CHIEF COMPLAINT: 

PRESENT ILLNESS: [**Doctor Last Name **] is a 24 year-old woman who
is originally from [**Country 149**] and has been asymptomatic.  She was
discovered to have a heart murmur on routine examination by
her primary care physician who sent her for an
echocardiogram.  The echocardiogram revealed a large atrial
septal defect leading to a cardiac catheterization.
Echocardiogram was done on [**2190-10-13**] and it showed
the left ventricular to have normal systolic function, but
there was diastolic septal flattening.  PA pressure was
estimated to be 35 to 40 and there was a secundum ASD with an
estimated QPQS of 3.0.

MEDICAL HISTORY: 

MEDICATION ON ADMISSION: 

ALLERGIES: None.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: Originally from [**Country 149**].  Denies alcohol use.
Denies tobacco use.  Lives with friend and family in the
[**Name (NI) 86**] area.
Ostium secundum type atrial septal defect
Secundum atrial sept def
Admission Date:  [**2190-12-6**]       Discharge Date:  [**2190-12-10**]

Date of Birth:   [**2166-8-26**]       Sex:  F

Service:  CARDIOTHORACIC

HISTORY OF PRESENT ILLNESS:  [**Doctor Last Name **] is a 24 year-old woman who
is originally from [**Country 149**] and has been asymptomatic.  She was
discovered to have a heart murmur on routine examination by
her primary care physician who sent her for an
echocardiogram.  The echocardiogram revealed a large atrial
septal defect leading to a cardiac catheterization.
Echocardiogram was done on [**2190-10-13**] and it showed
the left ventricular to have normal systolic function, but
there was diastolic septal flattening.  PA pressure was
estimated to be 35 to 40 and there was a secundum ASD with an
estimated QPQS of 3.0.

PAST MEDICAL HISTORY/SURGICAL HISTORY:  Noncontributory.

MEDICATION:  None.

ALLERGIES:  None.

SOCIAL HISTORY:  Originally from [**Country 149**].  Denies alcohol use.
Denies tobacco use.  Lives with friend and family in the
[**Name (NI) 86**] area.

ST[**Last Name (STitle) 54310**]  Electrocardiogram shows a right bundle branch block
with a right axis deviation, Q waves inferiorly.  Cardiac
catheterization showed normal ventricular size and systolic
function with an EF of 55 to 60, secundum ASD with
significant left to right shunting, dilated right atrium and
right ventricle with mild pulmonary hypertension, trace
mitral and tricuspid regurgitation, elevated transpulmonic
velocity consistent with increased flow from intracardiac
shunting.  The patient was referred to Dr. [**Last Name (Prefixes) **] for
ASD repair.

PHYSICAL EXAMINATION PRIOR TO ADMISSION:  Height 5'.  Weight
66 kilograms.  Vital signs temperature 96.2.  Heart rate 72.
Blood pressure 113/65.  Respiratory rate 16.  O2 sat 100% on
room air.  General young woman in no acute distress.  Skin
warm and dry.  No rashes or lesions.  HEENT pupils are equal,
round and reactive to light.  Anicteric.  Noninjected.  Neck
is supple. No JVD.  No lymphadenopathy.  Chest is clear to
auscultation bilaterally.  Heart regular rate and rhythm with
a 2/6 systolic ejection murmur.  Abdomen soft, nontender,
nondistended with positive bowel sounds.  Extremities are
warm and well perfused with no clubbing, cyanosis or edema.
No varicosities.  Neurological is a nonfocal examination.
Pulses are 1+ throughout.

LABORATORY DATA PREADMISSION TESTING [**12-3**]:  White blood cell
count 9, hematocrit 39, platelets 311.  [**Name (NI) 2591**] PT 13, PTT
25.8, INR 1.1.  Electrolytes sodium 139, potassium 3.8,
chloride 104, CO2 29, BUN 12, creatinine 0.5, glucose 88.

HOSPITAL COURSE:  The patient was a direct admission to the
Operating Room on [**12-6**] at which time she underwent an
AFB repair.  The patient tolerated the operation well and was
transferred from the Operating Room to the Cardiothoracic
Intensive Care Unit.  She did well in the immediate
postoperative period.  Her anesthesia was reversed.  She was
weaned from the ventilator and successfully extubated.  The p
remained hemodynamically stable throughout the day of her
surgery on postoperative day one.  She remained
hemodynamically stable without any cardioactive intravenous
medications and she was transferred to the floor for
continuing postoperative care and cardiac rehabilitation.
Once on the floor the patient had an uneventful postoperative
course.  On postoperative day two her chest tube was removed.
With the assistance of the nursing staff and physical therapy
her activity was increased gradually over the next several
days and on postoperative day four it was decided that the
patient was stable and ready to be discharged home.

At the time of discharge the patient's physical examination
revealed vital signs temperature 99.  Heart rate 75 sinus
rhythm.  Blood pressure 95/51.  Respiratory rate 18.  O2 sat
98% on room air.  Weight preoperatively 66 kilograms and at
discharge is 65.2 kilograms.  Physical examination
neurological alert and oriented times three.  Moves all
extremities and follows commands, nonfocal examination.
Respirations clear to auscultation bilaterally.
Cardiovascular regular rate and rhythm.  S1 and S2.  Right
thoracotomy incision with Steri-Strips open to air clean and
dry.  Abdomen soft, nontender, nondistended.  Normoactive
bowel sounds.  Extremities are warm and well perfuse with no
edema.  Left femoral cannulation site with Steri-Strips open
to air clean and dry.

Laboratories on discharge, white blood cell count 10.8,
hematocrit 31, sodium 135, potassium 3.6, chloride 107, CO2
26, BUN 6, creatinine 0.4, glucose 101.

CONDITION ON DISCHARGE:  Good.

DISCHARGE DIAGNOSIS:
Status post AFB repair.

DISCHARGE MEDICATIONS:
1.  Aspirin 325 mg po q.d.
2.  Colace 100 mg b.i.d.
3.  Ibuprofen 400 mg q 6 hours.
4.  Zantac 150 mg b.i.d.
5.  Percocet 5/325 one to two tabs q 4 to 6 hours prn.

DI[**Last Name (STitle) 408**]E STATUS:  She is to be discharged to home.  She is
to have follow up in the wound clinic in two weeks and follow
up with her primary care physician [**Last Name (NamePattern4) **]. [**Last Name (STitle) 349**] in three to
four weeks and follow up with Dr. [**Last Name (Prefixes) **] in four weeks.






                            [**Doctor Last Name 412**] [**Last Name (Prefixes) 413**], M.D.  [**MD Number(1) 414**]

Dictated By:[**Doctor Last Name 9076**]
MEDQUIST36

D:  [**2190-12-10**]  10:57
T:  [**2190-12-10**]  11:15
JOB#:  [**Job Number 54311**]
{'Ostium secundum type atrial septal defect'}


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: [**Doctor Last Name **] is a 24 year-old woman who
is originally from [**Country 149**] and has been asymptomatic.  She was
discovered to have a heart murmur on routine examination by
her primary care physician who sent her for an
echocardiogram.  The echocardiogram revealed a large atrial
septal defect leading to a cardiac catheterization.
Echocardiogram was done on [**2190-10-13**] and it showed
the left ventricular to have normal systolic function, but
there was diastolic septal flattening.  PA pressure was
estimated to be 35 to 40 and there was a secundum ASD with an
estimated QPQS of 3.0.

MEDICAL HISTORY: 

MEDICATION ON ADMISSION: 

ALLERGIES: None.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: Originally from [**Country 149**].  Denies alcohol use.
Denies tobacco use.  Lives with friend and family in the
[**Name (NI) 86**] area. 

### Response:
{'Ostium secundum type atrial septal defect'}
