CHAPTER 28: DISEASES OF THE CIRCULATORY SYSTEM

CHAPTER 28: DISEASES OF THE CIRCULATORYSYSTEMExercise 28.11. Mitral regurgitationI34.02. Mitral valve stenosis with congestive heart failureI05.0I50.93. Severe mitral stenosis and mild aortic insufficiencyI08.04. Aortic and mitral insufficiencyPersistent atrial fibrillationI08.0I48.15. Mitral insufficiency, congenitalQ23.36. Mitral valve insufficiency with aortic regurgitationI08.07. Chronic aortic and mitral valve insufficiency, rheumatic, with acute congestive I08.0heart failure due to rheumatic heart diseaseI09.81I50.9Exercise 28.21. Crescendo angina due to coronary arteriosclerosisRight and left cardiac catheterization, percutaneous2. Angina pectoris with essential hypertensionI25.1104A023N8I20.9I10Exercise 28.31. A patient felt well until around 10:00 p.m., when he began having severechest pain, which continued to increase in severity. He was brought to theemergency department by ambulance. There was no previous history ofcardiac disease, but the EKG showed an acute posterolateral myocardialinfarction, and the patient was admitted immediately for further care.I21.292. A patient with compensated congestive heart failure onLasix began to have extreme difficulty in breathing and was brought to theI21.19I50.9

emergency department, where he was found to be in congestive failure.Because it was felt that an impending infarction was possible, a percutaneoustransluminal coronary angioplasty (PTCA) was performed, but the patient wenton to have an acute inferolateral infarction.3. A patient was admitted with acute myocardial infarction involving the left main I21.01coronary artery with no history of previous infarction or previous care for thisI22.0episode. A week later during the hospital stay, he also experienced an acuteanterolateral infarction.4. A patient was admitted to Community Hospital with severe chest pain, whichwas identified as an acute anterolateral wall infarction (no history of earliercare). Patient was transferred to University Hospital two days later forangioplasty, returned toCommunity Hospital after three days at University to continue recovery, andstayed for four days.Code for first admission to Community HospitalI21.09Code for transfer to University HospitalCode for transfer back to Community HospitalI21.09I21.095. The patient in the situation described in item 4 above was readmitted toCommunity Hospital a week later because he was having severe chest painsand was diagnosed with a new inferior wall MI.I22.1I21.09Exercise 28.41. Acute myocardial infarction, inferolateral wallI21.19I44.2Third-degree atrioventricular block2. Acute myocardial infarction of inferoposterior wallCongestive heart failureHypertensionI21.11I50.9I103. Impending myocardial infarction (crescendo angina) resulting in occlusion ofcoronary arteryI24.04. Acute coronary insufficiencyI24.8

5. Hemopericardium as a complication of acute myocardial infarction of theinferior wall, which occurred three weeks ago. Patient had been discharged aweek before.I23.0I21.19Exercise 28.51. Occlusion of right internal carotid artery with cerebral infarction withmild hemiplegia resolved before dischargeI63.231G81.902. Hemiplegia on right (dominant) side due to old cerebral thrombosiswith infarctionI69.3513. Admission for treatment of new cerebral embolismI63.40with cerebral infarction and with aphasia remaining atdischarge (patient suffered cerebral embolism with infarctionR47.01one year ago, with residual apraxia and dysphagia)4. Cerebral infarction due to thrombosis with right hemiparesis(dominant) and aphasiaI63.30G81.91R47.015. Cerebral embolism right anterior cerebral arteryI66.116. Insufficiency of vertebrobasilar arteriesG45.07. Admission for rehabilitation because of monoplegia of the right armand right leg, each affecting dominant side (patient suffered anontraumatic extradural (intracranial) hemorrhage one month ago)I69.231I69.241Sequelae8. Quadriplegia due to ruptured berry aneurysm five years agoI69.065G82.50Exercise 28.6 (num bers 1-5)1. Left heart failure with hypertensionI50.1I102. Hypertensive cardiomegalyI11.9

3. Congestive heart failureCardiomegalyHypertensionI50.9I51.7I104. Acute congestive diastolic heart failure due to hypertensionI11.0I50.315. Hypertensive heart diseaseI11.9Myocardial degenerationExercise 28.7 (numbers 1-5)1. Stasis ulcer, left lower extremityLeft lesser saphenous vein stripping(percutaneous)I83.029L97.92906DS3ZZ2. Chronic venous embolism and thrombosis of subclavian veins on long-term I82.B23Coumadin therapyZ79.01Chronic orthostatic hypotensionI95.13. Arteriosclerosis of legs with intermittent claudicationI70.2134. Septic embolism pulmonary artery due to StaphylococcusA41.01Aureus sepsisSaphenous phlebitis, right leg5. Pulmonary hypertensionI26.90I80.01I27.2Exercise 28.8 (numbers 1-4)1. A patient was admitted through the emergency departmentcomplaining of chest pain with radiation down the left armincreasing in severity over the past three hours. Initialimpression was impending myocardial infarction, and thepatient was taken directly to the surgical suite, wherepercutaneous transluminal angioplasty with insertion ofcoronary stent was carried out on the right coronary artery.Infarction was aborted, and the diagnosis was listed as acutecoronary insufficiency .I24.802703DZ

2. Atherosclerosis of previous coronary artery bypass graft withunstable angina. Right greater saphenous vein graft was usedto bring blood from the aorta to the right coronary artery, theleft coronary artery, and the left anterior descending artery.Intraoperative continuous pacing pacemaker was used duringthe procedure as well as extracorporeal circulatory assistance.Pacemaker leads were inserted in left atria and ZBypass3. Occlusion of the right coronary artery. Right and left diagnosticcardiac catheterizationI24.04A023N84. A patient with known native vessel coronary atherosclerosisand unstable angina underwent percutaneous balloonangioplasty carried out on three coronary arteries with vesselbifurcationI25.11002723E65A1221ZInsertion of two stentsExtracorporeal circulation (continuous cardiac output)PerformanceExercise 28.9 (numbers 1-7)1. Second degree prolapsed hemorrhoidsHemorrhoidectomy by cryosurgery (open)K64.1065Y0ZC2. Painful varicose veins, right lower legRight greater saphenous ligation and stripping for varicosities, openI83.81106DP0ZZ3. Mitral stenosis and aortic insufficiencyAtrial fibrillationI08.0I48.91Hypertension4. Abdominal aortic aneurysmHypertensive cardiovascular disease essentialResection of abdominal aortic aneurysm with synthetic graft replacement,percutaneous endoscopic approachI10I71.4I11.904R04JZ5. Acute myocardial infarction , anterior wallI21.096. Renovascular hypertension secondary to fibromuscular hyperplasia, rightI77.3

renal arteryI15.0Nuclear renal scan with Tc-99mCT131ZZ7. Congestive heart failure due to hypertensive heart diseaseI11.0I50.9

with cerebral infarction and with aphasia remaining at R47.01 discharge (patient suffered cerebral embolism with infarction one year ago, with residual apraxia and dysphagia) 4.Cerebral infarction due to thrombosis with right hemiparesis (dominant) and aphasia I63.30 G81.91 R47.01