CHIEF COMPLAINT: chest pain

PRESENT ILLNESS: 45 yo M with acute onset chest pain, to ER at OSH where he was
initially treated as ACS, subsequent CTA showed Type A
dissection.

MEDICAL HISTORY: lyme disease
hemorrhoids
T&A

MEDICATION ON ADMISSION: 

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: 98.3 90 21 98% on 2l 123/70
NC/AT, EOMI, PERRL
Lungs CTAB
RRR
Abd benign
Extrem 2+ pulses

FAMILY HISTORY: NC

SOCIAL HISTORY: no tob
2 beers/day
2 marijuana cigarrettes daily
Dissection of aorta, thoracic,Congenital insufficiency of aortic valve,Hemorrhage complicating a procedure,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
Dsct of thoracic aorta,Cong aorta valv insuffic,Hemorrhage complic proc,Abn react-anastom/graft
Admission Date:  [**2148-12-1**]              Discharge Date:   [**2148-12-8**]

Date of Birth:  [**2103-11-27**]             Sex:   M

Service: CARDIOTHORACIC

Allergies:
Patient recorded as having No Known Allergies to Drugs

Attending:[**First Name3 (LF) 922**]
Chief Complaint:
chest pain

Major Surgical or Invasive Procedure:
[**12-1**] replacement of aortic valve and ascending aorta with [**Street Address(2) 70723**]. [**Male First Name (un) 923**] mechanical aortic valved composite graft


History of Present Illness:
45 yo M with acute onset chest pain, to ER at OSH where he was
initially treated as ACS, subsequent CTA showed Type A
dissection.

Past Medical History:
lyme disease
hemorrhoids
T&A

Social History:
no tob
2 beers/day
2 marijuana cigarrettes daily

Family History:
NC

Physical Exam:
98.3 90 21 98% on 2l 123/70
NC/AT, EOMI, PERRL
Lungs CTAB
RRR
Abd benign
Extrem 2+ pulses

Pertinent Results:
[**2148-12-8**] 05:10AM BLOOD WBC-15.6* RBC-4.56* Hgb-12.7* Hct-37.1*
MCV-81* MCH-27.9 MCHC-34.4 RDW-13.5 Plt Ct-333#
[**2148-12-5**] 05:55AM BLOOD WBC-10.9 RBC-3.88* Hgb-10.9* Hct-32.0*
MCV-82 MCH-28.0 MCHC-34.0 RDW-14.1 Plt Ct-200
[**2148-12-8**] 05:10AM BLOOD Plt Ct-333#
[**2148-12-8**] 05:10AM BLOOD PT-22.2* PTT-48.7* INR(PT)-2.2*
[**2148-12-7**] 05:00AM BLOOD PT-20.2* PTT-35.9* INR(PT)-1.9*
[**2148-12-6**] 04:05PM BLOOD PT-17.3* PTT-29.6 INR(PT)-1.6*
[**2148-12-8**] 05:10AM BLOOD Glucose-99 UreaN-17 Creat-0.8 Na-136
K-3.9 Cl-100 HCO3-22 AnGap-18

Brief Hospital Course:
Mr. [**Known lastname 70724**] was taken emergently to the operating room late in
the evening on [**12-1**] where he underwent a Bentall precedure with
#29 St. [**Male First Name (un) 923**] Mechanical Aortic Valve for aortic dissection and
bicuspid AV. He was extubated on POD #1. He was transfused with
2 units for an HCT of 24. He was weaned from his nitroglycerin
and transferred to the floor on POD #2. He was started on
coumadin and heparin drip for his mechanical valve. He was ready
for discharge home on [**12-8**].

Discharge Medications:
1. Metoprolol Tartrate 50 mg Tablet Sig: 1.5 Tablets PO TID (3
times a day).
Disp:*135 Tablet(s)* Refills:*2*
2. Aspirin 81 mg Tablet, Delayed Release (E.C.) Sig: One (1)
Tablet, Delayed Release (E.C.) PO DAILY (Daily).
Disp:*60 Tablet, Delayed Release (E.C.)(s)* Refills:*2*
3. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO
Q4H (every 4 hours) as needed for pain.
Disp:*50 Tablet(s)* Refills:*0*
4. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2
times a day).
Disp:*30 Capsule(s)* Refills:*2*
5. Lisinopril 20 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily).
Disp:*60 Tablet(s)* Refills:*2*
6. Amlodipine 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).
Disp:*30 Tablet(s)* Refills:*2*
7. Diltiazem HCl 30 mg Tablet Sig: One (1) Tablet PO QID (4
times a day).
Disp:*120 Tablet(s)* Refills:*2*
8. Outpatient Lab Work
check protime and INR Monday [**2148-12-9**] and Wed [**2148-12-11**]. Call
results to Dr. [**Last Name (STitle) **]. Bagdasian's office
9. Warfarin 5 mg Tablet Sig: Two (2) Tablet PO once a day.
Disp:*60 Tablet(s)* Refills:*2*


Discharge Disposition:
Home With Service

Facility:
Community Nurse [**First Name (Titles) **] [**Last Name (Titles) **] Care,Inc

Discharge Diagnosis:
1. Ascending aortic dissection
2. Placement of mechanical aortic valve and aortic graft


Discharge Condition:
Good


Discharge Instructions:
no heavy lifting >10lbs
no driving for 8 weeks.

Followup Instructions:
Follow up appointment with with Dr. [**Last Name (STitle) 914**]. Office will call to
arrage this.
Follow up appointment with Dr. [**Last Name (STitle) **]. Bagdasian.



Completed by:[**2148-12-9**]
{'Dissection of aorta, thoracic,Congenital insufficiency of aortic valve,Hemorrhage complicating a procedure,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: chest pain

PRESENT ILLNESS: 45 yo M with acute onset chest pain, to ER at OSH where he was
initially treated as ACS, subsequent CTA showed Type A
dissection.

MEDICAL HISTORY: lyme disease
hemorrhoids
T&A

MEDICATION ON ADMISSION: 

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: 98.3 90 21 98% on 2l 123/70
NC/AT, EOMI, PERRL
Lungs CTAB
RRR
Abd benign
Extrem 2+ pulses

FAMILY HISTORY: NC

SOCIAL HISTORY: no tob
2 beers/day
2 marijuana cigarrettes daily 

### Response:
{'Dissection of aorta, thoracic,Congenital insufficiency of aortic valve,Hemorrhage complicating a procedure,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'}
