CHIEF COMPLAINT: 

PRESENT ILLNESS: The patient is a 50 year old
white male with a history of insulin dependent diabetes
mellitus who has been experiencing left-sided chest pain on
exertion over the past month.  The patient reports walking
about five miles a day three times a week and was in his
usual state of health until about one month ago when he began
experiencing left-sided chest pain with a sensation of
indigestion while walking, not associated with shortness of
breath, nausea, vomiting, diaphoresis or radiation.  The pain
was relieved by rest and persisted on a daily basis.  The
patient saw his primary care physician, [**Last Name (NamePattern4) **]. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 50470**]
who referred the patient for a stress test which was positive
with a reversible apical defect.  The patient was
subsequently referred for cardiac catheterization today which
revealed single vessel disease with a 99% ulcerated proximal
left anterior descending stenosis.  Cardiac Surgery was
consulted for evaluation for coronary artery bypass graft,
left internal mammary artery to the left anterior descending
surgery.

MEDICAL HISTORY: High cholesterol, insulin dependent
diabetes mellitus with neuropathy, history of pancreatic
stone approximately three weeks ago, chronic back pain,
tonsillectomy.

MEDICATION ON ADMISSION: 

ALLERGIES: Sulfa causes a rash

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: The patient is a plumber who is married with
four children living in [**Location (un) **] [**State 350**].  The patient
smoked less than one pack per day for about ten years, quit
about 25 years ago.  He does not drink alcohol.
Coronary atherosclerosis of native coronary artery,Other and unspecified angina pectoris,Diabetes with neurological manifestations, type II or unspecified type, not stated as uncontrolled,Polyneuropathy in diabetes,Pure hypercholesterolemia,Unspecified acquired hypothyroidism
Crnry athrscl natve vssl,Angina pectoris NEC/NOS,DMII neuro nt st uncntrl,Neuropathy in diabetes,Pure hypercholesterolem,Hypothyroidism NOS
Admission Date:  [**2126-11-22**]       Discharge Date:  [**2126-12-1**]

Date of Birth:   [**2072-2-23**]       Sex:  M

Service:

HISTORY OF PRESENT ILLNESS:  The patient is a 50 year old
white male with a history of insulin dependent diabetes
mellitus who has been experiencing left-sided chest pain on
exertion over the past month.  The patient reports walking
about five miles a day three times a week and was in his
usual state of health until about one month ago when he began
experiencing left-sided chest pain with a sensation of
indigestion while walking, not associated with shortness of
breath, nausea, vomiting, diaphoresis or radiation.  The pain
was relieved by rest and persisted on a daily basis.  The
patient saw his primary care physician, [**Last Name (NamePattern4) **]. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 50470**]
who referred the patient for a stress test which was positive
with a reversible apical defect.  The patient was
subsequently referred for cardiac catheterization today which
revealed single vessel disease with a 99% ulcerated proximal
left anterior descending stenosis.  Cardiac Surgery was
consulted for evaluation for coronary artery bypass graft,
left internal mammary artery to the left anterior descending
surgery.

PAST MEDICAL HISTORY:  High cholesterol, insulin dependent
diabetes mellitus with neuropathy, history of pancreatic
stone approximately three weeks ago, chronic back pain,
tonsillectomy.

HOME MEDICATIONS:  Enteric coated Aspirin 81 mg q.d.,
Synthroid .125 mg Monday through Friday, 0.25 mcg Saturday
and Sunday, Atenolol 25 mg q.d., Glucophage 1 gm b.i.d.,
Lisinopril 5 mg q.d., Humalog sliding scale, Lantis insulin 9
units q.h.s.

ALLERGIES:  Sulfa causes a rash

SOCIAL HISTORY:  The patient is a plumber who is married with
four children living in [**Location (un) **] [**State 350**].  The patient
smoked less than one pack per day for about ten years, quit
about 25 years ago.  He does not drink alcohol.

LABORATORY DATA:  The patient has a normal complete blood
count, chem-7 and liver function tests.  Cardiac
catheterization showed non-CA with mild distal plaguing,
proximal left anterior descending 99% extending to ostium,
left circumflex and right coronary artery without disease,
ejection fraction 64%, no mitral regurgitation.

PHYSICAL EXAMINATION:  The patient in general is alert and
oriented times three, pleasant but nervous, in no acute
distress appearing stated age.  Head, eyes, ears, nose and
throat, pupils equal, round and reactive to light,
extraocular movements intact.  Normal mucosa.  No dentures.
Normal dentition.  Neck supple, no jugulovenous distension,
thyromegaly, lymphadenopathy or bruits.  Cardiac,
bradycardia, regular rhythm, no murmurs or rubs.  Chest,
clear to auscultation bilaterally, no crackles, wheezes or
rhonchi.  Abdomen, soft, nontender, nondistended, no
guarding, no rebound, no rigidity and no hepatosplenomegaly.
Extremities, warm, no edema, cyanosis, clubbing or
varicosities.  Carotid pulses were 1 and 2+ bilaterally,
radial pulses 2+ bilaterally, femoral pulses 2+ bilaterally.
Dorsalis pedis pulses 2+ bilaterally, posterior tibial 1+
bilaterally.

HOSPITAL COURSE:  The patient was admitted on [**11-22**], and
underwent his catheterization and remained in the hospital
for the duration of his preoperative testing with no
significant events.  On [**11-25**], the patient underwent
coronary artery bypass graft anastomosing the left internal
mammary artery to the left anterior descending.  The patient
tolerated the procedure quite well initially.  He was sent to
the Cardiac Surgery Recovery Unit intubated, however, was
quickly extubated.  He was initially on a small amount of
Neo-Synephrine for blood pressure maintenance.  He also
received perioperative Vancomycin.  Over the course of the
next few days the patient was transferred to the floor, his
chest tubes were removed.  His cardiac pacing wires were
removed.  The patient was started on Lasix and Lopressor.  He
was also started on Plavix.  The patient's diet was advanced
successfully.  The patient was seen by physical therapy who
over the course of a few days found the patient to be
sufficiently dependent to return home without further
physical therapy.  Now, on [**2126-12-1**] the patient will
be discharged after receiving his predischarge chest x-ray.

DISCHARGE INSTRUCTIONS:  He will be going home on all of his
usual home medications.  He will also be sent home on Toprol
25 mg p.o. q.d.  He will not be sent home on any Lasix.  He
will be sent home on Percocet for pain.  He is not to drive
while on pain medications.  He is to follow up with Dr. [**Last Name (STitle) 1537**]
in approximately one month.  He is to follow up with his
primary care physician in two to three weeks.




                            [**First Name11 (Name Pattern1) 275**] [**Last Name (NamePattern4) 1539**], M.D.  [**MD Number(1) 1540**]

Dictated By:[**Last Name (NamePattern4) 12487**]
MEDQUIST36

D:  01/11/1900  10:10
T:  [**2126-12-1**]  10:40
JOB#:  [**Job Number 50471**]
{'Coronary atherosclerosis of native coronary artery,Other and unspecified angina pectoris,Diabetes with neurological manifestations, type II or unspecified type, not stated as uncontrolled,Polyneuropathy in diabetes,Pure hypercholesterolemia,Unspecified acquired hypothyroidism'}


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: The patient is a 50 year old
white male with a history of insulin dependent diabetes
mellitus who has been experiencing left-sided chest pain on
exertion over the past month.  The patient reports walking
about five miles a day three times a week and was in his
usual state of health until about one month ago when he began
experiencing left-sided chest pain with a sensation of
indigestion while walking, not associated with shortness of
breath, nausea, vomiting, diaphoresis or radiation.  The pain
was relieved by rest and persisted on a daily basis.  The
patient saw his primary care physician, [**Last Name (NamePattern4) **]. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 50470**]
who referred the patient for a stress test which was positive
with a reversible apical defect.  The patient was
subsequently referred for cardiac catheterization today which
revealed single vessel disease with a 99% ulcerated proximal
left anterior descending stenosis.  Cardiac Surgery was
consulted for evaluation for coronary artery bypass graft,
left internal mammary artery to the left anterior descending
surgery.

MEDICAL HISTORY: High cholesterol, insulin dependent
diabetes mellitus with neuropathy, history of pancreatic
stone approximately three weeks ago, chronic back pain,
tonsillectomy.

MEDICATION ON ADMISSION: 

ALLERGIES: Sulfa causes a rash

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: The patient is a plumber who is married with
four children living in [**Location (un) **] [**State 350**].  The patient
smoked less than one pack per day for about ten years, quit
about 25 years ago.  He does not drink alcohol. 

### Response:
{'Coronary atherosclerosis of native coronary artery,Other and unspecified angina pectoris,Diabetes with neurological manifestations, type II or unspecified type, not stated as uncontrolled,Polyneuropathy in diabetes,Pure hypercholesterolemia,Unspecified acquired hypothyroidism'}
