CHIEF COMPLAINT: 

PRESENT ILLNESS: 

MEDICAL HISTORY: 1.  Hypertension.
2.  History of atrial fibrillation and flutter.
3.  History of right inguinal hernia.
4.  History of right radical neck resection for squamous cell
    carcinoma.
5.  Right thoracotomy.
6.  Right knee surgery.

MEDICATION ON ADMISSION: 

ALLERGIES: 

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: 
Abdominal aneurysm without mention of rupture,Hemorrhage complicating a procedure,Acute vascular insufficiency of intestine,Acute myocardial infarction of unspecified site, initial episode of care,Unspecified septicemia,Acidosis,Other and unspecified coagulation defects,Cardiogenic shock,Other ventral hernia with gangrene,Atrial fibrillation,Severe sepsis,Atherosclerosis of aorta,Other allied disorders of spine,Other specified disorders of gallbladder,Unspecified essential hypertension,Long-term (current) use of anticoagulants,Personal history of other malignant neoplasm of skin,Inguinal hernia, without mention of obstruction or gangrene, unilateral or unspecified (not specified as recurrent)
Abdom aortic aneurysm,Hemorrhage complic proc,Ac vasc insuff intestine,AMI NOS, initial,Septicemia NOS,Acidosis,Coagulat defect NEC/NOS,Cardiogenic shock,Gang ventral hernia NEC,Atrial fibrillation,Severe sepsis,Aortic atherosclerosis,Spinal disorders NEC,Dis of gallbladder NEC,Hypertension NOS,Long-term use anticoagul,Hx-skin malignancy NEC,Unilat inguinal hernia
Unit No:  [**Numeric Identifier 70000**]
Admission Date: [**2164-1-26**]
Discharge Date: [**2164-1-28**]
Date of Birth:  [**2083-8-23**]
Sex:  M
Service:  VSU


PRINCIPAL DIAGNOSIS:  Abdominal aortic aneurysm, 6.2 x 6.3 x
9.6 cm from the infrarenal to the aortic bifurcation seen on
CTA on [**2164-1-5**].

PROCEDURES:
1.  Abdominal aortic aneurysm repair with tube graft via
    retroperitoneal approach on [**2164-1-26**].
2.  Emergency laparotomy on [**2164-1-27**], with resection
    of necrotic large bowel.

PAST MEDICAL HISTORY:
1.  Hypertension.
2.  History of atrial fibrillation and flutter.
3.  History of right inguinal hernia.
4.  History of right radical neck resection for squamous cell
    carcinoma.
5.  Right thoracotomy.
6.  Right knee surgery.

MEDICATIONS:
1.  Coumadin.
2.  Lovastatin.

BRIEF HOSPITAL COURSE:  Mr. [**Known lastname 47777**] is an 80-year-old
gentleman who was admitted on [**2164-1-26**] to [**Doctor First Name **]-
[**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **] [**First Name (Titles) **] [**Last Name (Titles) **] for elective repair of
retroperitoneal abdominal aortic aneurysm for a 6.2 x 6.3 x
9.6 cm aneurysm. He was taken to the operating room on
[**2164-1-26**], and had a retroperitoneal approach for his
abdominal aortic aneurysm repair with tube graft from the
infrarenal side to his aortic bifurcation. Postoperatively he
was noted to be hypotensive and was started on Neo-
Synephrine. Over the course of the evening he had a rising
lactate and increasing pressor requirement. There was concern
of some ischemic episode and he was taken emergently to the
operating room on [**2164-1-27**], for exploratory
laparotomy. At this point his large bowel and his colon was
noted to be green and necrotic. He had a total abdominal
colectomy with  ileostomy done emergently. His abdomen was
left open with I-band and Broca to the bag. He was taken back
now to the surgical intensive care unit where he stabilized,
still requiring pressors and IV fluids throughout the
evening.

On [**2164-1-28**], his pressor requirement continued to go
up and he had a Swan in place which showed elevation of PA
numbers. He was maxed out on Levophed and Neo-Synephrine at
this point as well as vasopressor 1.2 per hour. At this point
because of his increasing PA pressures, there was a concern
that he may be having a cardiac dysfunction. His lactate
remained elevated at 4, however it did not rise. A second
look was done at the bedside serially of his abdominal
contents to see if there are any signs of small bowel
ischemia, however upon inspection there were no clear signs
of small bowel ischemia. He also had a stat echo done to
evaluate for cardiac function because of his increasing
pressor requirement and hypotension.

Upon evaluation of his cardiac echo he was noted to have
significant left ventricular dysfunction with very poor
ejection fraction indicating that he had a myocardial event.
At this point we discussed with the family that there is
significant change in his overall status in that in addition
to having some septic physiology he likely was in a
cardiogenic shock as well. He went into rapid atrial
fibrillation requiring synchronized cardioversion because of
hypotension. He was cardioverted twice and went into
asystole. Chest compressions were immediately started. He
received boluses of epinephrine. He was noted then to be in
ventricular tachycardia and again hypotensive. He was
cardioverted. He was coded for approximately 30 minutes.

A lengthy discussion was carried out with the family as to
how they would like to proceed. During this time he had
somewhat stabilized, however was still hypotensive requiring
maximal pressors and was on epinephrine drip. The family,
after a lengthy discussion, felt that he would not want to
proceed with any further care and he was made CMO.

The patient expired shortly thereafter at 6:20 p.m.  Dr.
[**First Name11 (Name Pattern1) **] [**Initial (NamePattern1) **] [**Last Name (NamePattern4) **] was informed of the patient's status this
entire time.



                        [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) **], [**MD Number(1) 5697**]

Dictated By:[**Name8 (MD) 57264**]
MEDQUIST36
D:  [**2164-1-29**] 06:00:46
T:  [**2164-1-29**] 14:13:35
Job#:  [**Job Number 70001**]
{'Abdominal aneurysm without mention of rupture,Hemorrhage complicating a procedure,Acute vascular insufficiency of intestine,Acute myocardial infarction of unspecified site, initial episode of care,Unspecified septicemia,Acidosis,Other and unspecified coagulation defects,Cardiogenic shock,Other ventral hernia with gangrene,Atrial fibrillation,Severe sepsis,Atherosclerosis of aorta,Other allied disorders of spine,Other specified disorders of gallbladder,Unspecified essential hypertension,Long-term (current) use of anticoagulants,Personal history of other malignant neoplasm of skin,Inguinal hernia, without mention of obstruction or gangrene, unilateral or unspecified (not specified as recurrent)'}


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: 

MEDICAL HISTORY: 1.  Hypertension.
2.  History of atrial fibrillation and flutter.
3.  History of right inguinal hernia.
4.  History of right radical neck resection for squamous cell
    carcinoma.
5.  Right thoracotomy.
6.  Right knee surgery.

MEDICATION ON ADMISSION: 

ALLERGIES: 

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY:  

### Response:
{'Abdominal aneurysm without mention of rupture,Hemorrhage complicating a procedure,Acute vascular insufficiency of intestine,Acute myocardial infarction of unspecified site, initial episode of care,Unspecified septicemia,Acidosis,Other and unspecified coagulation defects,Cardiogenic shock,Other ventral hernia with gangrene,Atrial fibrillation,Severe sepsis,Atherosclerosis of aorta,Other allied disorders of spine,Other specified disorders of gallbladder,Unspecified essential hypertension,Long-term (current) use of anticoagulants,Personal history of other malignant neoplasm of skin,Inguinal hernia, without mention of obstruction or gangrene, unilateral or unspecified (not specified as recurrent)'}
