CHIEF COMPLAINT: patent foramen ovale

PRESENT ILLNESS: This 35 year old female suffered a TIA in [**2122-12-7**]. Thsi
left no residua.  Workup revealed a PFO with left to right
shunting at rest and right to left with Valsalva. She was not a
candidate for percutaneous closure and is admitted now for
closure as she desires more children.

MEDICAL HISTORY: Right breast cancer age 25, treated with lumpectomy and RT.
Fibromyalgia

MEDICATION ON ADMISSION: ASA325 mg/D

ALLERGIES: Succinylcholine

PHYSICAL EXAM: Admission:
VSS, afebrile. Neuro grossly intact.
Cor:RSR w/o murmur.
Lungs: clear
abdomen: benign
extremeties: no CCE. Well healed scars RT lateral lumpectomies.

FAMILY HISTORY: noncontributory.

SOCIAL HISTORY: [**12-8**] glasses of wine QOD.
Non smoker
Works as a teacher. lives with her husband.
Ostium secundum type atrial septal defect,Personal history of malignant neoplasm of breast,Personal history of transient ischemic attack (TIA), and cerebral infarction without residual deficits,Myalgia and myositis, unspecified
Secundum atrial sept def,Hx of breast malignancy,Hx TIA/stroke w/o resid,Myalgia and myositis NOS
Admission Date:  [**2125-5-30**]              Discharge Date:   [**2125-6-2**]

Date of Birth:  [**2090-3-31**]             Sex:   F

Service: CARDIOTHORACIC

Allergies:
Succinylcholine

Attending:[**First Name3 (LF) 1505**]
Chief Complaint:
patent foramen ovale

Major Surgical or Invasive Procedure:
Closure of patent foramen ovale [**5-30**]


History of Present Illness:
This 35 year old female suffered a TIA in [**2122-12-7**]. Thsi
left no residua.  Workup revealed a PFO with left to right
shunting at rest and right to left with Valsalva. She was not a
candidate for percutaneous closure and is admitted now for
closure as she desires more children.

Past Medical History:
Right breast cancer age 25, treated with lumpectomy and RT.
Fibromyalgia

Social History:
[**12-8**] glasses of wine QOD.
Non smoker
Works as a teacher. lives with her husband.

Family History:
noncontributory.

Physical Exam:
Admission:
VSS, afebrile. Neuro grossly intact.
Cor:RSR w/o murmur.
Lungs: clear
abdomen: benign
extremeties: no CCE. Well healed scars RT lateral lumpectomies.

Pertinent Results:
[**2125-5-31**] 01:55AM BLOOD WBC-13.3* RBC-3.37* Hgb-10.6* Hct-31.5*
MCV-94 MCH-31.5 MCHC-33.7 RDW-12.6 Plt Ct-154
[**2125-5-30**] 09:41PM BLOOD K-3.9
[**2125-5-30**] 07:21PM BLOOD Lactate-1.5

Brief Hospital Course:
Following the same day admission she went to the Operating Room
where minimally invasive closure of the PFO was performed.
Please see the operative note for details.

She weaned from bypass on Propofol and neosynephrine in stable
condition.  She easily weaned from the ventilator and was
extubated.  Neosynephrine was off and on due to "soft" blood
pressure for 24 hours.   Her chest tubes were removed on the day
after surgery and she was transferred to the floor.  She was
seen in consultation by the physical therapy service.  By
post-operative day 3 she was ready for discharge to home.

Medications, activity limits and followup were discussed with
her prior to discharge.  Wounds were clean and healing well.
there were no untoward effects of her right femoral cannulation.

Medications on Admission:
ASA325 mg/D

Discharge Medications:
1. Aspirin 81 mg Tablet, Delayed Release (E.C.) Sig: One (1)
Tablet, Delayed Release (E.C.) PO DAILY (Daily).
2. Ranitidine HCl 150 mg Tablet Sig: One (1) Tablet PO BID (2
times a day) for 2 weeks.
Disp:*60 Tablet(s)* Refills:*2*
3. Metoprolol Tartrate 25 mg Tablet Sig: 0.5 Tablet PO BID (2
times a day).
Disp:*30 Tablet(s)* Refills:*2*
4. Ibuprofen 200 mg Capsule Sig: Three (3) Capsule PO three
times a day for 4 weeks: with meals.
5. Hydromorphone 2 mg Tablet Sig: 1-2 Tablets PO Q4H (every 4
hours) as needed for pain for 4 weeks.
Disp:*50 Tablet(s)* Refills:*0*
6. Acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO Q6H (every
6 hours) as needed for pain.


Discharge Disposition:
Home With Service

Facility:
Home Healthcare [**Location (un) 70951**], NH

Discharge Diagnosis:
Patent foramen ovale
s/p closure of patent foramen ovale
h/o breast cancer s/p lumpectomy
fibromyalgia


Discharge Condition:
good


Discharge Instructions:
shower daily, no baths or swimming
no lotions, creams or powders to incisions
no driving for 4 weeks and off all narcotics
no lifting more than 10 pounds for 10 weeks
report any redness of, or drainage from incisions
report any fever greater than 100.5
report any weight gain greater than 2 pounds a day or 5 pounds a
week
take all medications as directed

Followup Instructions:
Dr. [**Last Name (STitle) **] in 4 weeks ([**Telephone/Fax (1) 170**])
Dr. [**First Name11 (Name Pattern1) **] [**Initial (NamePattern1) **] [**Last Name (NamePattern4) 38408**] in [**12-8**] weeks ([**Telephone/Fax (1) 70952**])
[**Hospital Ward Name 121**] 6 wound clinic in 2 weeks
Please call for appointments



Completed by:[**2125-6-2**]
{'Ostium secundum type atrial septal defect,Personal history of malignant neoplasm of breast,Personal history of transient ischemic attack (TIA), and cerebral infarction without residual deficits,Myalgia and myositis, 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: patent foramen ovale

PRESENT ILLNESS: This 35 year old female suffered a TIA in [**2122-12-7**]. Thsi
left no residua.  Workup revealed a PFO with left to right
shunting at rest and right to left with Valsalva. She was not a
candidate for percutaneous closure and is admitted now for
closure as she desires more children.

MEDICAL HISTORY: Right breast cancer age 25, treated with lumpectomy and RT.
Fibromyalgia

MEDICATION ON ADMISSION: ASA325 mg/D

ALLERGIES: Succinylcholine

PHYSICAL EXAM: Admission:
VSS, afebrile. Neuro grossly intact.
Cor:RSR w/o murmur.
Lungs: clear
abdomen: benign
extremeties: no CCE. Well healed scars RT lateral lumpectomies.

FAMILY HISTORY: noncontributory.

SOCIAL HISTORY: [**12-8**] glasses of wine QOD.
Non smoker
Works as a teacher. lives with her husband. 

### Response:
{'Ostium secundum type atrial septal defect,Personal history of malignant neoplasm of breast,Personal history of transient ischemic attack (TIA), and cerebral infarction without residual deficits,Myalgia and myositis, unspecified'}
