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T1 Age 2 13 69-year-old T2 Sex 14 18 male T3 History 19 27 diabetic T4 Clinical_event 40 48 admitted E1 Clinical_event:T4 T5 Disease_disorder 60 89 left ventricular (LV) failure E2 Disease_disorder:T5 T6 Detailed_description 54 59 acute R1 MODIFY Arg1:T6 Arg2:E2 T7 Therapeutic_procedure 121 141 decongestive therapy E3 Therapeutic_procedure:T7 T8 Detailed_description 111 120 intensive R2 MODIFY Arg1:T8 Arg2:E3 T9 Sign_symptom 168 173 edema E4 Sign_symptom:T9 T10 Biological_structure 157 167 peripheral R3 MODIFY Arg1:T10 Arg2:E4 T11 Severity 150 156 severe R4 MODIFY Arg1:T11 Arg2:E4 T12 Sign_symptom 194 206 crepitations E5 Sign_symptom:T12 #1 AnnotatorNotes E5 crackling in the lungs T13 Detailed_description 178 187 bilateral T14 Detailed_description 188 193 basal R5 MODIFY Arg1:T14 Arg2:E5 R6 MODIFY Arg1:T13 Arg2:E5 T15 Diagnostic_procedure 216 222 workup E6 Diagnostic_procedure:T15 T16 Diagnostic_procedure 249 258 troponine E7 Diagnostic_procedure:T16 T17 Lab_value 260 271 <0.01 ng/ml T18 Lab_value 232 238 normal R7 MODIFY Arg1:T17 Arg2:E7 R8 MODIFY Arg1:T18 Arg2:E7 T19 Diagnostic_procedure 277 283 CPK-MB E8 Diagnostic_procedure:T19 T20 Lab_value 285 294 4.6 ng/ml R9 MODIFY Arg1:T20 Arg2:E8 R10 MODIFY Arg1:T18 Arg2:E8 T21 Disease_disorder 316 339 acute coronary syndrome E9 Disease_disorder:T21 A1 POLARITY E9 NEG T22 Diagnostic_procedure 354 357 BNP E10 Diagnostic_procedure:T22 T23 Lab_value 362 372 1230 pg/ml R11 MODIFY Arg1:T23 Arg2:E10 T24 Disease_disorder 401 414 heart failure E11 Disease_disorder:T24 T25 Diagnostic_procedure 416 444 Echocardiographic assessment E12 Diagnostic_procedure:T25 T26 Diagnostic_procedure 454 458 LVEF E13 Diagnostic_procedure:T26 #2 AnnotatorNotes E13 left ventricular ejection fraction T27 Lab_value 462 465 10% R12 MODIFY Arg1:T27 Arg2:E13 T28 Sign_symptom 471 495 dilated cardiac chambers E14 Sign_symptom:T28 T29 Diagnostic_procedure 511 545 pulmonary artery systolic pressure E15 Diagnostic_procedure:T29 T30 Diagnostic_procedure 547 551 PASP E16 Diagnostic_procedure:T30 R13 IDENTICAL Arg1:E16 Arg2:E15 T31 Lab_value 557 568 70 mm of Hg T32 Lab_value 574 614 features of raised LV diastolic pressure R14 MODIFY Arg1:T31 Arg2:E15 R15 MODIFY Arg1:T32 Arg2:E15 T33 Diagnostic_procedure 616 627 Angiography E17 Diagnostic_procedure:T33 T34 Duration 642 654 after 3 days E18 Duration:T34 T35 Therapeutic_procedure 658 678 decongestive therapy E19 Therapeutic_procedure:T35 T36 Disease_disorder 703 724 triple vessel disease E20 Disease_disorder:T36 T37 Severity 694 702 critical R16 MODIFY Arg1:T37 Arg2:E20 T38 Disease_disorder 740 763 coronary artery disease E21 Disease_disorder:T38 T39 Biological_structure 730 739 left main R17 MODIFY Arg1:T39 Arg2:E21 T40 Therapeutic_procedure 793 797 CABG E22 Therapeutic_procedure:T40 #3 AnnotatorNotes E22 Coronary artery bypass grafting (surgery) T41 Medication 822 831 frusemide E23 Medication:T41 T42 Administration 832 840 infusion R18 MODIFY Arg1:T42 Arg2:E23 T43 Medication 851 859 ramipril E24 Medication:T43 T44 Administration 846 850 oral R19 MODIFY Arg1:T44 Arg2:E24 T45 Medication 864 873 aldactone E25 Medication:T45 T46 Therapeutic_procedure 904 909 OPCAB E26 Therapeutic_procedure:T46 #4 AnnotatorNotes E26 Off-pump coronary artery bypass T47 Date 910 922 1 week after E27 Date:T47 T48 Coreference 923 934 angiography E28 Coreference:T48 R20 IDENTICAL Arg1:E28 Arg2:E17 T49 Diagnostic_procedure 936 950 Renal function E29 Diagnostic_procedure:T49 T50 Detailed_description 975 998 to adjust diuretic dose R21 MODIFY Arg1:T50 Arg2:E29 T51 Disease_disorder 1024 1045 end organ dysfunction E30 Disease_disorder:T51 A2 POLARITY E30 NEG T52 Diagnostic_procedure 1047 1068 STS risk of mortality E31 Diagnostic_procedure:T52 #5 AnnotatorNotes E31 Society of Thoracic Surgery Risk Score T53 Lab_value 1073 1077 2.4% R22 MODIFY Arg1:T53 Arg2:E31 T54 Diagnostic_procedure 1086 1114 echocardiographic assessment E32 Diagnostic_procedure:T54 T55 Clinical_event 780 788 referred E33 Clinical_event:T55 T56 Diagnostic_procedure 1139 1143 LVEF E34 Diagnostic_procedure:T56 T57 Lab_value 1124 1135 improvement T58 Lab_value 1147 1150 15% R23 MODIFY Arg1:T57 Arg2:E34 R24 MODIFY Arg1:T58 Arg2:E34 T59 Diagnostic_procedure 1167 1171 PASP E35 Diagnostic_procedure:T59 T60 Lab_value 1155 1163 decrease R25 MODIFY Arg1:T60 Arg2:E35 T61 Lab_value 1175 1183 30 mm Hg R26 MODIFY Arg1:T61 Arg2:E35 T62 Diagnostic_procedure 1200 1219 LV filling pressure E36 Diagnostic_procedure:T62 T63 Lab_value 1188 1196 decrease R27 MODIFY Arg1:T63 Arg2:E36 T64 Therapeutic_procedure 1221 1226 OPCAB E37 Therapeutic_procedure:T64 T65 Therapeutic_procedure 1249 1266 median sternotomy E38 Therapeutic_procedure:T65 R28 SUB_PROCEDURE Arg1:E38 Arg2:E37 T66 Biological_structure 1268 1276 Left ITA T67 Biological_structure 1299 1330 left anterior descending artery T68 Biological_structure 1332 1335 LAD R29 IDENTICAL Arg1:T68 Arg2:T67 T69 Therapeutic_procedure 1290 1298 grafting E39 Therapeutic_procedure:T69 R30 MODIFY Arg1:T66 Arg2:E39 R31 MODIFY Arg1:T67 Arg2:E39 R32 SUB_PROCEDURE Arg1:E39 Arg2:E37 T70 Therapeutic_procedure 1344 1359 revascularizing E40 Therapeutic_procedure:T70 T71 Biological_structure 1360 1363 LAD R33 MODIFY Arg1:T71 Arg2:E40 T72 Biological_structure 1365 1374 right ITA T73 Biological_structure 1376 1380 RITA R34 IDENTICAL Arg1:T73 Arg2:T72 R35 MODIFY Arg1:T72 Arg2:E40 T74 Biological_structure 1386 1388 RA R36 MODIFY Arg1:T74 Arg2:E40 R37 SUB_PROCEDURE Arg1:E40 Arg2:E37 T75 Therapeutic_procedure 1400 1405 graft E41 Therapeutic_procedure:T75 T76 Therapeutic_procedure 1456 1471 revascularizing E42 Therapeutic_procedure:T76 R38 SUB_PROCEDURE Arg1:E41 Arg2:E37 R39 SUB_PROCEDURE Arg1:E42 Arg2:E37 T77 Biological_structure 1424 1442 distal end of RITA T78 Biological_structure 1476 1491 diagonal artery R40 MODIFY Arg1:T77 Arg2:E42 R41 MODIFY Arg1:T78 Arg2:E42 T79 Diagnostic_procedure 1539 1553 blood pressure E43 Diagnostic_procedure:T79 T80 Detailed_description 1530 1538 systolic R42 MODIFY Arg1:T80 Arg2:E43 T81 Lab_value 1515 1526 improvement R43 MODIFY Arg1:T81 Arg2:E43 T82 Detailed_description 1503 1514 significant R44 MODIFY Arg1:T82 Arg2:T81 T83 Therapeutic_procedure 1572 1583 anastomosis E44 Therapeutic_procedure:T83 T84 Detailed_description 1565 1571 distal R45 MODIFY Arg1:T84 Arg2:E44 T85 Therapeutic_procedure 1619 1664 lifted for lateral and posterior wall vessels E45 Therapeutic_procedure:T85 T86 Biological_structure 1609 1614 heart R46 MODIFY Arg1:T86 Arg2:E45 T87 Therapeutic_procedure 1683 1696 skin incision E46 Therapeutic_procedure:T87 T88 Therapeutic_procedure 2106 2116 ventilated E47 Therapeutic_procedure:T88 T89 Duration 2121 2127 2 days E48 Duration:T89 T90 Diagnostic_procedure 2129 2145 Echocardiography E49 Diagnostic_procedure:T90 T91 Date 2149 2156 1st POD E50 Date:T91 T92 Diagnostic_procedure 2181 2185 LVEF E51 Diagnostic_procedure:T92 T93 Lab_value 2189 2192 20% R47 MODIFY Arg1:T93 Arg2:E51 T94 Lab_value 2166 2177 improvement R48 MODIFY Arg1:T94 Arg2:E51 T95 Medication 2221 2234 beta blockers E52 Medication:T95 T96 Dosage 2212 2220 low dose R49 MODIFY Arg1:T96 Arg2:E52 T97 Medication 2241 2259 inotropic supports E53 Medication:T97 A3 POLARITY E53 NEG T98 Clinical_event 2304 2312 recovery E54 Clinical_event:T98 T99 Lab_value 2284 2288 slow T100 Lab_value 2293 2303 uneventful R50 MODIFY Arg1:T100 Arg2:E54 R51 MODIFY Arg1:T99 Arg2:E54 T101 Diagnostic_procedure 2314 2330 Echocardiography E55 Diagnostic_procedure:T101 T102 Date 2334 2341 4th POD E56 Date:T102 T103 Diagnostic_procedure 2366 2370 LVEF E57 Diagnostic_procedure:T103 T104 Lab_value 2374 2377 30% T105 Lab_value 2351 2362 improvement R52 MODIFY Arg1:T104 Arg2:E57 R53 MODIFY Arg1:T105 Arg2:E57 T106 Sign_symptom 2407 2423 pleural drainage E58 Sign_symptom:T106 T107 Detailed_description 2396 2406 persistent R54 MODIFY Arg1:T107 Arg2:E58 T108 Nonbiological_location 2444 2463 intensive care unit T109 Clinical_event 2464 2468 stay E59 Clinical_event:T109 R55 MODIFY Arg1:T108 Arg2:E59 T110 Sign_symptom 2476 2492 pleural drainage E60 Sign_symptom:T110 A4 POLARITY E60 NEG T111 Medication 2548 2557 diuretics E61 Medication:T111 T112 Clinical_event 2534 2544 discharged E62 Clinical_event:T112 T113 Medication 2568 2580 beta blocker E63 Medication:T113 T114 Dosage 2559 2567 low dose R56 MODIFY Arg1:T114 Arg2:E63 T115 Medication 2586 2594 ramipril E64 Medication:T115 T116 Therapeutic_procedure 2038 2049 anastamoses E65 Therapeutic_procedure:T116 T117 Lab_value 2026 2030 five T118 Detailed_description 2031 2037 distal R57 MODIFY Arg1:T118 Arg2:E65 R58 MODIFY Arg1:T117 Arg2:E65 T119 Medication 1877 1894 inotropic support E66 Medication:T119 T120 Dosage 1860 1873 Liberal doses R59 MODIFY Arg1:T120 Arg2:E66 T121 Therapeutic_procedure 1933 1941 grafting E67 Therapeutic_procedure:T121 T122 Detailed_description 1922 1932 sequential R60 MODIFY Arg1:T122 Arg2:E67 T123 Biological_structure 1906 1908 RA R61 MODIFY Arg1:T123 Arg2:E67 T124 Biological_structure 1945 1960 obtuse marginal T125 Biological_structure 1962 1981 posterior LV branch T126 Biological_structure 1987 2014 posterior descending artery R62 MODIFY Arg1:T124 Arg2:E67 R63 MODIFY Arg1:T125 Arg2:E67 R64 MODIFY Arg1:T126 Arg2:E67 T127 Therapeutic_procedure 1850 1858 position E68 Therapeutic_procedure:T127 T128 Detailed_description 1837 1849 lateral tilt T129 Detailed_description 1825 1832 headlow R65 MODIFY Arg1:T128 Arg2:E68 #6 AnnotatorNotes T129 AKA Trendelenburg position R66 MODIFY Arg1:T129 Arg2:E68 T131 Therapeutic_procedure 1698 1714 open the sternum E69 Therapeutic_procedure:T131 T130 Therapeutic_procedure 1727 1746 release pericardium E70 Therapeutic_procedure:T130 * OVERLAP E1 E2 E3 E4 E5 E6 E7 E8 E9 E10 E11 E12 E13 E14 E15 R67 BEFORE Arg1:E15 Arg2:E17 R68 AFTER Arg1:E17 Arg2:E18 * OVERLAP E18 E19 E20 E21 R69 BEFORE Arg1:E21 Arg2:E33 * OVERLAP E33 E22 E23 E24 E25 R70 BEFORE Arg1:E25 Arg2:E26 R71 AFTER Arg1:E26 Arg2:E27 * OVERLAP E27 E28 R72 BEFORE Arg1:E28 Arg2:E29 * OVERLAP E29 E30 E31 R73 BEFORE Arg1:E31 Arg2:E32 * OVERLAP E32 E34 E35 E36 R74 BEFORE Arg1:E36 Arg2:E37 R75 BEFORE Arg1:E37 Arg2:E43 R76 AFTER Arg1:E43 Arg2:E44 R77 AFTER Arg1:E44 Arg2:E45 * OVERLAP E45 E46 E69 E70 E68 E66 E67 E65 R78 BEFORE Arg1:E65 Arg2:E47 * OVERLAP E47 E48 R79 BEFORE Arg1:E48 Arg2:E49 * OVERLAP E49 E50 E51 R80 BEFORE Arg1:E51 Arg2:E52 * OVERLAP E52 E53 R81 BEFORE Arg1:E53 Arg2:E54 R82 BEFORE Arg1:E54 Arg2:E55 * OVERLAP E55 E56 E57 E58 E59 R83 BEFORE Arg1:E59 Arg2:E60 * OVERLAP E60 E62 E61 E63 E64