CHIEF COMPLAINT: 

PRESENT ILLNESS: This is a 63 year old male with
a history of hypertension, hypercholesterolemia, who had new
onset of exertional shortness of breath and was shoveling
snow this past [**Month (only) 1096**].  The patient saw his primary care
physician who referred the patient for exercise treadmill
test which was done on [**2159-2-28**], and showed ejection fraction
of 47%, minimal left ventricular reversible dilatation and
moderately severe inferolateral reversible defect and
inferolateral hypokinesis.  The patient was then referred for
cardiac catheterization.  His catheterization was done on
[**2159-3-16**], and showed an ejection fraction of approximately
50%, left internal mammary artery of approximately 50% distal
and left anterior descending of approximately 80% distal
stenosis and 80% stenosis at D1, 50% at mid diagonal, left
circumflex total occlusion, 60% before left posterior
descending artery and right coronary artery 70% ostial and
total occlusion of mid.  The patient was then evaluated for
coronary artery bypass graft.

MEDICAL HISTORY: 1.  Hypertension.
2.  Hypercholesterolemia.
3.  Status post brain abscess, on prophylaxis with Tegretol
secondary to lung infection.
4.  Status post gastrointestinal bleed and partial gastric
resection.
5.  Status post right hernia repair.

MEDICATION ON ADMISSION: 1.  Aspirin 325 mg p.o. once daily.
2.  Tegretol 200 mg p.o. twice a day.
3.  Procardia XL 40 mg p.o. once daily.
4.  Zoloft 150 mg p.o. q.a.m.
5.  Toprol XL 25 mg p.o. once daily.
6.  Lipitor 10 mg p.o. once daily.
7.  Zestril 2.5 mg p.o. once daily.

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: The patient works at [**Company 52516**], married,
smoked cigars.  The patient quit approximately four years
ago.  He drinks two beers a day.
Coronary atherosclerosis of native coronary artery,Pure hypercholesterolemia,Unspecified essential hypertension
Crnry athrscl natve vssl,Pure hypercholesterolem,Hypertension NOS
Admission Date:  [**2159-3-26**]       Discharge Date:  [**2159-4-2**]

Date of Birth:   [**2100-4-4**]       Sex:  M

Service:  CARDIAC SURGERY

HISTORY OF PRESENT ILLNESS:  This is a 63 year old male with
a history of hypertension, hypercholesterolemia, who had new
onset of exertional shortness of breath and was shoveling
snow this past [**Month (only) 1096**].  The patient saw his primary care
physician who referred the patient for exercise treadmill
test which was done on [**2159-2-28**], and showed ejection fraction
of 47%, minimal left ventricular reversible dilatation and
moderately severe inferolateral reversible defect and
inferolateral hypokinesis.  The patient was then referred for
cardiac catheterization.  His catheterization was done on
[**2159-3-16**], and showed an ejection fraction of approximately
50%, left internal mammary artery of approximately 50% distal
and left anterior descending of approximately 80% distal
stenosis and 80% stenosis at D1, 50% at mid diagonal, left
circumflex total occlusion, 60% before left posterior
descending artery and right coronary artery 70% ostial and
total occlusion of mid.  The patient was then evaluated for
coronary artery bypass graft.

PAST MEDICAL HISTORY:
1.  Hypertension.
2.  Hypercholesterolemia.
3.  Status post brain abscess, on prophylaxis with Tegretol
secondary to lung infection.
4.  Status post gastrointestinal bleed and partial gastric
resection.
5.  Status post right hernia repair.

SOCIAL HISTORY:  The patient works at [**Company 52516**], married,
smoked cigars.  The patient quit approximately four years
ago.  He drinks two beers a day.

ALLERGIES:  No known drug allergies.

MEDICATIONS ON ADMISSION:
1.  Aspirin 325 mg p.o. once daily.
2.  Tegretol 200 mg p.o. twice a day.
3.  Procardia XL 40 mg p.o. once daily.
4.  Zoloft 150 mg p.o. q.a.m.
5.  Toprol XL 25 mg p.o. once daily.
6.  Lipitor 10 mg p.o. once daily.
7.  Zestril 2.5 mg p.o. once daily.

REVIEW OF SYSTEMS:  The patient denies visual changes,
dysphasia, palpitations, melena, hematochezia, nocturia,
weakness, numbness, transient ischemic attack, and
cerebrovascular accident.

PHYSICAL EXAMINATION:  In general, the patient is pleasant
male in no apparent distress.  Heart rate is 66, blood
pressure 134/90, respiratory rate 19, oxygen saturation 95%
in room air.  The pupils are equal, round, and reactive to
light and accommodation.  Extraocular movements are intact.
The pharynx was clear.  Examination of the neck revealed
supple neck, no jugular venous distention, no bruits, and
carotid pulses 1+ bilaterally.  Examination of the lungs
revealed lungs clear to auscultation bilaterally.
Examination of the heart revealed regular rate and rhythm,
without murmurs, rubs or gallops.  Examination of the abdomen
revealed positive bowel sounds, soft, nontender,
nondistended, well healed midline supraumbilical incision.
Extremities showed no cyanosis, clubbing or edema.  Dorsalis
pedis and posterior tibial pulses were 2+ bilaterally.
Radial artery pulses were 2+ bilaterally.  Neurologically,
the patient was awake, alert and oriented times three.
Sensory and motor examinations were grossly intact.

HOSPITAL COURSE:  The patient was admitted to the Cardiac
Surgery service and underwent coronary artery bypass graft
times three, left internal mammary artery to left anterior
descending, saphenous vein graft to diagonal, saphenous vein
graft to posterior descending artery.  The patient's mean
arterial pressure on transfer to the recovery room was 70,
central venous pressure was 12.  The patient was in normal
sinus rhythm at 80 beats per minute.  The patient was on
Propofol drip titrated.

On postoperative day number one, the patient was on
Neo-Synephrine drip of 0.6 with low grade fever of 100;
otherwise 90s.  Normal sinus rhythm.  Arterial blood gas was
7.41, 37, 88, 24 and 0, oxygen saturation 94% in room air.
He was otherwise doing well.  The patient was weaned off the
Neo-Synephrine and chest tubes were removed.  On
postoperative day number two, the patient remained afebrile
with stable vital signs.  White blood cell count was 14.6 and
hematocrit was 23.9.  The patient required some
Neo-Synephrine for pressure support.  On postoperative day
number three, the patient was completely off Neo-Synephrine
and the patient had previously received blood for low
hematocrit.  Pulse was at 104, good pressure, saturating
well.  White blood cell count was down to 9.1 and hematocrit
was 24.2.  He was otherwise doing well.  The patient was
started on Lasix and was transferred to the floor in stable
condition.  On postoperative day number four, the patient had
a low grade temperature of 100.3 and otherwise was doing
well.  He was in sinus rhythm, was taking good p.o. and
making good urine.  The patient's wires were removed.
Metoprolol was increased to 25 mg twice a day.  On
postoperative day number five, the patient was complaining of
not having any bowel movements.  He was otherwise doing well.
Pulse was 91, and blood pressure was 116/59.  He was taking
good p.o. and making good urine.  The patient was given
Magnesium Citrate which helped to have a bowel movement.  On
postoperative day number six, the patient was doing well,
remained afebrile with stable vital signs and the white blood
cell count was 7.6, hematocrit 26.6, platelet count 261,000
and creatinine 1.2.  Otherwise, the patient was doing well.
The patient was discharged home.

CONDITION ON DISCHARGE:  Good.

DISPOSITION:  Home.

FINAL DIAGNOSIS:  Coronary artery disease, status post
coronary artery bypass graft times three.

MEDICATIONS ON DISCHARGE:
1.  Aspirin 325 mg p.o. once daily.
2.  Carbamazepine 200 mg p.o. twice a day.
3.  Lasix 20 mg p.o. once daily for seven days.
4.  Sertraline 150 mg p.o. q.a.m.
5.  Metoprolol 25 mg p.o. twice a day.
6.  Lipitor 10 mg p.o. once daily.
7.  Colace 100 mg p.o. twice a day.
8.  Dilaudid 2 to 4 mg p.o. q4-6hours p.r.n. pain.
9.  Potassium Chloride 10 mEq p.o. once daily for seven days.

FO[**Last Name (STitle) **]P PLANS:  Please follow-up with Dr. ************ in
one to two weeks, and please follow-up with Dr. [**Last Name (Prefixes) **]
in four weeks.




                            [**Doctor Last Name 412**] [**Last Name (Prefixes) 413**], M.D.  [**MD Number(1) 414**]

Dictated By:[**Last Name (NamePattern1) 3118**]
MEDQUIST36

D:  [**2159-4-2**]  18:30
T:  [**2159-4-2**]  18:40
JOB#:  [**Job Number 52517**]
{'Coronary atherosclerosis of native coronary artery,Pure hypercholesterolemia,Unspecified essential hypertension'}


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 63 year old male with
a history of hypertension, hypercholesterolemia, who had new
onset of exertional shortness of breath and was shoveling
snow this past [**Month (only) 1096**].  The patient saw his primary care
physician who referred the patient for exercise treadmill
test which was done on [**2159-2-28**], and showed ejection fraction
of 47%, minimal left ventricular reversible dilatation and
moderately severe inferolateral reversible defect and
inferolateral hypokinesis.  The patient was then referred for
cardiac catheterization.  His catheterization was done on
[**2159-3-16**], and showed an ejection fraction of approximately
50%, left internal mammary artery of approximately 50% distal
and left anterior descending of approximately 80% distal
stenosis and 80% stenosis at D1, 50% at mid diagonal, left
circumflex total occlusion, 60% before left posterior
descending artery and right coronary artery 70% ostial and
total occlusion of mid.  The patient was then evaluated for
coronary artery bypass graft.

MEDICAL HISTORY: 1.  Hypertension.
2.  Hypercholesterolemia.
3.  Status post brain abscess, on prophylaxis with Tegretol
secondary to lung infection.
4.  Status post gastrointestinal bleed and partial gastric
resection.
5.  Status post right hernia repair.

MEDICATION ON ADMISSION: 1.  Aspirin 325 mg p.o. once daily.
2.  Tegretol 200 mg p.o. twice a day.
3.  Procardia XL 40 mg p.o. once daily.
4.  Zoloft 150 mg p.o. q.a.m.
5.  Toprol XL 25 mg p.o. once daily.
6.  Lipitor 10 mg p.o. once daily.
7.  Zestril 2.5 mg p.o. once daily.

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: The patient works at [**Company 52516**], married,
smoked cigars.  The patient quit approximately four years
ago.  He drinks two beers a day. 

### Response:
{'Coronary atherosclerosis of native coronary artery,Pure hypercholesterolemia,Unspecified essential hypertension'}
