CHIEF COMPLAINT: Shortness of [**First Name3 (LF) **]

PRESENT ILLNESS: 68 yo F with HIV (CD4 385), ESRD on HD, CAD s/p 2 MI's, DM2,
CHF, COPD who presented with resp failure secondary to diast
dysf and HTN.  Pt was SOBx 1 day no CP,N,V.  Cousin called 911
and brought to ED w/ O2 sats 53% and RR in 30's .

MEDICAL HISTORY: PAST MEDICAL HISTORY:  Coronary artery disease status post
non-ST elevation MI in [**2111-5-19**], status post PTCA/stent to
the left circumflex, status post PTCA/stent of mid left
circumflex in [**2113-5-18**], latest catheterization in [**2113-10-18**] with two-vessel disease.  ETT MIBI done on [**2114-5-10**] significant for no symptoms, EKG changes, and with only
a fixed inferior defect, ejection fraction 58 percent.

MEDICATION ON ADMISSION: 1. Zidovudine 200 mg po bid.
2. Nevirapine 200 mg po bid.
3. Lamivudine 50 mg po qd.
4. Nephrocaps 1 cap po qd.
5. Metoprolol 50 mg po qd.
6. Isosorbide dinitrate 10 mg po bid.
7. Aspirin, enteric-coated, 325 mg po qd.
8. Pantoprazole 40 mg po qd.
9. Calcium carbonate 1,000 mg po bid prn.
10. Nitroglycerin sublingual prn chest pain.
11. Senna 2 tablets po bid.
12. Colace 100 mg po bid.
13. Calcium acetate 667 mg 2 tablets po tid with meals.
14. Metoclopramine 10 mg po qd.
15. Albuterol 1-2 puffs inhaled q 6 h prn.
16. Atroven 1 puff inhaled qid prn shortness of [**Month/Year (2) 1440**] or
wheezing.
17. Albuterol 1 neb q 6 h prn shortness of [**Month/Year (2) 1440**] or wheezing.
18. EPO at HD
19. Loratadine 10 mg po qod for 1 month.

ALLERGIES: Motrin / Lipitor

PHYSICAL EXAM: Vs T98.5 P107 Bp 138/60 R18 O2 100% on AC
Gen intubated , sedated on propofol
HEENT - anicteric, no JVD
CV - tachy, no mormurs
Lungs - good air mvt b/l, mild exp wheezes, no rhonchi
Abd - S/Nt/ND +Bs
Ext l AVF +bruit/thrill, no LE edema

FAMILY HISTORY: 

SOCIAL HISTORY: SOCIAL HISTORY:  The patient currently lives in [**Location 16174**]
with her niece.  She was previously a housewife.  She denies
alcohol or drug use.  She smoked 2 packs a day for 40 years.
Hypertensive heart and chronic kidney disease, unspecified, with heart failure and chronic kidney disease stage V or end stage renal disease,Acute on chronic diastolic heart failure,Chronic airway obstruction, not elsewhere classified,Human immunodeficiency virus [HIV] disease,Urinary tract infection, site not specified,Mitral valve disorders,Acute respiratory failure,Hyperpotassemia
Hyp ht/kd NOS st V w hf,Ac on chr diast hrt fail,Chr airway obstruct NEC,Human immuno virus dis,Urin tract infection NOS,Mitral valve disorder,Acute respiratry failure,Hyperpotassemia
Admission Date:  [**2114-7-8**]              Discharge Date:   [**2114-7-15**]

Date of Birth:  [**2046-6-27**]             Sex:   F

Service: MED

Allergies:
Motrin / Lipitor

Attending:[**First Name3 (LF) 9874**]
Chief Complaint:
Shortness of [**First Name3 (LF) **]

Major Surgical or Invasive Procedure:
Intubation.


History of Present Illness:
68 yo F with HIV (CD4 385), ESRD on HD, CAD s/p 2 MI's, DM2,
CHF, COPD who presented with resp failure secondary to diast
dysf and HTN.  Pt was SOBx 1 day no CP,N,V.  Cousin called 911
and brought to ED w/ O2 sats 53% and RR in 30's .


Past Medical History:
PAST MEDICAL HISTORY:  Coronary artery disease status post
non-ST elevation MI in [**2111-5-19**], status post PTCA/stent to
the left circumflex, status post PTCA/stent of mid left
circumflex in [**2113-5-18**], latest catheterization in [**2113-10-18**] with two-vessel disease.  ETT MIBI done on [**2114-5-10**] significant for no symptoms, EKG changes, and with only
a fixed inferior defect, ejection fraction 58 percent.

Diabetes mellitus type 2, diet controlled.

HIV.  Last viral load undetectable.  CD count 41 in [**2114-1-18**].

Factor VIII deficiency diagnosed in [**2109-10-18**] thought
secondary to a rapid steroid taper.

End-stage renal disease on hemodialysis.

History of GI bleed in the setting of coagulopathy and NSAID
use.

Recent pericarditis.

Eosinophilic pneumonia diagnosed in [**2114-4-19**] and treated
with prednisone.

Chronic anemia of end-stage renal disease.

Vulvar intraepithelial neoplasia diagnosed in [**2113-4-18**].

CHF with her latest echo in [**2114-4-19**] with an ejection
fraction of 60 percent and 3 plus MR.

COPD.


Social History:
SOCIAL HISTORY:  The patient currently lives in [**Location 16174**]
with her niece.  She was previously a housewife.  She denies
alcohol or drug use.  She smoked 2 packs a day for 40 years.


Physical Exam:
Vs T98.5 P107 Bp 138/60 R18 O2 100% on AC
Gen intubated , sedated on propofol
HEENT - anicteric, no JVD
CV - tachy, no mormurs
Lungs - good air mvt b/l, mild exp wheezes, no rhonchi
Abd - S/Nt/ND +Bs
Ext l AVF +bruit/thrill, no LE edema


Pertinent Results:
[**2114-7-8**] 06:40PM   PT-12.2 PTT-21.4* INR(PT)-1.0
[**2114-7-8**] 06:40PM   PLT COUNT-170
[**2114-7-8**] 06:40PM   WBC-13.8* RBC-2.96* HGB-12.7 HCT-40.2
MCV-136* MCH-42.9* MCHC-31.6 RDW-18.2*
[**2114-7-8**] 06:40PM   CALCIUM-8.4 PHOSPHATE-5.9*# MAGNESIUM-2.6
[**2114-7-8**] 06:40PM   CK-MB-3 cTropnT-0.11*
[**2114-7-8**] 06:40PM   CK(CPK)-123
[**2114-7-8**] 06:40PM   GLUCOSE-267* UREA N-66* CREAT-6.8* SODIUM-136
POTASSIUM-6.4* CHLORIDE-91* TOTAL CO2-27 ANION GAP-24*
[**2114-7-8**] 07:25PM URINE  bnzodzpn-NEG barbitrt-NEG opiates-NEG
cocaine-NEG amphetmn-NEG mthdone-NEG


Brief Hospital Course:
Resp - Pt was intubated shortly after admission.  Upon
intubation the pt's sats returned to high 90's.  Pt thought to
be experiencing COPD exacerbation and given azith and steroids,
but CXR was more consistant with heart failure.  She stabalized
with aggresive BP control and dialysis removoal of [**6-25**] L.  Pt
weaned from vent and extubated on [**7-10**] and developed flash
edema.  The edema resolved on dialysis, hydralyzine, and lasix.
She was transfered to the floor on [**7-11**].
Pt received an echo in MICU which demonsrtated no change in pts
3+MR.  Pt had decided against surgical options with outpt
cardiologist in past and no further work up of MR was done.

ID - [**7-10**] urine Cx grew enterococcus and vanc started.  This was
later found to be VRE and Linezolid started [**7-11**].  Also BAL from
bronch [**7-10**] revealed pseudomonas and Ceftaz started [**7-11**].  Upon
arival to floor SBP fell to hihg 80's which was thought to be
due to dialysis or possible sepsis from UTI, lungs, or line.
She received IVF.  By [**7-12**] pt's SBP came back to >100 and has
remained stable.  Also pt has remained afebrile.

ESRD - Cont on dialysis mon, wed, fri.
DM - Insulin Sliding Scale.  Glucose was fairly well controlled
during stay.
[**Name (NI) 61133**] Pt had 3 episodes of Diarrhea on [**4-11**].  Cdiff was negative.
Only one episode since.

Medications on Admission:
1. Zidovudine 200 mg po bid.
2. Nevirapine 200 mg po bid.
3. Lamivudine 50 mg po qd.
4. Nephrocaps 1 cap po qd.
5. Metoprolol 50 mg po qd.
6. Isosorbide dinitrate 10 mg po bid.
7. Aspirin, enteric-coated, 325 mg po qd.
8. Pantoprazole 40 mg po qd.
9. Calcium carbonate 1,000 mg po bid prn.
10. Nitroglycerin sublingual prn chest pain.
11. Senna 2 tablets po bid.
12. Colace 100 mg po bid.
13. Calcium acetate 667 mg 2 tablets po tid with meals.
14. Metoclopramine 10 mg po qd.
15. Albuterol 1-2 puffs inhaled q 6 h prn.
16. Atroven 1 puff inhaled qid prn shortness of [**Month/Year (2) 1440**] or
wheezing.
17. Albuterol 1 neb q 6 h prn shortness of [**Month/Year (2) 1440**] or wheezing.
18. EPO at HD
19. Loratadine 10 mg po qod for 1 month.


Discharge Medications:
1. Zidovudine 100 mg Capsule Sig: Two (2) Capsule PO BID (2
times a day).
2. Nevirapine 200 mg Tablet Sig: One (1) Tablet PO BID (2 times
a day).
3. Lamivudine 10 mg/mL Solution Sig: Five (5) ml PO QD (once a
day).
4. B Complex-Vitamin C-Folic Acid 1 mg Capsule Sig: One (1) Cap
PO QD (once a day).
Disp:*30 Cap(s)* Refills:*2*
5. Aspirin 325 mg Tablet, Delayed Release (E.C.) Sig: One (1)
Tablet, Delayed Release (E.C.) PO QD (once a day).
6. Insulin Regular Human 100 unit/mL Solution Sig: as directed
Injection ASDIR (AS DIRECTED): Pt has an insulin sliding scale
at home.  She checks 3 times per day.
7. Linezolid 600 mg Tablet Sig: One (1) Tablet PO Q12H (every 12
hours) for 6 days: take for 6 days.
Disp:*12 Tablet(s)* Refills:*0*
8. Famotidine 20 mg Tablet Sig: One (1) Tablet PO Q24H (every 24
hours).
9. Lisinopril 5 mg Tablet Sig: 0.5 Tablet PO QD (once a day).
Disp:*15 Tablet(s)* Refills:*2*
10. Albuterol Sulfate 0.083 % Solution Sig: One (1)  Inhalation
four times a day as needed for shortness of [**Month/Year (2) 1440**] or wheezing.

11. Atrovent 18 mcg/Actuation Aerosol Sig: One (1) puff
Inhalation four times a day as needed for shortness of [**Month/Year (2) 1440**] or
wheezing.
12. Albuterol 90 mcg/Actuation Aerosol Sig: 1-2 puffs Inhalation
four times a day as needed for shortness of [**Month/Year (2) 1440**] or wheezing.

13. Metoprolol Tartrate 25 mg Tablet Sig: One (1) Tablet PO
twice a day.
Disp:*60 Tablet(s)* Refills:*2*
14. Cipro 250 mg Tablet Sig: One (1) Tablet PO twice a day for
10 days.
Disp:*20 Tablet(s)* Refills:*0*


Discharge Disposition:
Home With Service

Facility:
Uphams Corner Home Care

Discharge Diagnosis:
Repiratory failure due to CHF.
UTI with VRE
Pseudomonas in sputum.


Discharge Condition:
Stable

Discharge Instructions:
Pt to go home with VNA services.  Please call primary care
provider if fevers, shortness of [**Month/Year (2) 1440**], or chest pain develops.

Followup Instructions:
Provider: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 1013**], M.D. Where: [**Hospital6 29**]
CARDIAC SERVICES Phone:[**Telephone/Fax (1) 127**] Date/Time:[**2114-8-28**] 11:45
{'Hypertensive heart and chronic kidney disease, unspecified, with heart failure and chronic kidney disease stage V or end stage renal disease,Acute on chronic diastolic heart failure,Chronic airway obstruction, not elsewhere classified,Human immunodeficiency virus [HIV] disease,Urinary tract infection, site not specified,Mitral valve disorders,Acute respiratory failure,Hyperpotassemia'}


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: Shortness of [**First Name3 (LF) **]

PRESENT ILLNESS: 68 yo F with HIV (CD4 385), ESRD on HD, CAD s/p 2 MI's, DM2,
CHF, COPD who presented with resp failure secondary to diast
dysf and HTN.  Pt was SOBx 1 day no CP,N,V.  Cousin called 911
and brought to ED w/ O2 sats 53% and RR in 30's .

MEDICAL HISTORY: PAST MEDICAL HISTORY:  Coronary artery disease status post
non-ST elevation MI in [**2111-5-19**], status post PTCA/stent to
the left circumflex, status post PTCA/stent of mid left
circumflex in [**2113-5-18**], latest catheterization in [**2113-10-18**] with two-vessel disease.  ETT MIBI done on [**2114-5-10**] significant for no symptoms, EKG changes, and with only
a fixed inferior defect, ejection fraction 58 percent.

MEDICATION ON ADMISSION: 1. Zidovudine 200 mg po bid.
2. Nevirapine 200 mg po bid.
3. Lamivudine 50 mg po qd.
4. Nephrocaps 1 cap po qd.
5. Metoprolol 50 mg po qd.
6. Isosorbide dinitrate 10 mg po bid.
7. Aspirin, enteric-coated, 325 mg po qd.
8. Pantoprazole 40 mg po qd.
9. Calcium carbonate 1,000 mg po bid prn.
10. Nitroglycerin sublingual prn chest pain.
11. Senna 2 tablets po bid.
12. Colace 100 mg po bid.
13. Calcium acetate 667 mg 2 tablets po tid with meals.
14. Metoclopramine 10 mg po qd.
15. Albuterol 1-2 puffs inhaled q 6 h prn.
16. Atroven 1 puff inhaled qid prn shortness of [**Month/Year (2) 1440**] or
wheezing.
17. Albuterol 1 neb q 6 h prn shortness of [**Month/Year (2) 1440**] or wheezing.
18. EPO at HD
19. Loratadine 10 mg po qod for 1 month.

ALLERGIES: Motrin / Lipitor

PHYSICAL EXAM: Vs T98.5 P107 Bp 138/60 R18 O2 100% on AC
Gen intubated , sedated on propofol
HEENT - anicteric, no JVD
CV - tachy, no mormurs
Lungs - good air mvt b/l, mild exp wheezes, no rhonchi
Abd - S/Nt/ND +Bs
Ext l AVF +bruit/thrill, no LE edema

FAMILY HISTORY: 

SOCIAL HISTORY: SOCIAL HISTORY:  The patient currently lives in [**Location 16174**]
with her niece.  She was previously a housewife.  She denies
alcohol or drug use.  She smoked 2 packs a day for 40 years. 

### Response:
{'Hypertensive heart and chronic kidney disease, unspecified, with heart failure and chronic kidney disease stage V or end stage renal disease,Acute on chronic diastolic heart failure,Chronic airway obstruction, not elsewhere classified,Human immunodeficiency virus [HIV] disease,Urinary tract infection, site not specified,Mitral valve disorders,Acute respiratory failure,Hyperpotassemia'}
