CHIEF COMPLAINT: SAH

PRESENT ILLNESS: 49-year-old man with no significant PMH who presents with
unresponsiveness. Per his wife, who is a VA MICU nurse, he was
behaving unusually yesterday. He had 3 motor vehicle accidents
in one day, each time because he was following too closely. His
wife also notes that he was having some difficulty speaking,
substituting incorrect words - hospital for church, for example.
He was also disoriented, not knowing what day of the week it
was. She was unaware of any fever, headache, or other complaint.
She did note that he had some upper respiratory symptoms
(cold-like) one week prior.
After the 3rd MVA, he was taken to [**Hospital3 417**] where a head
CT was reportedly normal. He was discharged.
This morning, he was sleeping comfortably when his wife woke up
at 8 am. She took a shower, and returned to find him in bed not
breathing. She could not find a carotid pulse, and so told her
daughter to call 911 and she began performing CPR. EMS intubated
him in the field and administered one defibrillator shock. At
[**Hospital3 **], he received 1 additional shock, 3 amps of epi and 3 of
atropine before pulse restored weakly. CT showed diffuse
cerebral edema with SAH. He was transferred to [**Hospital1 18**]

MEDICAL HISTORY: None significant per wife

MEDICATION ON ADMISSION: ASA
Iron

ALLERGIES: No Drug Allergy Information on File

PHYSICAL EXAM: Vitals: T: 93.1 P: 129 R: 30 (vent setting) BP: 77/58 on
Dopamine, Levophed, Neosynephrine, and Vasopressin SaO2: 85% on
AC 30 x550, PEEP 5
General: Awake, cooperative, NAD.
HEENT: Periorbital edema, dried blood around nares.
Pulmonary: Lungs CTA bilaterally without R/R/W
Cardiac: Tachycardic, nl. S1S2, no M/R/G noted
Abdomen: soft, NT/ND, normoactive bowel sounds, no masses or
organomegaly noted.
Extremities: Cool.
Skin: no rashes or lesions noted.
Neurologic:
He is unresponsive to painful stimuli. GCS 3.
His pupils are fixed bilaterally at 9 mm. No corneal,
oculocephalic, or gag reflex.
No movement to pain in any extremity.
No reflexes throughout. Toes mute.

FAMILY HISTORY: Non contrib

SOCIAL HISTORY: Lives with wife. Only travel had been to [**Country 149**] in [**Month (only) **]
Cardiac arrest,Subarachnoid hemorrhage,Cerebral edema,Personal history of sudden cardiac arrest
Cardiac arrest,Subarachnoid hemorrhage,Cerebral edema,Hx sudden cardiac arrest
Admission Date:  [**2181-7-10**]              Discharge Date:   [**2181-7-10**]

Date of Birth:  [**2132-6-13**]             Sex:   M

Service: SURGERY

Allergies:
No Drug Allergy Information on File

Attending:[**First Name3 (LF) 2534**]
Chief Complaint:
SAH

Major Surgical or Invasive Procedure:
None

History of Present Illness:
49-year-old man with no significant PMH who presents with
unresponsiveness. Per his wife, who is a VA MICU nurse, he was
behaving unusually yesterday. He had 3 motor vehicle accidents
in one day, each time because he was following too closely. His
wife also notes that he was having some difficulty speaking,
substituting incorrect words - hospital for church, for example.
He was also disoriented, not knowing what day of the week it
was. She was unaware of any fever, headache, or other complaint.
She did note that he had some upper respiratory symptoms
(cold-like) one week prior.
After the 3rd MVA, he was taken to [**Hospital3 417**] where a head
CT was reportedly normal. He was discharged.
This morning, he was sleeping comfortably when his wife woke up
at 8 am. She took a shower, and returned to find him in bed not
breathing. She could not find a carotid pulse, and so told her
daughter to call 911 and she began performing CPR. EMS intubated
him in the field and administered one defibrillator shock. At
[**Hospital3 **], he received 1 additional shock, 3 amps of epi and 3 of
atropine before pulse restored weakly. CT showed diffuse
cerebral edema with SAH. He was transferred to [**Hospital1 18**]


Past Medical History:
None significant per wife

Social History:
Lives with wife. Only travel had been to [**Country 149**] in [**Month (only) **]

Family History:
Non contrib

Physical Exam:
Vitals: T: 93.1 P: 129 R: 30 (vent setting) BP: 77/58 on
Dopamine, Levophed, Neosynephrine, and Vasopressin SaO2: 85% on
AC 30 x550, PEEP 5
General: Awake, cooperative, NAD.
HEENT: Periorbital edema, dried blood around nares.
Pulmonary: Lungs CTA bilaterally without R/R/W
Cardiac: Tachycardic, nl. S1S2, no M/R/G noted
Abdomen: soft, NT/ND, normoactive bowel sounds, no masses or
organomegaly noted.
Extremities: Cool.
Skin: no rashes or lesions noted.
Neurologic:
He is unresponsive to painful stimuli. GCS 3.
His pupils are fixed bilaterally at 9 mm. No corneal,
oculocephalic, or gag reflex.
No movement to pain in any extremity.
No reflexes throughout. Toes mute.


Pertinent Results:
[**2181-7-10**] 04:48PM   FDP-[**Telephone/Fax (1) 14007**]*
[**2181-7-10**] 04:45PM   TYPE-ART PO2-49* PCO2-52* PH-7.08* TOTAL
CO2-16* BASE XS--15
[**2181-7-10**] 04:45PM   LACTATE-4.5* K+-4.5
[**2181-7-10**] 04:45PM   freeCa-1.11*
[**2181-7-10**] 04:44PM   PT-48.0* PTT-150* INR(PT)-5.4*
[**2181-7-10**] 03:39PM   TYPE-ART PO2-70* PCO2-62* PH-7.02* TOTAL
CO2-17* BASE XS--16
[**2181-7-10**] 03:39PM   NA+-137 K+-4.8 CL--116*
[**2181-7-10**] 03:39PM   freeCa-1.10*
[**2181-7-10**] 03:21PM   TYPE-ART PO2-74* PCO2-67* PH-6.98* TOTAL
CO2-17* BASE XS--17
[**2181-7-10**] 03:21PM   GLUCOSE-91 LACTATE-4.2*
[**2181-7-10**] 03:21PM   freeCa-1.00*
[**2181-7-10**] 03:00PM   GLUCOSE-119* UREA N-20 CREAT-2.4* SODIUM-139
POTASSIUM-6.1* CHLORIDE-105 TOTAL CO2-19* ANION GAP-21*
[**2181-7-10**] 03:00PM   estGFR-Using this
[**2181-7-10**] 03:00PM   ALT(SGPT)-2220* AST(SGOT)-1719* CK(CPK)-960*
ALK PHOS-169* AMYLASE-796* TOT BILI-0.4
[**2181-7-10**] 03:00PM   LIPASE-268*
[**2181-7-10**] 03:00PM   CK-MB-89* MB INDX-9.3 cTropnT-1.83*
[**2181-7-10**] 03:00PM   ALBUMIN-3.6 CALCIUM-8.6 PHOSPHATE-10.2*
MAGNESIUM-2.5
[**2181-7-10**] 03:00PM   WBC-15.3* RBC-5.03 HGB-15.0 HCT-46.7 MCV-93
MCH-29.8 MCHC-32.1 RDW-13.8
[**2181-7-10**] 03:00PM   NEUTS-58 BANDS-27* LYMPHS-9* MONOS-2 EOS-0
BASOS-0 ATYPS-0 METAS-3* MYELOS-1* NUC RBCS-1*
[**2181-7-10**] 03:00PM   HYPOCHROM-NORMAL ANISOCYT-1+ POIKILOCY-1+
MACROCYT-1+ MICROCYT-NORMAL POLYCHROM-NORMAL OVALOCYT-OCCASIONAL
BURR-OCCASIONAL TEARDROP-OCCASIONAL
[**2181-7-10**] 03:00PM   PLT SMR-NORMAL PLT COUNT-242

Brief Hospital Course:
Pt is a 49 year old AA married M medflighted from [**Hospital3 417**]
Hospital in [**Hospital1 1474**] s/p being found w/o pulse by his wife
earlier this morning. Per pt's wife, [**Name (NI) **] [**Name (NI) **], pt displayed
changes in mental status yesterday, followed by 3(?) car
accidents. He was brought to [**Hospital3 **] Hospital yesterday and
released last night when his CT was clear.  This morning, pt's
wife left him alone for approx 15 minutes and returned to find
him w/o a pulse. She performed CPR and he was brought back to
[**Hospital3 **] and then transf'd to [**Hospital1 18**]. Imaging at [**Hospital3 **]
revealed diffuse cerebral edema with SAH. Patient was evaluated
by neurosurgery who believed there was no intervention possible.
Patient was resuscitated in the TICU, however patient was brain
dead and soon passed away.

Medications on Admission:
ASA
Iron


Discharge Medications:
None

Discharge Disposition:
Expired

Discharge Diagnosis:
SAH

Discharge Condition:
Expired

Discharge Instructions:
None

Followup Instructions:
None
{'Cardiac arrest,Subarachnoid hemorrhage,Cerebral edema,Personal history of sudden cardiac arrest'}


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: SAH

PRESENT ILLNESS: 49-year-old man with no significant PMH who presents with
unresponsiveness. Per his wife, who is a VA MICU nurse, he was
behaving unusually yesterday. He had 3 motor vehicle accidents
in one day, each time because he was following too closely. His
wife also notes that he was having some difficulty speaking,
substituting incorrect words - hospital for church, for example.
He was also disoriented, not knowing what day of the week it
was. She was unaware of any fever, headache, or other complaint.
She did note that he had some upper respiratory symptoms
(cold-like) one week prior.
After the 3rd MVA, he was taken to [**Hospital3 417**] where a head
CT was reportedly normal. He was discharged.
This morning, he was sleeping comfortably when his wife woke up
at 8 am. She took a shower, and returned to find him in bed not
breathing. She could not find a carotid pulse, and so told her
daughter to call 911 and she began performing CPR. EMS intubated
him in the field and administered one defibrillator shock. At
[**Hospital3 **], he received 1 additional shock, 3 amps of epi and 3 of
atropine before pulse restored weakly. CT showed diffuse
cerebral edema with SAH. He was transferred to [**Hospital1 18**]

MEDICAL HISTORY: None significant per wife

MEDICATION ON ADMISSION: ASA
Iron

ALLERGIES: No Drug Allergy Information on File

PHYSICAL EXAM: Vitals: T: 93.1 P: 129 R: 30 (vent setting) BP: 77/58 on
Dopamine, Levophed, Neosynephrine, and Vasopressin SaO2: 85% on
AC 30 x550, PEEP 5
General: Awake, cooperative, NAD.
HEENT: Periorbital edema, dried blood around nares.
Pulmonary: Lungs CTA bilaterally without R/R/W
Cardiac: Tachycardic, nl. S1S2, no M/R/G noted
Abdomen: soft, NT/ND, normoactive bowel sounds, no masses or
organomegaly noted.
Extremities: Cool.
Skin: no rashes or lesions noted.
Neurologic:
He is unresponsive to painful stimuli. GCS 3.
His pupils are fixed bilaterally at 9 mm. No corneal,
oculocephalic, or gag reflex.
No movement to pain in any extremity.
No reflexes throughout. Toes mute.

FAMILY HISTORY: Non contrib

SOCIAL HISTORY: Lives with wife. Only travel had been to [**Country 149**] in [**Month (only) **] 

### Response:
{'Cardiac arrest,Subarachnoid hemorrhage,Cerebral edema,Personal history of sudden cardiac arrest'}
