CHIEF COMPLAINT: upper back and shoulder pain

PRESENT ILLNESS: 60 year old female transferred from
LGH with ascending anyeursum and upper back pain. Referred to
cardiac surgery for further evaluation.

MEDICAL HISTORY: hyperlipidemia

MEDICATION ON ADMISSION: statin and motrin

ALLERGIES: No Known Allergies / Adverse Drug Reactions

PHYSICAL EXAM: Physical Exam

FAMILY HISTORY: non-contributory

SOCIAL HISTORY: lives with daughter
non [**Name2 (NI) 1818**]; no etoh
Thoracic aneurysm without mention of rupture,Pain in joint, shoulder region,Other and unspecified hyperlipidemia
Thoracic aortic aneurysm,Joint pain-shlder,Hyperlipidemia NEC/NOS
Admission Date:  [**2154-1-8**]              Discharge Date:   [**2154-1-10**]

Date of Birth:  [**2093-2-16**]             Sex:   F

Service: CARDIOTHORACIC

Allergies:
No Known Allergies / Adverse Drug Reactions

Attending:[**First Name3 (LF) 165**]
Chief Complaint:
upper back and shoulder pain

Major Surgical or Invasive Procedure:
None


History of Present Illness:
60 year old female transferred from
LGH with ascending anyeursum and upper back pain. Referred to
cardiac surgery for further evaluation.


Past Medical History:
hyperlipidemia

Social History:
lives with daughter
non [**Name2 (NI) 1818**]; no etoh

Family History:
non-contributory

Physical Exam:
Physical Exam

Pulse:93 Resp:14  O2 sat: 92/RA
B/P  112/80
Height:5'2"     Weight:

General:
Skin: Dry [x] intact [x]
HEENT: PERRLA [x] EOMI [x]
Neck:  Supple [x] Full ROM [x]
Chest: Lungs clear bilaterally [x]
Heart: RRR [x]  Irregular []  Murmur
Abdomen: Soft [x] non-distended [x] non-tender [x]  bowel sounds
+ [x]
Extremities: Warm [x], well-perfused [x]  Edema Varicosities:
None [x]
Neuro: Grossly intact
Pulses:
Femoral      Right:  +2 Left: +2
DP           Right:  +2 Left: +2
PT           [**Name (NI) 167**]:  +2 Left: +2
Radial       Right:  +2 Left: +2

Carotid Bruit        Right:  0  Left: 0


Pertinent Results:
[**2154-1-8**] 10:35PM URINE  BLOOD-NEG NITRITE-POS PROTEIN-NEG
GLUCOSE-NEG KETONE-NEG BILIRUBIN-NEG UROBILNGN-NEG PH-7.0
LEUK-NEG
[**2154-1-8**] 07:00PM   WBC-10.4 RBC-4.80 HGB-13.6 HCT-41.1 MCV-86
MCH-28.3 MCHC-33.1 RDW-13.3
[**2154-1-8**] 07:00PM   GLUCOSE-109* UREA N-13 CREAT-1.0 SODIUM-138
POTASSIUM-4.4 CHLORIDE-100 TOTAL CO2-24 ANION GAP-18

RIGHT SHOULDER, [**2154-1-9**]

CLINICAL INFORMATION: Question fracture, right subscapular pain.


FINDINGS:

There is a lucency arising at the glenoid neck suspicious for a
nondisplaced
fracture. If scapular fracture is suspected, then CT would be
more sensitive
for assessing this finding. The acromioclavicular joint and
glenohumeral
joints are otherwise congruent.


Brief Hospital Course:
Mrs. [**Known lastname 88086**] was admitted from LGH for evaluation of right
shulder and upper back pain. CT scan was done revealing 3.8cm
ascedning aortic aneurysm. She was also evaluated by orthopedics
and thought to have a subacute scapular glenoid neck fx. However
this may be old since the patient does not report any recent
trauma. Her pain is mostly based at the medial border of the
scapular suggestive of thoracoscapular  bursal pain. PT was
recommended for shoudler girlde strengthening and ROM. pain was
controlled with tylenol and warm packs. A repeat CT scan was
dome which revealed 3.8cm ascending aorta without aneurysmal
dilitation- this is unchanged from the CT scan two days prior.
She was cleared for discharge to home by Dr. [**First Name (STitle) **] and will
need a follow chest CT scan in 6-12months and physical therapy.


Medications on Admission:
statin and motrin

Discharge Medications:
1. aspirin 81 mg Tablet, Delayed Release (E.C.) Sig: One (1)
Tablet, Delayed Release (E.C.) PO DAILY (Daily).
Disp:*30 Tablet, Delayed Release (E.C.)(s)* Refills:*2*
2. ranitidine HCl 150 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
Disp:*30 Tablet(s)* Refills:*2*
3. docusate sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2
times a day).
4. acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO Q4H (every
4 hours) as needed for pain/fever.
5. atorvastatin 10 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
Disp:*30 Tablet(s)* Refills:*2*
6. metoprolol tartrate 25 mg Tablet Sig: One (1) Tablet PO TID
(3 times a day).
Disp:*90 Tablet(s)* Refills:*2*
7. ciprofloxacin 500 mg Tablet Sig: One (1) Tablet PO BID (2
times a day) for 5 days.
Disp:*10 Tablet(s)* Refills:*0*


Discharge Disposition:
Home With Service

Facility:
All Care VNA of Greater [**Location (un) **]

Discharge Diagnosis:
3.8cm Ascending aneurysm


Discharge Condition:
ambulating independently. pain controlled with tylenol and warm
packs.


Discharge Instructions:
Contact your primary care doctor if you developing worsening
shoulder or back pain, any difficulty breathing or symptoms that
concern you.

Followup Instructions:
Contact your primary care doctor for a follow appointment and
you will need a follow up chset CT scan in 6 months to one year


                             [**Name6 (MD) **] [**Name8 (MD) **] MD [**MD Number(2) 173**]

Completed by:[**2154-1-17**]
{'Thoracic aneurysm without mention of rupture,Pain in joint, shoulder region,Other and unspecified hyperlipidemia'}


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: upper back and shoulder pain

PRESENT ILLNESS: 60 year old female transferred from
LGH with ascending anyeursum and upper back pain. Referred to
cardiac surgery for further evaluation.

MEDICAL HISTORY: hyperlipidemia

MEDICATION ON ADMISSION: statin and motrin

ALLERGIES: No Known Allergies / Adverse Drug Reactions

PHYSICAL EXAM: Physical Exam

FAMILY HISTORY: non-contributory

SOCIAL HISTORY: lives with daughter
non [**Name2 (NI) 1818**]; no etoh 

### Response:
{'Thoracic aneurysm without mention of rupture,Pain in joint, shoulder region,Other and unspecified hyperlipidemia'}
