CHIEF COMPLAINT: 

PRESENT ILLNESS: This is a 78-year old female
patient being worked up for a carotid endarterectomy.  Found
to have a positive exercise tolerance test.  Subsequently
referred for cardiac catheterization and was found to have an
80 percent left main coronary artery stenosis as well as a 70
percent to 80 percent circumflex and 100 percent right
coronary artery with collateral.  She was referred for
coronary artery bypass graft.

MEDICAL HISTORY: Significant for known coronary artery
disease, status post myocardial infarction in [**2163**],
hypercholesterolemia, hypertension, osteoporosis, status post
deep venous thrombosis with an IVC filter placed, status post
bilateral mastectomies due to fibrocystic breast disease,
status post cataract surgery, and status post right total hip
replacement.

MEDICATION ON ADMISSION: 

ALLERGIES: 

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: The patient lives alone but has family that
lives close by.  Her alcohol intake is very rare.  She denies
ever having smoked.
Coronary atherosclerosis of native coronary artery,Occlusion and stenosis of multiple and bilateral precerebral arteries without mention of cerebral infarction,Pulmonary collapse,Osteoporosis, unspecified,Unspecified essential hypertension,Intermediate coronary syndrome,Other constipation
Crnry athrscl natve vssl,Ocl mlt bi art wo infrct,Pulmonary collapse,Osteoporosis NOS,Hypertension NOS,Intermed coronary synd,Constipation NEC
Admission Date: [**2173-6-29**]        Discharge Date: [**2173-7-6**]

Date of Birth:  [**2094-9-29**]        Sex:  F

Service:  CSU


HISTORY OF PRESENT ILLNESS:  This is a 78-year old female
patient being worked up for a carotid endarterectomy.  Found
to have a positive exercise tolerance test.  Subsequently
referred for cardiac catheterization and was found to have an
80 percent left main coronary artery stenosis as well as a 70
percent to 80 percent circumflex and 100 percent right
coronary artery with collateral.  She was referred for
coronary artery bypass graft.

PAST MEDICAL HISTORY:  Significant for known coronary artery
disease, status post myocardial infarction in [**2163**],
hypercholesterolemia, hypertension, osteoporosis, status post
deep venous thrombosis with an IVC filter placed, status post
bilateral mastectomies due to fibrocystic breast disease,
status post cataract surgery, and status post right total hip
replacement.

PREOPERATIVE MEDICATIONS:  Atenolol 50 mg by mouth once per
day, hydrochlorothiazide 25 mg by mouth once per day, Lipitor
20 mg by mouth once per day, Norvasc 5 mg by mouth once per
day, aspirin 325 mg by mouth once per day, Zestril 20 mg by
mouth once per day, vitamin B6, folic acid, and potassium
replacement.

SOCIAL HISTORY:  The patient lives alone but has family that
lives close by.  Her alcohol intake is very rare.  She denies
ever having smoked.

SUMMARY OF HOSPITAL COURSE:  The patient under evaluation
from the Neurology Stroke Service to evaluate her carotid
disease and risk for stroke undergoing coronary artery bypass
graft.  After subsequent evaluation by the Neurology Stroke
Service as well as the Interventional Cardiology Service to
assess the patient's carotid artery disease, she underwent a
carotid angiography.  It was felt that the patient did not
need to have a carotid stenting procedure done prior to
coronary revascularization.

She was ultimately taken to the operating room on [**Month (only) 216**]
____, [**2172**] where she underwent coronary artery bypass
grafting times three with a LIMA to the LAD a saphenous vein
graft to the PDA and a saphenous vein graft to the OM by Dr.
[**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 70**].

Postoperatively, she was transported from the Operating Room
to the Cardiac Surgery Recovery Unit in good condition on a
propofol drip.  On the night of surgery, she was weaned from
mechanical ventilation and subsequently extubated.  She
remained hemodynamically stable, requiring some pulmonary
toilet issues.

On postoperative day one, her chest tubes were discontinued.
She remained on low-dose Neo-Synephrine for some hypotension.
On postoperative day two, she remained hemodynamically stable
on vasoactive drip.  She began to advance ambulation and
mobility and was transferred out of the Intensive Care Unit
to the telemetry floor on postoperative day three on 4 liters
nasal cannula oxygen at that time.

The patient continued to progress from a mobility standpoint
and cardiac rehabilitation; however, she continued to
progress slowly and was not able to ambulate independently at
this time.  She has remained stable from a cardiovascular
standpoint.  Felt to be in the patient's best interest that
she continue to progress with her mobility and independence
issues in a rehabilitation facility.

DISCHARGE STATUS:  On postoperative day five, her condition
is good.  Her temperature was 98.8, her blood pressure was
128/55, her heart rate was 95 (normal sinus rhythm), her
respiratory rate was 18, and her oxygen saturation was 93
percent on 1 liter nasal cannula.  Her weight today was 72.9
kilograms (up slightly from her preoperative weight of 71
kilograms.  Most recent laboratory values from today included
a hematocrit of 28 and a potassium of 4.2.  Her chest x-ray
from approximately 48 hours previously showed bibasilar
atelectasis with a very small left effusion.

MEDICATIONS ON DISCHARGE:
1. Plavix 75 mg by mouth once per day.
2. Enteric coated aspirin 325 mg by mouth once per day.
3. Zantac 150 mg by mouth twice per day.
4. Colace 100 mg by mouth twice per day.
5. Lasix 20 mg by mouth twice per day (times seven more
   days).
6. Percocet 5/325 one tablet by mouth q.6h. as needed (for
   pain).
7. Lipitor 20 mg by mouth once per day.
8. Lopressor 25 mg by mouth twice per day.
9. Potassium chloride 20 mEq by mouth once per day.


DISCHARGE FOLLOWUP:  The patient was to follow up with her
primary care physician (Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 1275**]) in approximately
one to two weeks or upon discharge from rehabilitation.  The
patient was also to follow up with her primary cardiologist
(Dr. [**Last Name (STitle) 5874**] in one to two weeks.  She should follow up
with Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 70**] from Cardiothoracic Surgery in
approximately five weeks for a postoperative evaluation.

DISCHARGE DIAGNOSES:
1. Coronary artery disease.
2. Carotid artery stenosis.


CONDITION ON DISCHARGE:  Good.

DISCHARGE DISPOSITION:  She is being discharged to a
rehabilitation facility for further progression of  mobility
and cardiac rehabilitation.



                        [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 5662**], [**MD Number(1) 5663**]

Dictated By:[**Last Name (NamePattern1) 5664**]
MEDQUIST36
D:  [**2173-7-6**] 09:12:14
T:  [**2173-7-6**] 10:04:42
Job#:  [**Job Number 47794**]
{'Coronary atherosclerosis of native coronary artery,Occlusion and stenosis of multiple and bilateral precerebral arteries without mention of cerebral infarction,Pulmonary collapse,Osteoporosis, unspecified,Unspecified essential hypertension,Intermediate coronary syndrome,Other constipation'}


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 78-year old female
patient being worked up for a carotid endarterectomy.  Found
to have a positive exercise tolerance test.  Subsequently
referred for cardiac catheterization and was found to have an
80 percent left main coronary artery stenosis as well as a 70
percent to 80 percent circumflex and 100 percent right
coronary artery with collateral.  She was referred for
coronary artery bypass graft.

MEDICAL HISTORY: Significant for known coronary artery
disease, status post myocardial infarction in [**2163**],
hypercholesterolemia, hypertension, osteoporosis, status post
deep venous thrombosis with an IVC filter placed, status post
bilateral mastectomies due to fibrocystic breast disease,
status post cataract surgery, and status post right total hip
replacement.

MEDICATION ON ADMISSION: 

ALLERGIES: 

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: The patient lives alone but has family that
lives close by.  Her alcohol intake is very rare.  She denies
ever having smoked. 

### Response:
{'Coronary atherosclerosis of native coronary artery,Occlusion and stenosis of multiple and bilateral precerebral arteries without mention of cerebral infarction,Pulmonary collapse,Osteoporosis, unspecified,Unspecified essential hypertension,Intermediate coronary syndrome,Other constipation'}
