CHIEF COMPLAINT: ? VT arrest

PRESENT ILLNESS: Mrs. [**Known firstname 2270**] [**Known lastname 100793**] [**Last Name (un) **] is a very nice 76 year-old woman
with history of CAD s/p CABG x 4, recent [**Last Name (un) 7792**] in [**11-4**], sCHF
(EF 25-30%), CAFib, and HTN who was found down at Rehab with VT.
Per report, she was doing well at [**Hospital 392**] Rehab until yesterday
8:15 PM when she was found minimally responsive in the toilet
without signs of trauma. To minutes afterwards became
unresponsive, without pulse and without breathing in front of
nursing staff. They started CPR immediately and placed AED that
shocked her twice (120 J and 150 J respectively). EMS arrived
and per their report she was in sinus rhythm with ventricular
ectopy. She had a pulse and was breathing. She received 100 mg
lidocaine IV bolus. She was transfered to [**Hospital3 5365**]. Her
initial BP was ~70/40 mmHg and no neurologic exam or [**Location (un) 2611**] is
documented. She was intubated for "airway protection" with
Propofol, etomidate and succynilcoline and BP dropped afterwards
and dopamine was started.
.
Initial labs showed: K of 7.5, creatinine of 3.38, Na 132, WBC
of 15.9 with left shift, PLT 246, CK 38, MB 2.3, TNT 0.05. Other
labs included: PT 14, INR 1.4, BUN 66, Ca 8.3, AST 52, ALT 39,
TP 5.3, Albumin 2.9, Globulin 2.4, AP 162. Her ECG showed sinus
rhythm with LBBB unchanged from prior here on [**11-14**]. She
received kayexalate, insulin, calcium gluconate and was
transfered to the [**Hospital1 18**] for further care.
.
In the BIDMCs ER VS were T 97.7, HR 81, BP 104/46, RR 19, SpO2
100% on AC 450/5/50/RR?. Per report she was moving L
.
In discussion with RN at rehab, she denies that patient has h/o
of stroke, TIA, deep venous thrombosis, pulmonary embolism,
bleeding at the time of surgery, myalgias, joint pains, cough,
hemoptysis, black stools or red stools. She further denies
patient with complaints of recent fevers, chills or rigors,
exertional buttock or calf pain.
.
Cardiac review of systems [**Name8 (MD) **] RN is notable for absence of chest
pain, dyspnea on exertion, paroxysmal nocturnal dyspnea,
orthopnea, ankle edema, palpitations, syncope or presyncope.

MEDICAL HISTORY: PAST CARDIOVASCULAR HISTORY:
1. CARDIAC RISK FACTORS: - Diabetes, -Dyslipidemia,
+Hypertension
2. CARDIAC HISTORY:
-CABG: X4 with anatomy: LIMA-D, SVG-LAD, SVG-PDA, SVG-OM
-PERCUTANEOUS CORONARY INTERVENTIONS: None
-PACING/ICD: [**Company 1543**] PPM
3. OTHER PAST MEDICAL HISTORY:
LMCA had a 90% stenosis filling
LAD 100% at the origin
LCx 100% at the origin
RCA 100% at the mid-vessel.
SVG-PDA 100% occluded
SVG-LAD patent filling anterograde and retrograde
Collaterals to PDA and faintly to the OMB
LVG-OMB was occluded proximaly
LIMA-diagonal patent
60% stenosis of the left subclavian artery with a 10-15 mmHg
gradient

MEDICATION ON ADMISSION: Spironolactone 25 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
Aspirin 325 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).
Clopidogrel 75 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).
Atorvastatin 80 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: VITAL SIGNS - Temp 97.8 F, BP 140/90 mmHg, HR 85 BPM, RR 20 X',
O2-sat 100% 50%

FAMILY HISTORY: Brother with Stroke, Sister with CAD s/p CABG, Sister with
Angina

SOCIAL HISTORY: Lives in [**Location (un) 50955**] with husband (step-father to daughters in
[**Name (NI) 86**]). No tobacco, EtOH or illicit drug use.
Unspecified septicemia,Cerebral artery occlusion, unspecified with cerebral infarction,Septic shock,Acute kidney failure with lesion of tubular necrosis,Anoxic brain damage,Chronic systolic heart failure,Intestinal infection due to Clostridium difficile,Coronary atherosclerosis of autologous vein bypass graft,Compression of vein,Urinary tract infection, site not specified,Acidosis,Other and unspecified coagulation defects,Severe sepsis,Atrial fibrillation,Subendocardial infarction, subsequent episode of care,Other chronic pulmonary heart diseases,Hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage I through stage IV, or unspecified,Chronic kidney disease, Stage III (moderate),Asthma, unspecified type, unspecified,Other left bundle branch block,Gout, unspecified,Unspecified acquired hypothyroidism,Peripheral vascular disease, unspecified,Examination of participant in clinical trial,Cardiac pacemaker in situ
Septicemia NOS,Crbl art ocl NOS w infrc,Septic shock,Ac kidny fail, tubr necr,Anoxic brain damage,Chr systolic hrt failure,Int inf clstrdium dfcile,Crn ath atlg vn bps grft,Compression of vein,Urin tract infection NOS,Acidosis,Coagulat defect NEC/NOS,Severe sepsis,Atrial fibrillation,Subendo infarct, subseq,Chr pulmon heart dis NEC,Hy kid NOS w cr kid I-IV,Chr kidney dis stage III,Asthma NOS,Left bb block NEC,Gout NOS,Hypothyroidism NOS,Periph vascular dis NOS,Exam-clincal trial,Status cardiac pacemaker
Admission Date:  [**2131-12-29**]              Discharge Date:   [**2132-1-2**]

Date of Birth:  [**2055-8-12**]             Sex:   F

Service: MEDICINE

Allergies:
Patient recorded as having No Known Allergies to Drugs

Attending:[**First Name3 (LF) 4765**]
Chief Complaint:
? VT arrest

Major Surgical or Invasive Procedure:
intubation


History of Present Illness:
Mrs. [**Known firstname 2270**] [**Known lastname 100793**] [**Last Name (un) **] is a very nice 76 year-old woman
with history of CAD s/p CABG x 4, recent [**Last Name (un) 7792**] in [**11-4**], sCHF
(EF 25-30%), CAFib, and HTN who was found down at Rehab with VT.
Per report, she was doing well at [**Hospital 392**] Rehab until yesterday
8:15 PM when she was found minimally responsive in the toilet
without signs of trauma. To minutes afterwards became
unresponsive, without pulse and without breathing in front of
nursing staff. They started CPR immediately and placed AED that
shocked her twice (120 J and 150 J respectively). EMS arrived
and per their report she was in sinus rhythm with ventricular
ectopy. She had a pulse and was breathing. She received 100 mg
lidocaine IV bolus. She was transfered to [**Hospital3 5365**]. Her
initial BP was ~70/40 mmHg and no neurologic exam or [**Location (un) 2611**] is
documented. She was intubated for "airway protection" with
Propofol, etomidate and succynilcoline and BP dropped afterwards
and dopamine was started.
.
Initial labs showed: K of 7.5, creatinine of 3.38, Na 132, WBC
of 15.9 with left shift, PLT 246, CK 38, MB 2.3, TNT 0.05. Other
labs included: PT 14, INR 1.4, BUN 66, Ca 8.3, AST 52, ALT 39,
TP 5.3, Albumin 2.9, Globulin 2.4, AP 162. Her ECG showed sinus
rhythm with LBBB unchanged from prior here on [**11-14**]. She
received kayexalate, insulin, calcium gluconate and was
transfered to the [**Hospital1 18**] for further care.
.
In the BIDMCs ER VS were T 97.7, HR 81, BP 104/46, RR 19, SpO2
100% on AC 450/5/50/RR?. Per report she was moving L
.
In discussion with RN at rehab, she denies that patient has h/o
of stroke, TIA, deep venous thrombosis, pulmonary embolism,
bleeding at the time of surgery, myalgias, joint pains, cough,
hemoptysis, black stools or red stools. She further denies
patient with complaints of recent fevers, chills or rigors,
exertional buttock or calf pain.
.
Cardiac review of systems [**Name8 (MD) **] RN is notable for absence of chest
pain, dyspnea on exertion, paroxysmal nocturnal dyspnea,
orthopnea, ankle edema, palpitations, syncope or presyncope.


Past Medical History:
PAST CARDIOVASCULAR HISTORY:
1. CARDIAC RISK FACTORS: - Diabetes, -Dyslipidemia,
+Hypertension
2. CARDIAC HISTORY:
-CABG: X4 with anatomy: LIMA-D, SVG-LAD, SVG-PDA, SVG-OM
-PERCUTANEOUS CORONARY INTERVENTIONS: None
-PACING/ICD: [**Company 1543**] PPM
3. OTHER PAST MEDICAL HISTORY:
LMCA had a 90% stenosis filling
LAD 100% at the origin
LCx 100% at the origin
RCA 100% at the mid-vessel.
SVG-PDA 100% occluded
SVG-LAD patent filling anterograde and retrograde
Collaterals to PDA and faintly to the OMB
LVG-OMB was occluded proximaly
LIMA-diagonal patent
60% stenosis of the left subclavian artery with a 10-15 mmHg
gradient

PAST MEDICAL HISTORY:
CAD s/p CABG x 4 in [**2128**]: marekdly positive stress c/w 3VD in
[**2128**] and
refused cath at that time. EF last year was >40%.
Chronic systolic heart failure EF 25-30% ([**11-4**])
[**Month (only) 7792**] [**Month (only) **]/09
PPM: [**Company 1543**] Sensia SEDR01. Tachy-brady/complete heart block
likely in the setting of [**Company 7792**].
Lead Information
Chamber Date Implanted Manufacturer Model # Fixation Serial #
[**2131-11-14**] ([**12-29**]+) mitral regurgitation
Pulmonary Hypertension
Chronic AFib: Not anticoagulated due to h/o GIB that required
multiple transfusions
.
Chronic kidney disease: Stage III with eGFR of 46 ml/min and
baseline creatinine 1.2. PTH target 35/70.
HTN
Asthma
Gout
Hypothyroidism


Social History:
Lives in [**Location (un) 50955**] with husband (step-father to daughters in
[**Name (NI) 86**]). No tobacco, EtOH or illicit drug use.

Family History:
Brother with Stroke, Sister with CAD s/p CABG, Sister with
Angina

Physical Exam:
VITAL SIGNS - Temp 97.8 F, BP 140/90 mmHg, HR 85 BPM, RR 20 X',
O2-sat 100% 50%


GENERAL - [**Name (NI) **]-appearing woman, responsive to pain stimuli.
HEENT - NC/AT, PERRLA, pupils 3 mm, symetric and responsive to
light, EOMI, sclerae anicteric, MMM, OP clear, Conjunctiva were
pink, no pallor or cyanosis of the oral mucosa. No xanthalesma.

NECK - supple, no thyromegaly, no JVD, no carotid bruits, RIJ in
place
LUNGS - CTA bilat, no r/rh/wh, good air movement, resp
unlabored, no accessory muscle use
HEART - PMI located in 5th intercostal space, midclavicular
line. RRR, normal S1, S2. No m/r/g. No thrills, lifts. No S3 or
S4.
ABDOMEN - NABS, soft/NT/ND, no masses or HSM, no
rebound/guarding. Abd aorta not enlarged by palpation. No
abdominial bruits.
EXTREMITIES - WWP, no c/c/e, 2+ peripheral pulses (radials,
DPs), No c/c/e. No femoral bruits.
SKIN - no rashes or lesions. No stasis dermatitis, ulcers,
scars, or xanthomas.
LYMPH - no cervical, axillary, or inguinal LAD
NEUROLOGIC:
Mental status: Awake and alert, cooperative with exam, normal
affect.
Cranial Nerves:
Pupils equally round and reactive to light, 4 to 2 mm
bilaterally. Non papilledema on fundoscopic exam. Extraocular
movements unable to assess. Tone in muscles of neck normal.
.
Cerebellum: Unable to assess.
.
Motor:
Normal bulk bilaterally. Tone normal to increased symetric
bilateraly. No observed myoclonus or tremor. No pronator drift.

.
Sensation: Unable to assess
.
Reflexes:
Hyper-reflectic in right leg; otherwise symetric.
Toes downgoing bilaterally.
.
Coordination: Unable to assess.
.
Gait: Unable to assess..


PULSES:
Right: Carotid 2+ Femoral 2+ Popliteal 2+ DP 2+ PT 2+
Left: Carotid 2+ Femoral 2+ Popliteal 2+ DP 2+ PT 2+





Pertinent Results:
CXR-AP (portable) [**2131-12-28**]:
1. Mild volume overload without overt pulmonary edema.
2. ET tube positioned 3.6 cm from the carina.
.
CT Head w/out contrast [**2131-12-28**]:
No acute intracranial hemorrhage. Two small regions of
hypodensity in the
right frontal lobe, age indeterminate w/o prior study for
comparison, but
likely chronic infarct.
.
[**2131-12-29**]
URINE: Blood-MOD Nitrite-POS Protein-75 Glucose-NEG Ketone-TR
Bilirub-NEG Urobiln-NEG pH-5.0 Leuks-TR RBC-[**6-5**]* WBC-[**6-5**]*
Bacteri-MANY Yeast-NONE Epi-0-2 Hours-RANDOM UreaN-321 Creat-155
Na-25 Cl-20 Osmolal-334
.
BLOOD: WBC-18.0*# RBC-3.27* Hgb-9.8* Hct-31.4* MCV-96 MCH-30.1
MCHC-31.3 RDW-17.3* Plt Ct-289# Neuts-82* Bands-3 Lymphs-3*
Monos-7 Eos-2 Baso-1 Atyps-1* Metas-1* Myelos-0 PT-14.8*
PTT-82.4* INR(PT)-1.3*
Glucose-131* UreaN-66* Creat-3.3*# Na-137 K-6.4* Cl-109*
HCO3-18* AnGap-16
Type-ART pO2-306* pCO2-36 pH-7.29* calTCO2-18* Base XS--8
Glucose-121* Lactate-1.5 Na-136 K-6.1* Cl-108 calHCO3-18*
.
CT HEAD [**1-1**]
There is interval development of hypodense appearance of the
cerebral
parenchyma on the right side diffusely, in the right frontal,
parietal and
temporal lobes predominantly, with sulcal effacement and loss of
[**Doctor Last Name 352**]-white matter differentiation. Findings can relate to acute
infarction or
hypoxic/anoxic/ischemic injury Evaluation of basal ganglia,
brain stem and
posterior fossa structures is limited, as also evidence for
herniation. No
acute gross hemorrhage is noted. Study significantly limited due
to artifacts from the electrodes. Consider repeating after
removal of electrodes, if appropriate and correlate clinically.
Evaluation for associated infection is limited

KUB [**12-31**]
An NG tube has been advanced, and is
likely within distal stomach. There has been a decrease in
distension of a
loop of bowel within the mid abdomen, now measuring
approximately 4.5 cm
(previously 5.5 cm). This likely reflects a small bowel loop
rather than
colon. There is no free air or pneumatosis.

IMPRESSION:
1. Interval improvement in a dilated loop of bowel in the mid
abdomen, likely reflecting small bowel.
2. NG tube tip in distal stomach.


Brief Hospital Course:
Mrs. [**Known firstname 2270**] [**Known lastname 100793**] [**Last Name (un) **] is a very nice 76 year-old woman
with history of CAD s/p CABG x 4, recent [**Last Name (un) 7792**] in [**11-4**], HTN,
sCHF (EF 25-30%) who had VT arrest in rehab. She was transferred
to CCU, received Arctic Sun protocol but never regained cortical
function. She passed on [**2131-1-2**]
.
# Anoxic Brain Injury, R MCA CVA - patient never regained
cortical function after neurologic insult prior to admission.
EEG showed diffuse brain dysfunction. Repeat CTs showed massive
CVA. Serial neuro exams were concerning for brain death. Given
prognosis, family communicated that patient would rather pass
than "live as a vegetable". A decision was made to slowly
withdraw care. Roughly 20 family members were at the bedside in
her final days.
.
#. VF/VT Arrest - No strips, but AED fired twice, so most likely
VF/VT arrest secondarely to ischemia after his [**Date Range 7792**]. Never
clear how long she was pulseless. There was suggestion of focal
neurologic deficits in ED, CT negative. Artic sun protocol
completed and repeat CT showed R MCA CVA. While her cardiac
status was stable in a LBBB pattern, she had permanent and
terminal damage
.
#. Hypotension/Septic Shock - most likely in the setting of
starting mechanical ventilation and with sedation. Patient also
dehydrated given diarrhea at rehab. Had + U/A on admission. On
rewarming, she required more pressors. Ultimately, she had C.
Diff colitis complicated by sepsis and renal failure. She was on
PO Vanc and IV flagyl until care was withdrawn
.
#. Acute Renal Failure (ATN)
# Acute on Chronic kidney disease - Patient with diarrhea at
home, poor PO intake on lisinopril and spironolactone who comes
with worsening of the creatinine. She ultimately had anuric
renal failure likely [**1-29**] to sepsis and c diff
.
# Complicated C Diff Colitis, - had diarrhea at rehab and after
cooling was stopped, became septic and KUB showed dilated bowel
(likely small). Patient was on PO Vanc and IV flagyl until care
withdrawn
.
# Peripheral Vascular Disease: Patient admitted with dopplerable
dorsalis pedis pulses. During septic shock, those pulses became
undetectable. By the time of death, her feet were cyanotic and
black on the toes.
.
# Tophaceous Gout: Patient had severe, voluminous tophaceous
gout on the feet, R > L

Medications on Admission:
Spironolactone 25 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
Aspirin 325 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).
Clopidogrel 75 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).
Atorvastatin 80 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).

Furosemide 40 mg Tablet Sig: One (1) Tablet PO every twelve (12)
hours.
Lisinopril 5 mg Tablet Sig: 0.5 Tablet PO DAILY (Daily).
Digoxin 125 mcg Tablet Sig: .5 Tablet PO DAILY (Daily).
Metoprolol Tartrate 25 mg Tablet Sig: 1.5 Tablets PO TID (3
times a day).
Levothyroxine 137 mcg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
Allopurinol 300 mg Tablet Sig: 0.5 Tablet PO DAILY (Daily). .
Ranitidine HCl 150 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
Miconazole Nitrate 2 % Cream Sig: One (1) Appl Topical [**Hospital1 **] (2
times a day) as needed for rash.
Nystatin 100,000 unit/mL Suspension Sig: Five (5) ML PO QID (4
times a day).
Camphor-Menthol 0.5-0.5 % Lotion Sig: One (1) Appl Topical QID
(4 times a day) as needed for itching.
Maalox 200-200-20 mg/5 mL Suspension Sig: 15-30 MLs PO QID (4
times a day) as needed for tongue sores.
Albuterol Sulfate 2.5 mg /3 mL (0.083 %) Solution for
Nebulization Sig: One (1) Inhalation Q6H (every 6 hours) as
needed for SOB.
Ipratropium Bromide 0.02 % Solution Sig: One (1) Inhalation Q6H
(every 6 hours).
Guaifenesin 100 mg/5 mL Syrup Sig: 5-10 MLs PO Q6H (every 6
hours) as needed for cough.
Acetaminophen 325 mg Tablet Sig: 1-2 Tablets PO Q6H (every 6
hours) as needed for pain.


Discharge Medications:
deceased

Discharge Disposition:
Expired

Discharge Diagnosis:
deceased

Discharge Condition:
deceased

Discharge Instructions:
deceased

Followup Instructions:
deceased


Completed by:[**2132-1-2**]
{'Unspecified septicemia,Cerebral artery occlusion, unspecified with cerebral infarction,Septic shock,Acute kidney failure with lesion of tubular necrosis,Anoxic brain damage,Chronic systolic heart failure,Intestinal infection due to Clostridium difficile,Coronary atherosclerosis of autologous vein bypass graft,Compression of vein,Urinary tract infection, site not specified,Acidosis,Other and unspecified coagulation defects,Severe sepsis,Atrial fibrillation,Subendocardial infarction, subsequent episode of care,Other chronic pulmonary heart diseases,Hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage I through stage IV, or unspecified,Chronic kidney disease, Stage III (moderate),Asthma, unspecified type, unspecified,Other left bundle branch block,Gout, unspecified,Unspecified acquired hypothyroidism,Peripheral vascular disease, unspecified,Examination of participant in clinical trial,Cardiac pacemaker in situ'}


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: ? VT arrest

PRESENT ILLNESS: Mrs. [**Known firstname 2270**] [**Known lastname 100793**] [**Last Name (un) **] is a very nice 76 year-old woman
with history of CAD s/p CABG x 4, recent [**Last Name (un) 7792**] in [**11-4**], sCHF
(EF 25-30%), CAFib, and HTN who was found down at Rehab with VT.
Per report, she was doing well at [**Hospital 392**] Rehab until yesterday
8:15 PM when she was found minimally responsive in the toilet
without signs of trauma. To minutes afterwards became
unresponsive, without pulse and without breathing in front of
nursing staff. They started CPR immediately and placed AED that
shocked her twice (120 J and 150 J respectively). EMS arrived
and per their report she was in sinus rhythm with ventricular
ectopy. She had a pulse and was breathing. She received 100 mg
lidocaine IV bolus. She was transfered to [**Hospital3 5365**]. Her
initial BP was ~70/40 mmHg and no neurologic exam or [**Location (un) 2611**] is
documented. She was intubated for "airway protection" with
Propofol, etomidate and succynilcoline and BP dropped afterwards
and dopamine was started.
.
Initial labs showed: K of 7.5, creatinine of 3.38, Na 132, WBC
of 15.9 with left shift, PLT 246, CK 38, MB 2.3, TNT 0.05. Other
labs included: PT 14, INR 1.4, BUN 66, Ca 8.3, AST 52, ALT 39,
TP 5.3, Albumin 2.9, Globulin 2.4, AP 162. Her ECG showed sinus
rhythm with LBBB unchanged from prior here on [**11-14**]. She
received kayexalate, insulin, calcium gluconate and was
transfered to the [**Hospital1 18**] for further care.
.
In the BIDMCs ER VS were T 97.7, HR 81, BP 104/46, RR 19, SpO2
100% on AC 450/5/50/RR?. Per report she was moving L
.
In discussion with RN at rehab, she denies that patient has h/o
of stroke, TIA, deep venous thrombosis, pulmonary embolism,
bleeding at the time of surgery, myalgias, joint pains, cough,
hemoptysis, black stools or red stools. She further denies
patient with complaints of recent fevers, chills or rigors,
exertional buttock or calf pain.
.
Cardiac review of systems [**Name8 (MD) **] RN is notable for absence of chest
pain, dyspnea on exertion, paroxysmal nocturnal dyspnea,
orthopnea, ankle edema, palpitations, syncope or presyncope.

MEDICAL HISTORY: PAST CARDIOVASCULAR HISTORY:
1. CARDIAC RISK FACTORS: - Diabetes, -Dyslipidemia,
+Hypertension
2. CARDIAC HISTORY:
-CABG: X4 with anatomy: LIMA-D, SVG-LAD, SVG-PDA, SVG-OM
-PERCUTANEOUS CORONARY INTERVENTIONS: None
-PACING/ICD: [**Company 1543**] PPM
3. OTHER PAST MEDICAL HISTORY:
LMCA had a 90% stenosis filling
LAD 100% at the origin
LCx 100% at the origin
RCA 100% at the mid-vessel.
SVG-PDA 100% occluded
SVG-LAD patent filling anterograde and retrograde
Collaterals to PDA and faintly to the OMB
LVG-OMB was occluded proximaly
LIMA-diagonal patent
60% stenosis of the left subclavian artery with a 10-15 mmHg
gradient

MEDICATION ON ADMISSION: Spironolactone 25 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
Aspirin 325 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).
Clopidogrel 75 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).
Atorvastatin 80 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: VITAL SIGNS - Temp 97.8 F, BP 140/90 mmHg, HR 85 BPM, RR 20 X',
O2-sat 100% 50%

FAMILY HISTORY: Brother with Stroke, Sister with CAD s/p CABG, Sister with
Angina

SOCIAL HISTORY: Lives in [**Location (un) 50955**] with husband (step-father to daughters in
[**Name (NI) 86**]). No tobacco, EtOH or illicit drug use. 

### Response:
{'Unspecified septicemia,Cerebral artery occlusion, unspecified with cerebral infarction,Septic shock,Acute kidney failure with lesion of tubular necrosis,Anoxic brain damage,Chronic systolic heart failure,Intestinal infection due to Clostridium difficile,Coronary atherosclerosis of autologous vein bypass graft,Compression of vein,Urinary tract infection, site not specified,Acidosis,Other and unspecified coagulation defects,Severe sepsis,Atrial fibrillation,Subendocardial infarction, subsequent episode of care,Other chronic pulmonary heart diseases,Hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage I through stage IV, or unspecified,Chronic kidney disease, Stage III (moderate),Asthma, unspecified type, unspecified,Other left bundle branch block,Gout, unspecified,Unspecified acquired hypothyroidism,Peripheral vascular disease, unspecified,Examination of participant in clinical trial,Cardiac pacemaker in situ'}
