CHIEF COMPLAINT: Aneurysm

PRESENT ILLNESS: Ms. [**Known lastname **] is a 59-year-old female with a history of an
incidental left MC aneurysm that was detected as part of workup
for moyamoya disease. She had a diagnostic angiogram.  She has
had significant disease of the right
hemisphere and she agreed to proceed for stent assisted coiling
of treatment of
the left middle cerebral artery aneurysm.

MEDICAL HISTORY: Past Medical History:
1. hypertension
2. hypercholesterolemia
3. vertigo

MEDICATION ON ADMISSION: metoprolol and nifedipine, omeprazole, oxybutynin, simvastatin,
ASA 81, Plavix

ALLERGIES: No Known Allergies / Adverse Drug Reactions

PHYSICAL EXAM: At discharge:nonfocal
groin soft and no hematoma, dorsalis pedis pulses 2+ bilaterally

FAMILY HISTORY: Non contributory

SOCIAL HISTORY: No smoking, etoh or illicit use.
Cantonese speaking. She has two children, she lives with her
daughter.
Cerebral aneurysm, nonruptured,Unspecified essential hypertension,Pure hypercholesterolemia
Nonrupt cerebral aneurym,Hypertension NOS,Pure hypercholesterolem
Admission Date:  [**2191-6-1**]              Discharge Date:   [**2191-6-2**]

Date of Birth:  [**2131-5-25**]             Sex:   F

Service: NEUROSURGERY

Allergies:
No Known Allergies / Adverse Drug Reactions

Attending:[**First Name3 (LF) 78**]
Chief Complaint:
Aneurysm

Major Surgical or Invasive Procedure:
[**2191-6-1**]: Cerebral Angiogram and stent/coiling of aneusyrm


History of Present Illness:
Ms. [**Known lastname **] is a 59-year-old female with a history of an
incidental left MC aneurysm that was detected as part of workup
for moyamoya disease. She had a diagnostic angiogram.  She has
had significant disease of the right
hemisphere and she agreed to proceed for stent assisted coiling
of treatment of
the left middle cerebral artery aneurysm.


Past Medical History:
Past Medical History:
1. hypertension
2. hypercholesterolemia
3. vertigo

Past Surgical History
1.  tubal ligation.


Social History:
No smoking, etoh or illicit use.
Cantonese speaking. She has two children, she lives with her
daughter.


Family History:
Non contributory


Physical Exam:
At discharge:nonfocal
groin soft and no hematoma, dorsalis pedis pulses 2+ bilaterally


Pertinent Results:
[**2191-6-1**] 09:40AM   GLUCOSE-104* UREA N-13 CREAT-0.6 SODIUM-144
POTASSIUM-3.5 CHLORIDE-109* TOTAL CO2-27 ANION GAP-12
[**2191-6-1**] 09:40AM   estGFR-Using this
[**2191-6-1**] 09:40AM   HCT-40.6
[**2191-6-1**] 09:40AM   PLT COUNT-283
[**2191-6-1**] 09:40AM   PT-13.1* PTT-31.3 INR(PT)-1.2*

Angiogram: successful stent assisted coiling of brain aneurysm

Brief Hospital Course:
Ms. [**Known lastname **] was taken to the IR suite with Dr. [**First Name (STitle) **] and
underwent a stent assisted coiling without complication under
GETA. She was extubated and taken to the SICU and was
neurologically intact post-op. She was on Aspirin and Plavix.
Overnight, her HOB and diet was advanced. On [**6-2**], patient was
nonfocal on exam and groin soft with no hematoma. She was
discharged home in stable condition.

Medications on Admission:
 metoprolol and nifedipine, omeprazole, oxybutynin, simvastatin,
ASA 81, Plavix


Discharge Medications:
1. aspirin 325 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).
Disp:*60 Tablet(s)* Refills:*2*
2. clopidogrel 75 mg Tablet Sig: One (1) Tablet PO DAILY (Daily)
for 1 months.
Disp:*QS Tablet(s)* Refills:*0*
3. metoprolol succinate 50 mg Tablet Extended Release 24 hr Sig:
One (1) Tablet Extended Release 24 hr PO DAILY (Daily).
4. nifedipine 30 mg Tablet Extended Release Sig: Two (2) Tablet
Extended Release PO DAILY (Daily).
5. omeprazole 20 mg Capsule, Delayed Release(E.C.) Sig: One (1)
Capsule, Delayed Release(E.C.) PO DAILY (Daily).
6. simvastatin 10 mg Tablet Sig: Two (2) Tablet PO DAILY
(Daily).
7. calcium carbonate 200 mg calcium (500 mg) Tablet, Chewable
Sig: One (1) Tablet, Chewable PO DAILY (Daily).
8. oxybutynin chloride 5 mg Tablet Sig: Two (2) Tablet PO TID (3
times a day).
9. oxycodone-acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO
Q6H (every 6 hours) as needed for pain.
Disp:*30 Tablet(s)* Refills:*0*


Discharge Disposition:
Home

Discharge Diagnosis:
MCA aneurysm


Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.


Discharge Instructions:
Medications:
??????	Take Aspirin 325mg (enteric coated) once daily.
??????	Take Plavix (Clopidogrel) 75mg once daily.
??????	Continue all other medications you were taking before surgery,
unless otherwise directed
??????	You make take Tylenol or prescribed pain medications for any
post procedure pain or discomfort.

What activities you can and cannot do:
??????	When you go home, you may walk and go up and down stairs.
??????	You may shower (let the soapy water run over groin incision,
rinse and pat dry)
??????	Your incision may be left uncovered, unless you have small
amounts of drainage from the wound, then place a dry dressing or
band aid over the area that is draining, as needed
??????	No heavy lifting, pushing or pulling (greater than 5 lbs) for
1 week (to allow groin puncture to heal).
??????	After 1 week, you may resume sexual activity.
??????	After 1 week, gradually increase your activities and distance
walked as you can tolerate.
??????	No driving until you are no longer taking pain medications


Followup Instructions:
Please call [**Telephone/Fax (1) 1669**] for follow up with Dr. [**First Name (STitle) **] in in 6
months with MRI/A of the head.



Completed by:[**2191-6-2**]
{'Cerebral aneurysm, nonruptured,Unspecified essential hypertension,Pure hypercholesterolemia'}


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: Aneurysm

PRESENT ILLNESS: Ms. [**Known lastname **] is a 59-year-old female with a history of an
incidental left MC aneurysm that was detected as part of workup
for moyamoya disease. She had a diagnostic angiogram.  She has
had significant disease of the right
hemisphere and she agreed to proceed for stent assisted coiling
of treatment of
the left middle cerebral artery aneurysm.

MEDICAL HISTORY: Past Medical History:
1. hypertension
2. hypercholesterolemia
3. vertigo

MEDICATION ON ADMISSION: metoprolol and nifedipine, omeprazole, oxybutynin, simvastatin,
ASA 81, Plavix

ALLERGIES: No Known Allergies / Adverse Drug Reactions

PHYSICAL EXAM: At discharge:nonfocal
groin soft and no hematoma, dorsalis pedis pulses 2+ bilaterally

FAMILY HISTORY: Non contributory

SOCIAL HISTORY: No smoking, etoh or illicit use.
Cantonese speaking. She has two children, she lives with her
daughter. 

### Response:
{'Cerebral aneurysm, nonruptured,Unspecified essential hypertension,Pure hypercholesterolemia'}
