CHIEF COMPLAINT: 7.2- cm infrarenal aortic aneurysm

PRESENT ILLNESS: The patient is a 71-year-old male with a known infrarenal
abdominal aortic aneurysm. He has a past medical history
significant for COPD with home oxygen, hypertension and obesity.
Do this the patients high risk of rupture the decision was made
to intervene and fix the aneursym. He was scheduled outpatient
for an endoluminal repair of abdominal aortic aneurysm on
[**2145-5-19**].

MEDICAL HISTORY: - COPD- baseline home O2 3LCN
- Morbid Obesity
- HTN
- HL
- AAA
- Pulm. nodule
- Edema
- S/P abd. hernia repair

MEDICATION ON ADMISSION: asa, enalapril, flovent, lasix, spiriva, simvastatin, home
oxygen 3L

ALLERGIES: scallops

PHYSICAL EXAM: VS:  T: 98    HR: 89     BP: 103/51    RR: 20      Spo2: 94%
2LNC
Gen: NAD, alert and oriented x 3
Neuro: CN II-XII intact
CV: RRR, no mrg,  + S1 + S2
Lungs: CTA bilaterally
Abd: soft, NT, obese, no rebound or guarding
Wound: Left groin with some erythema in skin folds
JP drain with minimal serous drainage
Bilateral lower extremities warm and dry. Signals per doppler
bilaterally.

FAMILY HISTORY: CAD/PVD - father and mother, died in their 70s
CVA - brother in 60s.  Brother diagnosed with alzheimers at age
60.

SOCIAL HISTORY: Lives at home with wife, daughter, son-in-law and 3
grandchildren.  Used to work as a office equipment repairman.
Tobacco - quit [**2136**], was a lifetime smoker - 1-2ppd for 43 years
EtOH - occasional ethanol
drug use - denies.
Abdominal aneurysm without mention of rupture,Cardiogenic shock,Subendocardial infarction, initial episode of care,Cardiac complications, not elsewhere classified,Arterial embolism and thrombosis of lower extremity,Acute posthemorrhagic anemia,Hematoma complicating a procedure,Coronary atherosclerosis of native coronary artery,Chronic airway obstruction, not elsewhere classified,Morbid obesity,Unspecified disorder of skin and subcutaneous tissue,Unspecified essential hypertension,Other and unspecified hyperlipidemia,Personal history of tobacco use,Other dependence on machines, supplemental oxygen,Surgical operation with anastomosis, bypass, or graft, with natural or artificial tissues used as implant causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation
Abdom aortic aneurysm,Cardiogenic shock,Subendo infarct, initial,Surg compl-heart,Lower extremity embolism,Ac posthemorrhag anemia,Hematoma complic proc,Crnry athrscl natve vssl,Chr airway obstruct NEC,Morbid obesity,Skin disorder NOS,Hypertension NOS,Hyperlipidemia NEC/NOS,History of tobacco use,Depend-supplement oxygen,Abn react-anastom/graft
Admission Date:  [**2145-5-19**]              Discharge Date:   [**2145-6-1**]

Date of Birth:  [**2073-9-20**]             Sex:   M

Service: SURGERY

Allergies:
scallops

Attending:[**First Name3 (LF) 2597**]
Chief Complaint:
7.2- cm infrarenal aortic aneurysm

Major Surgical or Invasive Procedure:
[**2145-5-19**] Endovascular AAA repair
[**2145-5-21**]  cardiac L main, RCA stents, L SFA thromb, CFA vein
followed by L SFA thrombectomy, CFA vein patch angioplasty


History of Present Illness:
The patient is a 71-year-old male with a known infrarenal
abdominal aortic aneurysm. He has a past medical history
significant for COPD with home oxygen, hypertension and obesity.
Do this the patients high risk of rupture the decision was made
to intervene and fix the aneursym. He was scheduled outpatient
for an endoluminal repair of abdominal aortic aneurysm on
[**2145-5-19**].


Past Medical History:
- COPD- baseline home O2 3LCN
- Morbid Obesity
- HTN
- HL
- AAA
- Pulm. nodule
- Edema
- S/P abd. hernia repair


Social History:
Lives at home with wife, daughter, son-in-law and 3
grandchildren.  Used to work as a office equipment repairman.
Tobacco - quit [**2136**], was a lifetime smoker - 1-2ppd for 43 years
EtOH - occasional ethanol
drug use - denies.


Family History:
CAD/PVD - father and mother, died in their 70s
CVA - brother in 60s.  Brother diagnosed with alzheimers at age
60.


Physical Exam:
VS:  T: 98    HR: 89     BP: 103/51    RR: 20      Spo2: 94%
2LNC
Gen: NAD, alert and oriented x 3
Neuro: CN II-XII intact
CV: RRR, no mrg,  + S1 + S2
Lungs: CTA bilaterally
Abd: soft, NT, obese, no rebound or guarding
Wound: Left groin with some erythema in skin folds
JP drain with minimal serous drainage
Bilateral lower extremities warm and dry. Signals per doppler
bilaterally.


Pertinent Results:
[**2145-6-1**] 07:08AM BLOOD WBC-9.9 RBC-4.25* Hgb-12.3* Hct-37.6*
MCV-89 MCH-29.0 MCHC-32.7 RDW-15.7* Plt Ct-372
[**2145-5-29**] 06:13AM BLOOD WBC-8.0 RBC-3.95* Hgb-11.7* Hct-35.3*
MCV-89 MCH-29.6 MCHC-33.1 RDW-16.0* Plt Ct-302
[**2145-5-28**] 04:28AM BLOOD WBC-7.2 RBC-3.73* Hgb-11.2* Hct-33.2*
MCV-89 MCH-29.9 MCHC-33.6 RDW-16.1* Plt Ct-257
[**2145-5-27**] 02:09AM BLOOD WBC-6.9 RBC-3.72* Hgb-11.2* Hct-33.7*
MCV-91 MCH-30.1 MCHC-33.3 RDW-16.3* Plt Ct-225
[**2145-6-1**] 07:08AM BLOOD Plt Ct-372
[**2145-5-29**] 06:13AM BLOOD Plt Ct-302
[**2145-5-28**] 06:19AM BLOOD PT-13.5* PTT-29.0 INR(PT)-1.2*
[**2145-5-28**] 04:28AM BLOOD Plt Ct-257
[**2145-6-1**] 07:08AM BLOOD Glucose-97 UreaN-33* Creat-1.1 Na-135
K-4.1 Cl-96 HCO3-28 AnGap-15
[**2145-5-30**] 07:55AM BLOOD Glucose-96 UreaN-25* Creat-0.9 Na-138
K-4.5 Cl-98 HCO3-31 AnGap-14
[**2145-5-29**] 06:13AM BLOOD Glucose-105* UreaN-22* Creat-0.9 Na-136
K-4.1 Cl-100 HCO3-30 AnGap-10
[**2145-5-28**] 04:28AM BLOOD Glucose-108* UreaN-23* Creat-0.9 Na-135
K-3.7 Cl-100 HCO3-27 AnGap-12
[**2145-5-24**] 03:13AM BLOOD ALT-23 AST-38 LD(LDH)-532* CK(CPK)-78
AlkPhos-80 Amylase-25 TotBili-1.4
[**2145-5-23**] 02:13AM BLOOD ALT-32 AST-91* LD(LDH)-701* CK(CPK)-223
AlkPhos-58 Amylase-16 TotBili-1.1
[**2145-5-24**] 03:13AM BLOOD CK-MB-6
[**2145-5-23**] 02:13AM BLOOD CK-MB-17* MB Indx-7.6* cTropnT-2.44*
[**2145-5-22**] 06:31AM BLOOD CK-MB-99* MB Indx-10.4* cTropnT-2.59*
[**2145-5-21**] 11:37PM BLOOD CK-MB-175* MB Indx-12.7* cTropnT-3.08*
[**2145-6-1**] 07:08AM BLOOD Calcium-8.5 Phos-3.3 Mg-2.4
[**2145-5-30**] 07:55AM BLOOD Calcium-8.8 Phos-3.6 Mg-2.3
[**2145-5-29**] 06:13AM BLOOD Calcium-8.6 Phos-2.9 Mg-2.3
[**2145-5-27**] 02:19AM BLOOD Type-ART pO2-88 pCO2-51* pH-7.34*
calTCO2-29 Base XS-0
[**2145-5-27**] 02:19AM BLOOD Glucose-86 K-4.4
[**2145-5-26**] 10:53PM BLOOD Glucose-81 K-3.8
[**2145-5-26**] 05:27PM BLOOD Glucose-81 K-3.5
[**2145-5-27**] 02:19AM BLOOD O2 Sat-95
[**2145-5-27**] 02:19AM BLOOD freeCa-1.27
[**2145-5-26**] 10:53PM BLOOD freeCa-1.23

CXR: [**2145-5-28**]
INDICATION: Abdominal aortic aneurysm stent, acute myocardial
infarct,
followup for resolution of congestive cardiac failure.

COMPARISON: Radiographs dating back to [**2145-2-3**] and most
recently [**2145-5-26**].

FINDINGS: A narrow tracheal coronal diameter is consistent with
a saber
sheath configuration. Indistinctness of the perihilar
vasculature bilaterally
with generalized ground-glass opacity has slightly improved
since [**2145-5-26**]
suggesting improving pulmonary venous congestion. The left hilum
is
prominent, but this most likely relates to mild pulmonary
arterial
enlargement, better characterized on CT of [**2145-2-4**]. Mild
cardiomegaly is
stable.

A right internal jugular central venous catheter tip is
projected over the
expected location of the brachiocephalic confluence. Since
[**2145-5-26**], an
endotracheal tube has been removed.

IMPRESSION:
Improving pulmonary edema.

The study and the report were reviewed by the staff radiologist.


Echo [**2145-5-24**]
Conclusions
The left atrium is mildly elongated. No atrial septal defect is
seen by 2D or color Doppler. Left ventricular wall thickness,
cavity size, and global systolic function are normal (LVEF>55%).
Due to suboptimal technical quality, a focal wall motion
abnormality cannot be fully excluded. Right ventricular chamber
size and free wall motion are normal. The aortic valve leaflets
are mildly thickened (?#). No aortic regurgitation is seen
(images suboptimal). The mitral valve is grossly normal. No
definite mitral regurgitation is seen. There is moderate
pulmonary artery systolic hypertension. There is an anterior
space which most likely represents a prominent fat pad.

Compared with the prior study (images reviewed) of [**2145-5-10**],
moderate pulmonary artery systolic hypertension is now
identified. Global biventricular systolic function is similar.



Brief Hospital Course:
On [**2145-5-19**] the patient presented to [**Hospital1 18**] for a scheduled
endovascular AAA repair by Dr. [**Last Name (STitle) **]. He was kept intubated
post operatively due to COPD history and transferred to the VICU
on a Neo-Synephrine gtt. Overnight in the ICU the patient
developed an acutely cold left foot without pedal signals.

An [**2145-5-20**] ECG obtained also showed changes in lateral lead with
elevated troponins which was concerning for coronary ischemia.
Bedside echo showed normal LF function. Cardiology recommended
medical management of heparin drip, serial ECGS and enzymes with
plavix, beta blocker,aspirin and lipitor. The decision was made
to extubate the patient which he tolerated for a few hours. By
mid afternoon the patient continues to have a cold, pulseless
foot on heparin drip. He required re-intubation and the decision
was made to return the patient to the cath lab for a coronary
intervention for STEMI as well as an attempt to revascularize
his left leg.

[**2145-5-21**] Taken to the Cath lab and the Cardiology team placed
PTCA/stent of the LM and RCA (the patient will need to remain on
plavix for at least 3 months). He subsequently had a left common
iliac thrombectomy and vein patch of the common femoral artery.
Transferred back to ICU on levo and nitro gtt and fluid boluses
for hypotension. Kept in ICU on heparin gtt. Foot perfusion
improved and hct stable.

4/16-222
Remained in ICU with BP management and vent support. Required
days of weaning to extubation. Cardiac enzymes continued to
trend down. Continued on heparin gtt. Continued to diuresis in
the ICU. Levo weaned for BP management. On [**5-26**] the patient was
extubated, OOB with physical therapy as a max assist. Continued
on heparin gtt. On [**2145-5-28**] the patient was transferred to the
Vascular stepdown. OOB with PT. Continued diuresis.

[**2145-5-30**] Stable in VICU on nasal cannula. Dermatology saw patient
in VICU for left shin skin lesion. Recommended biopsy as an
outpatient- patient is aware but refused presently. Physical
therapy recommended Rehab. Patient awaiting bed placement. No
acute issues.

[**2145-6-1**] Discharged to Rehab. Family aware of plan. Will be sent
with JP drain. Will follow up with Dr. [**Last Name (STitle) **] in 1 week for
drain and staple removal and wound check. Atrius Cards office
was notified of patient's discharge and will call [**Location (un) 2199**]
Lifecare with a time.

Medications on Admission:
asa, enalapril, flovent, lasix, spiriva, simvastatin, home
oxygen 3L

Discharge Medications:
1. miconazole nitrate 2 % Powder Sig: One (1) Appl Topical QID
(4 times a day) as needed for left groin fold.
2. cephalexin 500 mg Capsule Sig: One (1) Capsule PO Q6H (every
6 hours).
3. aspirin 325 mg Tablet, Delayed Release (E.C.) Sig: One (1)
Tablet, Delayed Release (E.C.) PO DAILY (Daily).
4. clopidogrel 75 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
5. albuterol sulfate 2.5 mg /3 mL (0.083 %) Solution for
Nebulization Sig: One (1)  Inhalation Q6H (every 6 hours) as
needed for wheezing.
6. ipratropium bromide 0.02 % Solution Sig: One (1)  Inhalation
Q6H (every 6 hours) as needed for wheezing.
7. heparin (porcine) 5,000 unit/mL Solution Sig: One (1)
Injection TID (3 times a day): while decreased mobility.
8. docusate sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2
times a day).
9. enalapril maleate 5 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
10. tiotropium bromide 18 mcg Capsule, w/Inhalation Device Sig:
One (1) Cap Inhalation DAILY (Daily).
11. albuterol sulfate 90 mcg/Actuation HFA Aerosol Inhaler Sig:
2-4 Puffs Inhalation Q4H (every 4 hours) as needed for wheezing.

12. fluticasone 110 mcg/Actuation Aerosol Sig: Two (2) Puff
Inhalation [**Hospital1 **] (2 times a day).
13. ipratropium bromide 17 mcg/Actuation HFA Aerosol Inhaler
Sig: Four (4) Puff Inhalation QID (4 times a day).
14. acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO Q6H
(every 6 hours) as needed for pain.
15. simvastatin 40 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
16. pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One
(1) Tablet, Delayed Release (E.C.) PO Q24H (every 24 hours).
17. Lasix 20 mg Tablet Sig: One (1) Tablet PO once a day: may
increase to twice daily if needed .
18. metoprolol tartrate 25 mg Tablet Sig: One (1) Tablet PO TID
(3 times a day): new med
.
19. Insulin Sliding Scale- Regular
Insulin SC Sliding Scale
  Breakfast Lunch Dinner Bedtime
Regular Regular Regular Regular
Glucose Insulin Dose Insulin Dose Insulin Dose Insulin Dose
0-70   mg/dL Proceed with hypoglycemia protocol
71-119   mg/dL 0   Units 0   Units 0   Units 0   Units
120-159   mg/dL 2   Units 2   Units 2   Units 0   Units
160-199   mg/dL 4   Units 4   Units 4   Units 2   Units
200-239   mg/dL 6   Units 6   Units 6   Units 4   Units
240-280   mg/dL 8   Units 8   Units 8   Units 6   Units
> 280   mg/dL Notify M.D.


Discharge Disposition:
Extended Care

Facility:
Life Care Center at [**Location (un) 2199**]

Discharge Diagnosis:
AAA (preop)

PMH:
COPD on home oxygen (3L)
Morbid Obesity
Hypertension


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


Discharge Instructions:
Division of Vascular and Endovascular Surgery
Endovascular Abdominal Aortic Aneurysm (AAA) Discharge
Instructions

Medications:
??????	Take Aspirin 325mg (enteric coated) once daily
??????	Do not stop Aspirin unless your Vascular Surgeon instructs you
to do so.
??????	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 to expect when you go home:
It is normal to have slight swelling of the legs:
??????	Elevate your leg above the level of your heart (use [**3-11**]
pillows or a recliner) every 2-3 hours throughout the day and at
night
??????	Avoid prolonged periods of standing or sitting without your
legs elevated
It is normal to feel tired and have a decreased appetite, your
appetite will return with time
??????	Drink plenty of fluids and eat small frequent meals
??????	It is important to eat nutritious food options (high fiber,
lean meats, vegetables/fruits, low fat, low cholesterol) to
maintain your strength and assist in wound healing
??????	To avoid constipation: eat a high fiber diet and use stool
softener while taking pain medication

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
??????	Call and schedule an appointment to be seen in [**5-12**] weeks for
post procedure check and CTA

What to report to office:
??????	Numbness, coldness or pain in lower extremities
??????	Temperature greater than 101.5F for 24 hours
??????	New or increased drainage from incision or white, yellow or
green drainage from incisions
??????	Bleeding from groin puncture site

SUDDEN, SEVERE BLEEDING OR SWELLING (Groin puncture site or
incision)
??????	Lie down, keep leg straight and have someone apply firm
pressure to area for 10 minutes. If bleeding stops, call
vascular office. If bleeding does not stop, call 911 for
transfer to closest Emergency Room.

Division of Vascular and Endovascular Surgery
Lower Extremity Angioplasty/Stent Discharge Instructions

Medications:
??????	Take Aspirin 325mg (enteric coated) once daily
??????	If instructed, 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 to expect when you go home:
It is normal to have slight swelling of the legs:
??????	Elevate your leg above the level of your heart (use [**3-11**]
pillows or a recliner) every 2-3 hours throughout the day and at
night
??????	Avoid prolonged periods of standing or sitting without your
legs elevated
??????	It is normal to feel tired and have a decreased appetite, your
appetite will return with time
??????	Drink plenty of fluids and eat small frequent meals
??????	It is important to eat nutritious food options (high fiber,
lean meats, vegetables/fruits, low fat, low cholesterol) to
maintain your strength and assist in wound healing
??????	To avoid constipation: eat a high fiber diet and use stool
softener while taking pain medication

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
??????	Call and schedule an appointment to be seen in [**4-9**] weeks for
post procedure check and ultrasound

What to report to office:
??????	Numbness, coldness or pain in lower extremities
??????	Temperature greater than 101.5F for 24 hours
??????	New or increased drainage from incision or white, yellow or
green drainage from incisions
??????	Bleeding from groin puncture site

SUDDEN, SEVERE BLEEDING OR SWELLING (Groin puncture site)
??????	Lie down, keep leg straight and have someone apply firm
pressure to area for 10 minutes. If bleeding stops, call
vascular office [**Telephone/Fax (1) 1237**]. If bleeding does not stop, call
911 for transfer to closest Emergency Room.


Followup Instructions:
Provider: [**First Name11 (Name Pattern1) 1112**] [**Last Name (NamePattern4) 2604**], MD Phone:[**Telephone/Fax (1) 1237**]
Date/Time:[**2145-6-7**] 1:15
Provider: [**Name10 (NameIs) **] SCAN Phone:[**Telephone/Fax (1) 327**] Date/Time:[**2145-6-21**] 1:30
Provider: [**First Name11 (Name Pattern1) 1112**] [**Last Name (NamePattern4) 2604**], MD Phone:[**Telephone/Fax (1) 1237**]
Date/Time:[**2145-6-21**] 2:15

You should follow up with [**Location (un) 2274**] Cardioligy in 1 month at the
[**Location (un) 1468**] Office with Dr. [**Last Name (STitle) 6512**]. The Cardiology office has been
notified and will call your Rehab with the time of your
appointment.

It was recommneded that you follow up with [**Hospital1 18**] Dermatology for
a skin biopsy of your growth on your leg. Please call if you
decide you would like this done: [**Location (un) 830**]
[**Location (un) 86**], [**Numeric Identifier 718**]
([**Telephone/Fax (1) 8132**]



Completed by:[**2145-6-1**]
{'Abdominal aneurysm without mention of rupture,Cardiogenic shock,Subendocardial infarction, initial episode of care,Cardiac complications, not elsewhere classified,Arterial embolism and thrombosis of lower extremity,Acute posthemorrhagic anemia,Hematoma complicating a procedure,Coronary atherosclerosis of native coronary artery,Chronic airway obstruction, not elsewhere classified,Morbid obesity,Unspecified disorder of skin and subcutaneous tissue,Unspecified essential hypertension,Other and unspecified hyperlipidemia,Personal history of tobacco use,Other dependence on machines, supplemental oxygen,Surgical operation with anastomosis, bypass, or graft, with natural or artificial tissues used as implant causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation'}


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: 7.2- cm infrarenal aortic aneurysm

PRESENT ILLNESS: The patient is a 71-year-old male with a known infrarenal
abdominal aortic aneurysm. He has a past medical history
significant for COPD with home oxygen, hypertension and obesity.
Do this the patients high risk of rupture the decision was made
to intervene and fix the aneursym. He was scheduled outpatient
for an endoluminal repair of abdominal aortic aneurysm on
[**2145-5-19**].

MEDICAL HISTORY: - COPD- baseline home O2 3LCN
- Morbid Obesity
- HTN
- HL
- AAA
- Pulm. nodule
- Edema
- S/P abd. hernia repair

MEDICATION ON ADMISSION: asa, enalapril, flovent, lasix, spiriva, simvastatin, home
oxygen 3L

ALLERGIES: scallops

PHYSICAL EXAM: VS:  T: 98    HR: 89     BP: 103/51    RR: 20      Spo2: 94%
2LNC
Gen: NAD, alert and oriented x 3
Neuro: CN II-XII intact
CV: RRR, no mrg,  + S1 + S2
Lungs: CTA bilaterally
Abd: soft, NT, obese, no rebound or guarding
Wound: Left groin with some erythema in skin folds
JP drain with minimal serous drainage
Bilateral lower extremities warm and dry. Signals per doppler
bilaterally.

FAMILY HISTORY: CAD/PVD - father and mother, died in their 70s
CVA - brother in 60s.  Brother diagnosed with alzheimers at age
60.

SOCIAL HISTORY: Lives at home with wife, daughter, son-in-law and 3
grandchildren.  Used to work as a office equipment repairman.
Tobacco - quit [**2136**], was a lifetime smoker - 1-2ppd for 43 years
EtOH - occasional ethanol
drug use - denies. 

### Response:
{'Abdominal aneurysm without mention of rupture,Cardiogenic shock,Subendocardial infarction, initial episode of care,Cardiac complications, not elsewhere classified,Arterial embolism and thrombosis of lower extremity,Acute posthemorrhagic anemia,Hematoma complicating a procedure,Coronary atherosclerosis of native coronary artery,Chronic airway obstruction, not elsewhere classified,Morbid obesity,Unspecified disorder of skin and subcutaneous tissue,Unspecified essential hypertension,Other and unspecified hyperlipidemia,Personal history of tobacco use,Other dependence on machines, supplemental oxygen,Surgical operation with anastomosis, bypass, or graft, with natural or artificial tissues used as implant causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation'}
