CHIEF COMPLAINT: 

PRESENT ILLNESS: This is a 52-year-old female
with known aortic stenosis, who has been experiencing
dizziness for the past two months.  She has also complained
of substernal burning with exercise, which occurs 1-2x a
month over the last 3-4 months.  Echocardiogram [**2176-6-13**]
showed moderate left atrial dilatation, moderate left
ventricular hypertrophy, and left ventricular ejection
fraction of 55% with thickened aortic valve leaflets and
aortic valve area of 0.7 cm squared.

MEDICAL HISTORY: 1. Aortic stenosis.
2. Asthma.
3. Thyroiditis.
4. Questionable history of gastric ulcer
5. Status post right oophorectomy.

MEDICATION ON ADMISSION: 

ALLERGIES: Vioxx which gives her a rash.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: 
Aortic valve disorders,Asthma, unspecified type, with (acute) exacerbation,Other chronic pulmonary heart diseases
Aortic valve disorder,Asthma NOS w (ac) exac,Chr pulmon heart dis NEC
Admission Date:  [**2176-7-15**]       Discharge Date:  [**2176-7-25**]

Date of Birth:   [**2124-7-12**]       Sex:  F

Service:  CARDIAC SURGERY

HISTORY OF PRESENT ILLNESS:  This is a 52-year-old female
with known aortic stenosis, who has been experiencing
dizziness for the past two months.  She has also complained
of substernal burning with exercise, which occurs 1-2x a
month over the last 3-4 months.  Echocardiogram [**2176-6-13**]
showed moderate left atrial dilatation, moderate left
ventricular hypertrophy, and left ventricular ejection
fraction of 55% with thickened aortic valve leaflets and
aortic valve area of 0.7 cm squared.

She underwent cardiac catheterization at [**Hospital1 **] [**First Name (Titles) **] [**2176-7-9**], which showed severe aortic
stenosis with an aortic valve area of 0.5 cm squared.  No
significant mitral regurgitation, ejection fraction of 60%,
mean aortic valve gradient of 49 mm Hg and moderate pulmonary
hypertension.  No significant coronary artery disease.  She
was referred to Cardiac Surgery for aortic valve replacement.

PAST MEDICAL HISTORY:
1. Aortic stenosis.
2. Asthma.
3. Thyroiditis.
4. Questionable history of gastric ulcer
5. Status post right oophorectomy.

ALLERGIES:  Vioxx which gives her a rash.

PREOPERATIVE MEDICATIONS:
1. Flovent two puffs qid.
2. Albuterol two puffs qid.
3. Zantac 150 mg po bid.
4. Zyrtec 10 mg po q day.
5. Cozaar 100 mg po q day.
6. Atenolol 50 mg po q day.
7. Flurbiprofen 200 mg po q day.
8. Lasix 10 mg po q day.
9. Norvasc 5 mg po q day.

Patient was taken to the operating room on [**2176-7-17**] with
Dr. [**Last Name (STitle) 1537**] for a minimally invasive aortic valve replacement
with a 21 mm CarboMedics mechanical valve.  Patient tolerated
the procedure well, and was transferred to the Intensive Care
Unit in stable condition.  The patient was weaned and
extubated from mechanical ventilation on the first
postoperative evening.

Patient was transferred from the Intensive Care Unit to the
floor on postoperative day #1.  The patient was started on
Coumadin on postoperative day #1.  Patient was weaned off of
nasal cannula to room air.  On postoperative day #2, the
patient began ambulating with Physical Therapy.  Patient's
chest tubes were removed.  On postoperative day #2, patient
began to diurese.

On postoperative day #3, patient began complaining that she
was having increasing wheezing.

On postoperative day #4, patient complained of incisional
chest pain and difficulty breathing.  Chest x-ray at that
time showed no effusion or infiltrate, no pneumothorax.  The
patient was found to have bilateral wheezes.  The patient was
medicated with an albuterol nebulizer and given Percocet for
pain relief.  Patient's Lasix was increased to IV and she
continued to diurese well.

Postoperative day #5, the patient's INR increased from 1.1 to
2.5, and rose to a high of 3.8 on postoperative day #7.
Patient had been cleared by Physical Therapy on postoperative
day #3.  The patient continued to ambulate in the hallway,
and on postoperative day #8, patient was cleared for
discharge to home.

CONDITION ON DISCHARGE:  Temperature max 98.1, pulse 86 sinus
rhythm, blood pressure 126/58, respiratory rate 16, and on
room air oxygen saturation 96%.  Patient's weight on [**7-25**] is
85.4 kg.  Preoperatively, the patient weighed 84 kg.  Patient
is awake, alert, conversant, and nonfocal.  Heart is regular,
rate, and rhythm with a sharp click, no rub.  Respiratory:
Lungs are clear to auscultation.  Abdomen is soft, nontender,
and nondistended, normoactive bowel sounds.  Extremities are
with 1+ pitting edema, warm, and well perfused.  Sternum is
stable.  Incision is clean, dry, and intact.

Laboratory data from [**7-25**]:  White blood cell count 11.9,
hematocrit 30.1, platelet count of 704.  Sodium 133,
potassium 4.8, chloride 93, bicarb 30, BUN 11, creatinine
0.8, glucose 106.  PT 23.5, INR 3.9.

DISCHARGE MEDICATIONS:
1. Lasix 40 mg po bid x2 weeks.
2. Potassium chloride 20 mEq po bid x2 weeks.
3. Colace 100 mg po bid while taking Percocet.
4. Enteric coated aspirin 81 mg po q day.
5. Atenolol 75 mg po q day.
6. Flovent MDI two puffs [**Hospital1 **].
7. Atrovent two puffs [**Hospital1 **].
8. Albuterol MDI two puffs q4h prn.
9. Percocet 5/325 1-2 tablets po q4h prn.
10. Ibuprofen 600 mg po q6h prn.
11. Coumadin 2 mg po [**7-25**].  The patient is to have a PT/INR
drawn [**7-26**], results are to be called to Dr.[**Name (NI) 10373**]
office at [**Telephone/Fax (1) 250**], and his office is to determine
further dosing.  Patient's goal INR is 2.5-3.

DISCHARGE DIAGNOSES:
1. Aortic stenosis.
2. Status post aortic valve replacement minimally invasive
with a 21 mm CarboMedics valve.
3. Asthma.

CONDITION ON DISCHARGE:  The patient is to be discharged to
home in stable condition.

FOLLOW-UP INSTRUCTIONS:  Patient is to followup in the [**Hospital 409**]
Clinic in two weeks for a wound check.  The patient is to
followup with Dr. [**Last Name (STitle) **] in [**12-7**] weeks.  The patient is to
followup with Dr. [**Last Name (STitle) 4469**] in four weeks.



                            [**First Name11 (Name Pattern1) 275**] [**Last Name (NamePattern4) 1539**], M.D.  [**MD Number(1) 1540**]

Dictated By:[**Last Name (NamePattern1) 16172**]
MEDQUIST36

D:  [**2176-7-25**]  10:00
T:  [**2176-7-25**]  10:07
JOB#:  [**Job Number 16173**]
{'Aortic valve disorders,Asthma, unspecified type, with (acute) exacerbation,Other chronic pulmonary heart diseases'}


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: 

PRESENT ILLNESS: This is a 52-year-old female
with known aortic stenosis, who has been experiencing
dizziness for the past two months.  She has also complained
of substernal burning with exercise, which occurs 1-2x a
month over the last 3-4 months.  Echocardiogram [**2176-6-13**]
showed moderate left atrial dilatation, moderate left
ventricular hypertrophy, and left ventricular ejection
fraction of 55% with thickened aortic valve leaflets and
aortic valve area of 0.7 cm squared.

MEDICAL HISTORY: 1. Aortic stenosis.
2. Asthma.
3. Thyroiditis.
4. Questionable history of gastric ulcer
5. Status post right oophorectomy.

MEDICATION ON ADMISSION: 

ALLERGIES: Vioxx which gives her a rash.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY:  

### Response:
{'Aortic valve disorders,Asthma, unspecified type, with (acute) exacerbation,Other chronic pulmonary heart diseases'}
