CHIEF COMPLAINT: Chest pain, depression, with suicidal
ideation.

PRESENT ILLNESS: This is a 39-year-old male with
a history of cocaine-induced myocardial infarction times two
(with a clean cardiac catheterization), and extensive
polysubstance abuse, and a history of depression who
presented complaining of suicidal ideation.

MEDICAL HISTORY: 1.  Human immunodeficiency virus; diagnosed in [**2188**].
Contracted from intravenous drug abuse.
2.  Hepatitis C.
3.  Bilateral neuropathy (on Neurontin).
4.  Cocaine-induced myocardial infarction times two with
clean coronary arteries on cardiac catheterization at
[**Hospital6 1129**] in [**2199-8-22**].
5.  Antisocial personality disorder.
6.  History of suicidal ideation and attempts.
7.  Polysubstance abuse including alcohol, crack cocaine, and
heroin.
8.  Multiple psychiatric admissions for depression and
substance abuse.
9.  Recently diagnosed with bipolar disorder.

MEDICATION ON ADMISSION: (Medications at High [**Last Name (un) **] were)
1.  Dapsone 100 mg p.o. once per day.
2.  Neurontin 600 mg p.o. three times per day.
3.  Epivir 150 mg p.o. twice per day.
4.  Zerit 40 mg p.o. twice per day.
5.  Protonix 40 mg p.o. once per day.
6.  Lithium 300 mg p.o. three times per day.
7.  Wellbutrin 100 mg p.o. twice per day.
8.  Depakote 250 mg p.o. three times per day.
9.  Sustiva 600 mg p.o. q.h.s.

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: Multiple jail time.  Crack cocaine, heroin,
and alcohol abuse.  Homeless.  He lives with a friend.
Unspecified disease of pericardium,Chronic hepatitis C without mention of hepatic coma,Cocaine abuse, unspecified,Other disorders of muscle, ligament, and fascia,Depressive disorder, not elsewhere classified,Old myocardial infarction,Asymptomatic human immunodeficiency virus [HIV] infection status,Bipolar I disorder, most recent episode (or current) unspecified
Pericardial disease NOS,Chrnc hpt C wo hpat coma,Cocaine abuse-unspec,Muscle/ligament dis NEC,Depressive disorder NEC,Old myocardial infarct,Asymp hiv infectn status,Bipolor I current NOS
Admission Date:  [**2200-5-5**]       Discharge Date:  [**2200-5-8**]

Date of Birth:   [**2160-7-22**]       Sex:  M

Service:  Medical Intensive Care Unit/[**Hospital1 139**]

CHIEF COMPLAINT:  Chest pain, depression, with suicidal
ideation.

HISTORY OF PRESENT ILLNESS:  This is a 39-year-old male with
a history of cocaine-induced myocardial infarction times two
(with a clean cardiac catheterization), and extensive
polysubstance abuse, and a history of depression who
presented complaining of suicidal ideation.

The patient reports having been checked out of a treatment
program at High [**Last Name (un) **] for his polysubstance abuse on the day
of admission.  He was hitching a ride to [**Location (un) 86**] and found
someone with cocaine and had a cocaine binge, and he came in
complaining of suicidal ideation and depression.

While in the Emergency Department, he developed chest pain
two to four hours after his crack cocaine use.
Electrocardiogram in the Emergency Department showed ST
elevations diffusely in leads V3 to V6.  He was initially
started on a ACE inhibitor and a heparin drip; both of which
were discontinued after receiving the cardiac catheterization
report from [**Hospital6 1129**] showing clean
coronary arteries.  The patient was started on diltiazem and
morphine sulfate with relief of pain.  Creatine kinase was
4348, but MB index and troponin levels were negative.

The patient was thought to have pericarditis and was treated
with ibuprofen, and the patient was thought to have an
elevated creatine kinase secondary to cocaine-induced
rhabdomyolysis.

He was admitted to the Coronary Care Unit for observation.
The Coronary Care Unit course was also significant for
abdominal pain which resolved.  He was worked up and seen by
Surgery.  An abdominal computed tomography scan was obtained
which showed no pathology.  The patient remained stable
medically with decreasing creatine kinase levels and was then
transferred to the [**Hospital1 139**] Service for further observation.

On transfer to the [**Hospital1 139**] Service, the patient complained of
continued intermittent chest pain with cough, and depression.
He denied any active suicidal ideation at that time.  He
denied any shortness of breath, sore throat, dysuria,
abdominal pain, nausea, vomiting, or diarrhea.  He denied any
diaphoresis or palpitations.

PAST MEDICAL HISTORY:
1.  Human immunodeficiency virus; diagnosed in [**2188**].
Contracted from intravenous drug abuse.
2.  Hepatitis C.
3.  Bilateral neuropathy (on Neurontin).
4.  Cocaine-induced myocardial infarction times two with
clean coronary arteries on cardiac catheterization at
[**Hospital6 1129**] in [**2199-8-22**].
5.  Antisocial personality disorder.
6.  History of suicidal ideation and attempts.
7.  Polysubstance abuse including alcohol, crack cocaine, and
heroin.
8.  Multiple psychiatric admissions for depression and
substance abuse.
9.  Recently diagnosed with bipolar disorder.

ALLERGIES:  No known drug allergies.

MEDICATIONS ON ADMISSION:  (Medications at High [**Last Name (un) **] were)
1.  Dapsone 100 mg p.o. once per day.
2.  Neurontin 600 mg p.o. three times per day.
3.  Epivir 150 mg p.o. twice per day.
4.  Zerit 40 mg p.o. twice per day.
5.  Protonix 40 mg p.o. once per day.
6.  Lithium 300 mg p.o. three times per day.
7.  Wellbutrin 100 mg p.o. twice per day.
8.  Depakote 250 mg p.o. three times per day.
9.  Sustiva 600 mg p.o. q.h.s.

MEDICATIONS ON TRANSFER:  (From the Coronary Care Unit)
 1.  Ibuprofen 400 mg p.o. q.8h.
 2.  Colace.
 3.  Ambien.
 4.  Tylenol.
 5.  Valium.
 6.  Zerit 40 mg p.o. twice per day.
 7.  Sustiva 600 mg p.o. q.h.s.
 8.  Epivir 150 mg p.o. twice per day.
 9.  Protonix 40 mg p.o. once per day.
10.  Neurontin 600 mg p.o. three times per day.
11.  Dapsone 100 mg p.o. once per day.
12.  Aspirin 325 mg p.o. every day.
13.  Subcutaneous heparin 5000 units subcutaneously twice per
day.

SOCIAL HISTORY:  Multiple jail time.  Crack cocaine, heroin,
and alcohol abuse.  Homeless.  He lives with a friend.

PHYSICAL EXAMINATION ON PRESENTATION:   Physical examination
revealed temperature was 98, blood pressure was 120/62, heart
rate was 72, respiratory rate was 16, oxygen saturation was
94% on room air.  In general, in no acute distress.  A
well-nourished young male who was eating in bed.  Mucous
membranes were moist.  No jugular venous distention.  The
chest was clear to auscultation bilaterally.  Heart
examination revealed a regular rate and rhythm.  Normal first
heart sounds and second heart sounds.  Positive third heart
sound.  No murmurs.  The abdomen was soft and nontender.
Normal active bowel sounds.  Neurologically, he was alert and
oriented times three with a depressed affect.

PERTINENT LABORATORY VALUES ON PRESENTATION:  Laboratory
studies revealed white blood cell count was 4.9, hematocrit
was 36.6, and platelets were 194.  INR was 1.1 and partial
thromboplastin time was 26.5.  Sodium was 137, potassium was
3.9, chloride was 102, bicarbonate was 28, blood urea
nitrogen was 9, creatinine was 0.7, and blood glucose was
124.  Calcium was 9, phosphate was 2.8, and magnesium was 2.
CD4 count was 521.  Vitamin B12 level was 570 and folate was
16.8.  Urinalysis was negative.  Lipase was 29.  Creatine
kinase trended down to 400 by [**5-7**].  CK/MB was negative.
Troponin I was negative.  Urine culture was negative.
Thyroid-stimulating hormone was 7.5 (elevated), but T4 was
normal at 6.4.  Lithium level was 0.4.  Urine toxicology
screen was positive for cocaine.

PERTINENT RADIOLOGY/IMAGING:  A computed tomography of the
abdomen was negative.

A chest x-ray was negative.

Electrocardiogram showed diffuse ST elevations in leads V3 to
V6.

HOSPITAL COURSE:   During the hospital course, the patient
remained stable.  The patient was treated with ibuprofen for
his pericarditis.

He was evaluated by the Psychiatry Service who recommended
holding all of his psychiatric medications while trying to
clarify his diagnosis.  The patient denied suicidal ideation
for the remainder of his hospital course.  He was contracted
for safety.  He was continued on his antiretroviral therapy
for his human immunodeficiency virus and Dapsone for
prophylaxis.

He was thought to have sick euthyroid syndrome with a normal
T4 and an elevated thyroid-stimulating hormone.  He was
screened for a diagnosis program to treat substance abuse as
well as his depression.

CONDITION AT DISCHARGE:  The patient was discharged in good
condition.

DISCHARGE DIAGNOSES:
1.  Pericarditis.
2.  Rhabdomyolysis (induced by cocaine).

MEDICATIONS ON DISCHARGE:
1.  Dapsone 100 mg p.o. once per day.
2.  Neurontin 600 mg p.o. three times per day.
3.  Epivir 150 mg p.o. twice per day.
4.  Zerit 40 mg p.o. twice per day.
5.  Protonix 40 mg p.o. once per day.
6.  Sustiva 600 mg p.o. q.h.s.
7.  Ibuprofen 600 mg p.o. q.4-6h. with meals as needed (for
chest pain).

DISCHARGE INSTRUCTIONS/FOLLOWUP:   The patient was to follow
up with the Psychiatry Service.





                            [**Doctor Last Name **] [**Name6 (MD) **] [**Name8 (MD) **], M.D.  [**MD Number(1) 5712**]

Dictated By:[**Name8 (MD) 43719**]
MEDQUIST36

D:  [**2200-5-7**]  15:02
T:  [**2200-5-7**]  17:31
JOB#:  [**Job Number 43720**]
{'Unspecified disease of pericardium,Chronic hepatitis C without mention of hepatic coma,Cocaine abuse, unspecified,Other disorders of muscle, ligament, and fascia,Depressive disorder, not elsewhere classified,Old myocardial infarction,Asymptomatic human immunodeficiency virus [HIV] infection status,Bipolar I disorder, most recent episode (or current) unspecified'}


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: Chest pain, depression, with suicidal
ideation.

PRESENT ILLNESS: This is a 39-year-old male with
a history of cocaine-induced myocardial infarction times two
(with a clean cardiac catheterization), and extensive
polysubstance abuse, and a history of depression who
presented complaining of suicidal ideation.

MEDICAL HISTORY: 1.  Human immunodeficiency virus; diagnosed in [**2188**].
Contracted from intravenous drug abuse.
2.  Hepatitis C.
3.  Bilateral neuropathy (on Neurontin).
4.  Cocaine-induced myocardial infarction times two with
clean coronary arteries on cardiac catheterization at
[**Hospital6 1129**] in [**2199-8-22**].
5.  Antisocial personality disorder.
6.  History of suicidal ideation and attempts.
7.  Polysubstance abuse including alcohol, crack cocaine, and
heroin.
8.  Multiple psychiatric admissions for depression and
substance abuse.
9.  Recently diagnosed with bipolar disorder.

MEDICATION ON ADMISSION: (Medications at High [**Last Name (un) **] were)
1.  Dapsone 100 mg p.o. once per day.
2.  Neurontin 600 mg p.o. three times per day.
3.  Epivir 150 mg p.o. twice per day.
4.  Zerit 40 mg p.o. twice per day.
5.  Protonix 40 mg p.o. once per day.
6.  Lithium 300 mg p.o. three times per day.
7.  Wellbutrin 100 mg p.o. twice per day.
8.  Depakote 250 mg p.o. three times per day.
9.  Sustiva 600 mg p.o. q.h.s.

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: Multiple jail time.  Crack cocaine, heroin,
and alcohol abuse.  Homeless.  He lives with a friend. 

### Response:
{'Unspecified disease of pericardium,Chronic hepatitis C without mention of hepatic coma,Cocaine abuse, unspecified,Other disorders of muscle, ligament, and fascia,Depressive disorder, not elsewhere classified,Old myocardial infarction,Asymptomatic human immunodeficiency virus [HIV] infection status,Bipolar I disorder, most recent episode (or current) unspecified'}
