CHIEF COMPLAINT: 

PRESENT ILLNESS: This is a 72-year-old male,
who for the past several months began noticing significant
exertionally-related shortness of breath.  Very modest levels
of activity around the house would bring on these symptoms.
Upon recent evaluation he was found to have an ejection
fraction of 50% on echocardiogram and 4% mitral regurgitation
with a partially flailed posterior leaflet.  Right
ventricular size and function appeared to be normal.  A
cardiac catheterization was performed.  Selective coronary
angiography revealed 80% first diagonal branch stenosis and a
total occlusion of the first marginal branch of the
circumflex system.

MEDICAL HISTORY: 1.  Atrial fibrillation.
2.  Noninsulin dependent diabetes mellitus.
3.  Gout.
4.  Hypercholesterolemia.

MEDICATION ON ADMISSION: 

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: 
Mitral valve disorders,Coronary atherosclerosis of native coronary artery,Atrial fibrillation,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Gout, unspecified,Pure hypercholesterolemia
Mitral valve disorder,Crnry athrscl natve vssl,Atrial fibrillation,DMII wo cmp nt st uncntr,Gout NOS,Pure hypercholesterolem
Admission Date:  [**2190-12-19**]       Discharge Date:  [**2190-12-24**]

Date of Birth:   [**2118-2-10**]       Sex:  M

Service:  CARDIOTHOR

HISTORY OF THE PRESENT ILLNESS:  This is a 72-year-old male,
who for the past several months began noticing significant
exertionally-related shortness of breath.  Very modest levels
of activity around the house would bring on these symptoms.
Upon recent evaluation he was found to have an ejection
fraction of 50% on echocardiogram and 4% mitral regurgitation
with a partially flailed posterior leaflet.  Right
ventricular size and function appeared to be normal.  A
cardiac catheterization was performed.  Selective coronary
angiography revealed 80% first diagonal branch stenosis and a
total occlusion of the first marginal branch of the
circumflex system.

PAST MEDICAL HISTORY:
1.  Atrial fibrillation.
2.  Noninsulin dependent diabetes mellitus.
3.  Gout.
4.  Hypercholesterolemia.

PAST SURGICAL HISTORY:
1.  Appendectomy.
2.  Back fusion.
3.  Repair left ankle fracture.

MEDICATIONS:
1.  Coumadin.
2.  Atenolol 25.
3.  Lipitor.
4.  Glyburide.
5.  Allopurinol.

ALLERGIES:  No known drug allergies.

PHYSICAL EXAMINATION:  Examination revealed the following:
Vital signs:  97.9, heart rate 90, blood pressure 142/70,
respiratory rate 18, oxygen saturation 98% room air.
GENERAL:  The patient was in no acute distress.  CARDIAC:
Irregularly irregular with 4/6 systolic murmur.  LUNGS:
Lungs were clear to auscultation bilaterally.  ABDOMEN:  Soft
and nontender, nondistended.  EXTREMITIES:  There was no
edema.

LABORATORY DATA:  Laboratory values on admission revealed the
following:  White count 9.6, hematocrit 42.5, platelet count
206,000, sodium 142, potassium 4.0, chloride 105, bicarbonate
26, BUN 20, creatinine 1.0, glucose 67.

HOSPITAL COURSE:  The patient was brought to the operating
room on [**2190-12-20**].  He had a mitral valve repair
with [**Initials (NamePattern4) **] [**Last Name (NamePattern4) 405**] 28.  Also, he had a CABG times one with right
saphenous vein graft to the diagonal.  The pericardium was
left open.  Two ventricular wires were placed and two
mediastinal tubes were placed.  The patient was on propofol,
milrinone, and Neo-synephrine drips.  The patient was
transferred to the Intensive Care Unit.  In the Intensive
Care Unit, the patient was rapidly extubated.  All drips were
appropriately weaned.

On postoperative day #1, the patient was transferred to the
floor.  The patient had episodes of rapid atrial
fibrillation, which were controlled with IV Lopressor.  Chest
tubes were removed when output was minimal and no aid leak
was seen.  A chest x-ray revealed no pneumothorax and no
effusions.

On postoperative day #2, the patient began ambulation.  On
postoperative day Coumadin was started for chronic atrial
fibrillation.  On postoperative day #4, the patient's wires
were removed.  Heparin drip was started, due to the fact that
the INR was not yet therapeutic.

DISCHARGE MEDICATIONS:
1.  Lopressor 75 mg b.i.d.
2.  Lasix 20 mg b.i.d. times 7 days.
3.  Potassium chloride 20 mg b.i.d. times 7 days.
4.  Aspirin 325 mg q.d.
5.  Glyburide 1.25 mg q.d.
6.  Allopurinol 300 mg q.d.
7.  Pravachol 20 mg q.d.
8.  Coumadin 5 mg q.d.
9.  Lovenox 60 mg subcutaneously b.i.d. until the INR is
between 2.0 and 2.5.
10. Percocet 1 to 2 tablets p.o. q.4 to 6 h.p.r.n.
11. Colace 100 mg b.i.d.
12. Captopril 6.25 mg t.i.d.

DISCHARGE STATUS:  Rehabilitation facility.  At the
rehabilitation facility he will have INR checks and once INR
of 2.0 is reached the Lovenox will be discontinued and he
will continue to receive his Coumadin.

FOLLOW-UP CARE:  The patient will followup with Dr. [**Last Name (STitle) 70**]
in four weeks and the primary care physician or cardiologist
in three weeks.

LABORATORY DATA:  Laboratory values on discharge are as
follows:  White count 7.9, hematocrit 30.4, platelet count
187,000, INR 1.2, sodium 140, potassium 4.4, chloride 104,
bicarbonate 28, BUN 18, creatinine .9, glucose 9.

DIAGNOSIS:
1.  Status post mitral valve repair and CABG times one.
2.  Noninsulin dependent diabetes mellitus.
3.  Hypertension.
4.  Hyperlipidemia.
5.  Chronic atrial fibrillation.
6.  Gout.




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

Dictated By:[**Name8 (MD) 1308**]
MEDQUIST36

D:  [**2190-12-24**]  12:02
T:  [**2190-12-24**]  12:09
JOB#:  [**Job Number 36962**]
{'Mitral valve disorders,Coronary atherosclerosis of native coronary artery,Atrial fibrillation,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Gout, unspecified,Pure hypercholesterolemia'}


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: This is a 72-year-old male,
who for the past several months began noticing significant
exertionally-related shortness of breath.  Very modest levels
of activity around the house would bring on these symptoms.
Upon recent evaluation he was found to have an ejection
fraction of 50% on echocardiogram and 4% mitral regurgitation
with a partially flailed posterior leaflet.  Right
ventricular size and function appeared to be normal.  A
cardiac catheterization was performed.  Selective coronary
angiography revealed 80% first diagonal branch stenosis and a
total occlusion of the first marginal branch of the
circumflex system.

MEDICAL HISTORY: 1.  Atrial fibrillation.
2.  Noninsulin dependent diabetes mellitus.
3.  Gout.
4.  Hypercholesterolemia.

MEDICATION ON ADMISSION: 

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY:  

### Response:
{'Mitral valve disorders,Coronary atherosclerosis of native coronary artery,Atrial fibrillation,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Gout, unspecified,Pure hypercholesterolemia'}
