 105870**] operative report for further
details. Pt intubated and sedated transferred to CVICU
hemodynamically stable. She awoke neurologically intact and was
extubated in a timely fashion. All lines and drains were
discontinued with appropriate criteria met.POD#1 She was
transferred to the step down unit for further telemetry
monitoring. Beta-blocker, ACE-Inhibitor, aspirin, and statin
were initiated. The remainder of her postoperative course was
essentially uneventful. She continued to progress and was ready
for discharge on POD# 4.  All follow up appointments were
advised.

Medications on Admission:
Lipitor 80(1)
Lasix 20(1)
Lisinopril 40(2)
Toprol XL 200(1)
asa 325(1)


Discharge Medications:
1. Acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO Q4H (every
4 hours) as needed.
2. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2
times a day) for 1 months.
Disp:*60 Capsule(s)* Refills:*0*
3. Ranitidine HCl 150 mg Tablet Sig: One (1) Tablet PO BID (2
times a day) for 1 months.
Disp:*60 Tablet(s)* Refills:*0*
4. 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*
5. Atorvastatin 80 mg Tablet Sig: One (1) Tablet PO HS (at
bedtime).
Disp:*30 Tablet(s)* Refills:*0*
6. Tramadol 50 mg Tablet Sig: One (1) Tablet PO Q4H (every 4
hours) as needed.
Disp:*60 Tablet(s)* Refills:*0*
7. Captopril 12.5 mg Tablet Sig: One (1) Tablet PO TID (3 times
a day).
Disp:*90 Tablet(s)* Refills:*0*
8. Metoprolol Tartrate 50 mg Tablet Sig: One (1) Tablet PO twice
a day.
Disp:*60 Tablet(s)* Refills:*0*
9. Furosemide 20 mg Tablet Sig: Two (2) Tablet PO once a day for
2 weeks.
Disp:*28 Tablet(s)* Refills:*0*


Discharge Disposition:
Home With Service

Facility:
[**Hospital 119**] Homecare

Discharge Diagnosis:
S/p redo sternotomy, MVrepair (#28mm Rigid saddle ring)
CAD s/p LCx stent '[**33**]
s/p OPCAB (Lima->LAD)'[**35**]
HTN
hypercholesterolema
anemia
asthma
allergic rhinitis
depression
s/p right femoral pseudoanyrsm repair'[**35**]
uterine myomectomy
knee surgery


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:
Dr [**Last Name (STitle) **] in 4 weeks ([**Telephone/Fax (1) 170**]) please call for appointment

Dr [**Last Name (STitle) **], cardiology, in 1 week  please call for appointment
Wound check appointment [**Hospital Ward Name 121**] 2 as instructed by nurse
([**Telephone/Fax (1) 3071**])



Completed by:[**2144-1-19**]
{'Congestive heart failure, unspecified,Mitral valve disorders,Aortocoronary bypass status,Unspecified essential hypertension,Pure hypercholesterolemia,Asthma, unspecified type, unspecified,Depressive disorder, not elsewhere classified,Anemia, 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: Dyspnea on exertion, fatigue

PRESENT ILLNESS: 56 year old female s/p CABG'[**35**] presented with shortness of
breath secondary to Mitral Regurgitation. She was evaluated for
redo sternotomy/ Mitral valve repair with Dr.[**Last Name (STitle) **].

MEDICAL HISTORY: s/p OPCABG x1 '[**35**] (LIma-LAD)
s/p right femoral pseudoaneurysm repair '[**35**]
CAD
HTN
hypercholesterolemia
anemia
asthma
allergic rhinitis
depression
osteoarthritis
uterine myomectomy
knee surgery

MEDICATION ON ADMISSION: Lipitor 80(1)
Lasix 20(1)
Lisinopril 40(2)
Toprol XL 200(1)
asa 325(1)

ALLERGIES: Nifedipine / Iodine; Iodine Containing / Dicloxacillin /
Azithromycin / Penicillins

PHYSICAL EXAM: General: NAD
VSS
Skin: well healed sternotmy scar
HEENT:AT/NC, carotids:2+
CHEST: CTA (B)
CVS:RRR +sem
ABD:benign
EXT: NO cyanosis/clubbing/edema

FAMILY HISTORY: noncontributory

SOCIAL HISTORY: works as a project manager
denies tobacco
lives with mother
[**Name (NI) **]. ETOH 

### Response:
{'Congestive heart failure, unspecified,Mitral valve disorders,Aortocoronary bypass status,Unspecified essential hypertension,Pure hypercholesterolemia,Asthma, unspecified type, unspecified,Depressive disorder, not elsewhere classified,Anemia, unspecified'}
