CHIEF COMPLAINT: 

PRESENT ILLNESS: The patient is a 77-year-old
woman who came in for a diagnostic catheterization after
admission for a congestive heart failure exacerbation one
week earlier.

MEDICAL HISTORY: 

MEDICATION ON ADMISSION: 1.  Lisinopril 50 mg p.o. q.d.
2.  Niacin 100 mg p.o. q.d.
3.  Lipitor 20 mg p.o. q.d.
4.  Multivitamin.
5.  Enteric-coated aspirin 325 mg p.o. q.d.
6.  Atenolol 25 mg p.o. q.d.
7.  Imdur 30 mg p.o. q.d.
8.  Plavix 75 mg p.o. q.d.
9.  Insulin NPH 10 units q.a.m.

ALLERGIES: PENICILLIN, TETRACYCLINE, AZATHIOPRINE,
PROCARDIA.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: 
Coronary atherosclerosis of unspecified type of vessel, native or graft,Congestive heart failure, unspecified,Intermediate coronary syndrome,Methicillin susceptible Staphylococcus aureus septicemia,Iatrogenic cerebrovascular infarction or hemorrhage,Anoxic brain damage,Mitral valve disorders,Chronic airway obstruction, not elsewhere classified
Cor ath unsp vsl ntv/gft,CHF NOS,Intermed coronary synd,Meth susc Staph aur sept,Iatrogen CV infarc/hmrhg,Anoxic brain damage,Mitral valve disorder,Chr airway obstruct NEC
Name:  [**Known lastname 15272**], [**Known firstname 6758**]                     Unit No:  [**Numeric Identifier 15273**]

Admission Date:  [**2127-8-5**]     Discharge Date:  [**2127-8-20**]

Date of Birth:   [**2049-11-14**]     Sex:  F

Service:

ADDENDUM:

Patient's past medical history includes:
1.  Coronary artery disease status post myocardial infarction
on [**2-2**], [**6-20**].
2.  Congestive heart failure with an ejection fraction of 20%
(resting regional wall motion abnormalities including mid to
distal anterior, septal and apical akinesis with hypokinesis
elsewhere).
3.  Hypertension.
4.  PVD status post bilateral lower extremity toe amputation.
5.  Hip fracture times two, left shoulder fracture.
6.  Degenerative joint disease.
7.  Chronic obstructive pulmonary disease.




                      DR.[**Last Name (STitle) **],[**First Name3 (LF) **] 12-255

Dictated By:[**Last Name (NamePattern4) 15275**]

MEDQUIST36

D:  [**2127-8-20**]  16:04
T:  [**2127-8-21**]  12:13
JOB#:  [**Job Number 15276**]


Admission Date:  [**2127-8-5**]     Discharge Date:  [**2127-8-20**]


Service:  CCU

HISTORY OF PRESENT ILLNESS:  The patient is a 77-year-old
woman who came in for a diagnostic catheterization after
admission for a congestive heart failure exacerbation one
week earlier.

MEDICATIONS ON ADMISSION:
1.  Lisinopril 50 mg p.o. q.d.
2.  Niacin 100 mg p.o. q.d.
3.  Lipitor 20 mg p.o. q.d.
4.  Multivitamin.
5.  Enteric-coated aspirin 325 mg p.o. q.d.
6.  Atenolol 25 mg p.o. q.d.
7.  Imdur 30 mg p.o. q.d.
8.  Plavix 75 mg p.o. q.d.
9.  Insulin NPH 10 units q.a.m.

ALLERGIES:  PENICILLIN, TETRACYCLINE, AZATHIOPRINE,
PROCARDIA.

HOSPITAL COURSE:  The catheterization showed diffuse 3-vessel
coronary artery disease.  The left main coronary artery had
40% distal stenosis.  The left anterior descending artery was
diffusely diseased with serial 50% lesions.  The dominant
left circumflex artery had a diffusely disease mid vessel,
and the first posterior descending artery was normal.  The
origin of the bifurcating first obtuse marginal branch with a
60% stenosis, and there was a long diffuse 60% stenosis
distal to the previously placed stent with a long 90%
stenosis in the lower pole.

The patient was awaiting coronary artery bypass graft on the
floor when she went into flash pulmonary edema and was
intubated.  She was believed at that point not to be an
appropriate surgical candidate and was sent back to the
catheterization laboratory for a therapeutic catheterization.
Successful percutaneous transluminal coronary angioplasty of
the bifurcating obtuse marginal branch was performed proximal
to the bifurcation but distal to the previously placed stent.

The patient was transferred to the Coronary Care Unit where
she experienced a prolonged intubation due to persistent
sedation.  Neurology was consulted, and a magnetic resonance
imaging was done which was nondiagnostic secondary to motion
defect.  An electroencephalogram was done as well showing
nonspecific flowing pattern.  As no other organic causes were
found, the patient's prolonged sedation was felt to be a
result of a hypoxic brain injury.  All sedatives were held,
and one week after being unresponsive even to painful
stimuli, the patient began to awaken.  She was extubated
successfully and had rapid improvement.

During her intubation, the patient spiked a fever and was pan
cultured.  She was found to have sputum positive for
levofloxacin-resistant Staphylococcus aureus.  All other
cultures, including blood and urine, were otherwise negative.
The patient was initially started on vancomycin and
levofloxacin.  Vancomycin was discontinued after five days
when sensitivities returned.  The patient was to be continued
on levofloxacin orally for a 14-day course.

MEDICATIONS ON DISCHARGE:
1.  Atorvastatin 20 mg p.o. q.d.
2.  Aspirin 325 mg p.o. q.d.
3.  Plavix 75 mg p.o. q.d.
4.  Lisinopril 20 mg p.o. q.d.
5.  Lasix 80 mg p.o. q.d.
6.  Metoprolol-XL 100 mg p.o. q.d.
7.  NPH 10 units q.a.m.
8.  Levofloxacin 500 mg p.o. q.d. (started on [**2127-8-12**]; to be completed on [**2127-8-26**]).

CONDITION AT DISCHARGE:  Condition on discharge was stable.

DISCHARGE STATUS:  Discharged to a rehabilitation facility.

CODE STATUS:  Full code.

DISCHARGE FOLLOWUP:  The patient was to follow up with her
primary care physician (Dr. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **]) within two weeks.





                          [**First Name11 (Name Pattern1) **] [**Initials (NamePattern4) **] [**Last Name (NamePattern4) **], M.D.  [**MD Number(1) 4786**]

Dictated By:[**Last Name (NamePattern4) 8500**]

MEDQUIST36

D:  [**2127-8-20**]  16:01
T:  [**2127-8-26**]  08:22
JOB#:  [**Job Number **]


Name:  [**Known lastname 15272**], [**Known firstname 6758**]                     Unit No:  [**Numeric Identifier 15273**]

Admission Date:  [**2127-8-5**]     Discharge Date:  [**2127-8-20**]

Date of Birth:   [**2049-11-14**]     Sex:  F

Service:

ADDENDUM:

Patient's past medical history includes:
1.  Coronary artery disease status post myocardial infarction
on [**2-2**], [**6-20**].
2.  Congestive heart failure with an ejection fraction of 20%
(resting regional wall motion abnormalities including mid to
distal anterior, septal and apical akinesis with hypokinesis
elsewhere).
3.  Hypertension.
4.  PVD status post bilateral lower extremity toe amputation.
5.  Hip fracture times two, left shoulder fracture.
6.  Degenerative joint disease.
7.  Chronic obstructive pulmonary disease.




                        DR.[**Last Name (STitle) **],[**First Name3 (LF) **] 12-255

Dictated By:[**Last Name (NamePattern4) 15275**]

MEDQUIST36

D:  [**2127-8-20**]  16:04
T:  [**2127-8-21**]  12:13
JOB#:  [**Job Number 15276**]
{'Coronary atherosclerosis of unspecified type of vessel, native or graft,Congestive heart failure, unspecified,Intermediate coronary syndrome,Methicillin susceptible Staphylococcus aureus septicemia,Iatrogenic cerebrovascular infarction or hemorrhage,Anoxic brain damage,Mitral valve disorders,Chronic airway obstruction, not elsewhere classified'}


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 77-year-old
woman who came in for a diagnostic catheterization after
admission for a congestive heart failure exacerbation one
week earlier.

MEDICAL HISTORY: 

MEDICATION ON ADMISSION: 1.  Lisinopril 50 mg p.o. q.d.
2.  Niacin 100 mg p.o. q.d.
3.  Lipitor 20 mg p.o. q.d.
4.  Multivitamin.
5.  Enteric-coated aspirin 325 mg p.o. q.d.
6.  Atenolol 25 mg p.o. q.d.
7.  Imdur 30 mg p.o. q.d.
8.  Plavix 75 mg p.o. q.d.
9.  Insulin NPH 10 units q.a.m.

ALLERGIES: PENICILLIN, TETRACYCLINE, AZATHIOPRINE,
PROCARDIA.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY:  

### Response:
{'Coronary atherosclerosis of unspecified type of vessel, native or graft,Congestive heart failure, unspecified,Intermediate coronary syndrome,Methicillin susceptible Staphylococcus aureus septicemia,Iatrogenic cerebrovascular infarction or hemorrhage,Anoxic brain damage,Mitral valve disorders,Chronic airway obstruction, not elsewhere classified'}
