CHIEF COMPLAINT: Transfer from [**Hospital3 417**] Hospital with pericardial effusion

PRESENT ILLNESS: This is a 56 year-old man with a recent history of pericarditis
who presented to [**Hospital3 417**] on [**2153-8-26**] with shortness of
breath. Patient's most relevant history dates to [**8-8**] when he
presented to [**Hospital3 **] with chest pain, had negative stress
test/myoview and was noted to ahave small pericardial effuision
on CT, EKG consistent with pericarditis. Treated with NSAIDs. He
was cathed here on [**8-17**] and had clean coronaries.  EF of 60-70%.

MEDICAL HISTORY: hyperlipidemia
GERD
Lyme disease-remote, 20 years ago-knee effusion
kidney stones requiring lithotripsy and ureteral stent

MEDICATION ON ADMISSION: Atorvastatin 20

ALLERGIES: Percocet

PHYSICAL EXAM: Temp:tmax 101.3 at OSH, 99 here BP: 140/90  HR:80   RR:18
96%rm airO2sat  Weight: 190lbs. pulsus:5

FAMILY HISTORY: father and siblings with prostate cancer

SOCIAL HISTORY: Civil judge.  No smoking, occasional alcohol, no drug use.
Acute idiopathic pericarditis,Unspecified pleural effusion,Unspecified disease of pericardium,Other and unspecified hyperlipidemia,Exercise induced bronchospasm,Personal history of urinary calculi
Ac idiopath pericarditis,Pleural effusion NOS,Pericardial disease NOS,Hyperlipidemia NEC/NOS,Exercse ind bronchospasm,Prsnl hst urnr dsrd calc
Admission Date:  [**2153-8-26**]              Discharge Date:   [**2153-8-31**]

Date of Birth:  [**2096-9-11**]             Sex:   M

Service: MEDICINE

Allergies:
Percocet

Attending:[**First Name3 (LF) 2704**]
Chief Complaint:
Transfer from [**Hospital3 417**] Hospital with pericardial effusion


Major Surgical or Invasive Procedure:
Pericardiocentesis with placement of drain.

History of Present Illness:
This is a 56 year-old man with a recent history of pericarditis
who presented to [**Hospital3 417**] on [**2153-8-26**] with shortness of
breath. Patient's most relevant history dates to [**8-8**] when he
presented to [**Hospital3 **] with chest pain, had negative stress
test/myoview and was noted to ahave small pericardial effuision
on CT, EKG consistent with pericarditis. Treated with NSAIDs. He
was cathed here on [**8-17**] and had clean coronaries.  EF of 60-70%.

.
Over the past 2 weeks he has had shortness of breath and some
pleuritic chest pain.  Denies fevers. Generally not feeling
himself.  Also reports GERD.  SOB described as inability to take
full breaths.
.
At [**Hospital3 417**] EKG consistent with pericarditis, no
alternans, ?decreased voltage and CXRAY demonstrating
cardiomegaly consistent effusion.  Blood pressure in 120-130's
by documentation.  Transferred to [**Hospital1 **] for further management.

Past Medical History:
hyperlipidemia
GERD
Lyme disease-remote, 20 years ago-knee effusion
kidney stones requiring lithotripsy and ureteral stent


Social History:
Civil judge.  No smoking, occasional alcohol, no drug use.


Family History:
father and siblings with prostate cancer

Physical Exam:
Temp:tmax 101.3 at OSH, 99 here BP: 140/90  HR:80   RR:18
96%rm airO2sat  Weight: 190lbs. pulsus:5

general: pleasant, comfortable, NAD
HEENT: PERLLA, EOMI, ano scleral icterus, MMM, op without
lesions, no supraclavicular or cervical lymphadenopathy, jvp
10-12cm, no carotid bruits
lungs: CTA b/l with good air movement throughout although no
deep breath secondary to pain
heart: RR, S1 and S2 wnl, +friction rub
abdomen: nd, +b/s, soft, nt, no masses or hepatosplenomegaly
extremities: no edema
skin/nails: no rashes/no jaundice/no splinters
neuro: AAOx3.  Cn II-XII intact.  5/5 strength throughout.


Pertinent Results:
[**2153-8-27**] 05:02AM    WBC 9.2 HCT 32.4* Plt 268
[**2153-8-29**] 05:39AM    ESR 23*
.
ECHO Study Date of [**2153-8-26**]
Conclusions:  The left atrium is normal in size. Left
ventricular wall thickness, cavity size, and systolic function
are normal (LVEF>55%). Right ventricular chamber size is
relatively small with preserved free wall motion. There is a
large circumferential pericardial effusion with sustained right
atrial and right ventricular diastolic collapse, consistent with
impaired fillling/tamponade physiology.
IMPRESSION: Large circumferential pericardial effusion with
evidence for
increased pericardial pressure/tamponade physiology.
.
ECHO Study Date of [**2153-8-30**]   (follow-up post-drain placement)
GENERAL COMMENTS: Left pleural effusion.
Conclusions:
1. Left ventricular wall thickness, cavity size, and systolic
functionare
normal (LVEF>55%). Regional left ventricular wall motion is
normal.
2. There is a small pericardial effusion. There are no
echocardiographic signs  of tamponade.
3. Compared with the prior study (images reviewed) of [**8-29**]/200,
the
pericardial effusion is smaller.
.
ECHO Study Date of [**2153-8-31**]: The left ventricular cavity size is
normal. Overall left ventricular systolic function is normal
(LVEF>55%). Right ventricular chamber size is normal. Right
ventricular systolic function is normal. There is a small
partially echo dense/organized pericardial effusion. There are
no echocardiographic signs of tamponade.
Compared with the prior study (images reviewed) of [**2153-8-30**],
findings are similar.


Brief Hospital Course:
This is a 56 year-old man with recent dx of pericarditis [**8-8**],
subsequent negative ischemic work-up, d/ced NSAIDs secondary to
GERD symptoms with shortness of breath over the past 2-3 weeks,
transferred from [**Hospital3 417**] for further management of
pericardial effusion.
.
1)CV:
-Ischemia: No CAD by recent cath. Continue statin.
-pump: large, primarily posterior, pericardial effusion with
slight impingement of rv filling.  JVP to 10-12 cm, bp's in
130's to 140, heart sound not distant, positive rub, slightly
decr voltage by ekg, small pulsus parodoxus. [**Doctor First Name **] to lab for
drainage. Revealed tamponade physiology. 860 cc drained in lab.
Transferred back to CCU with drain in place. 400 more drained
that day. Echo revealed question of loculated posterior portion,
but continued to drain for 2 more days with aggressive flushing.
Cardiac surgery followed for possible pericardial window. Window
uneccessary. Drain eventually pulled without event. Follow-up
echocardiogram revealed stable pericardial effusion.
-valves: no valcular dz
-rhythm: normal sinus

Medications on Admission:
Atorvastatin 20

Discharge Medications:
1. Atorvastatin 20 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
Disp:*30 Tablet(s)* Refills:*6*


Discharge Disposition:
Home

Discharge Diagnosis:
Idiopathic pericarditis w/ pericardial and pleural effusions


Discharge Condition:
Stable


Discharge Instructions:
Please return to the hospital if you have symptoms of shortness
of breath, chest pain or fever.

Followup Instructions:
Please follow up with your PCP [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **] within one week of
discharge.
.
Please follow up with your primary cardiologist, Dr. [**Last Name (STitle) **],
one week after discharge.
{'Acute idiopathic pericarditis,Unspecified pleural effusion,Unspecified disease of pericardium,Other and unspecified hyperlipidemia,Exercise induced bronchospasm,Personal history of urinary calculi'}


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: Transfer from [**Hospital3 417**] Hospital with pericardial effusion

PRESENT ILLNESS: This is a 56 year-old man with a recent history of pericarditis
who presented to [**Hospital3 417**] on [**2153-8-26**] with shortness of
breath. Patient's most relevant history dates to [**8-8**] when he
presented to [**Hospital3 **] with chest pain, had negative stress
test/myoview and was noted to ahave small pericardial effuision
on CT, EKG consistent with pericarditis. Treated with NSAIDs. He
was cathed here on [**8-17**] and had clean coronaries.  EF of 60-70%.

MEDICAL HISTORY: hyperlipidemia
GERD
Lyme disease-remote, 20 years ago-knee effusion
kidney stones requiring lithotripsy and ureteral stent

MEDICATION ON ADMISSION: Atorvastatin 20

ALLERGIES: Percocet

PHYSICAL EXAM: Temp:tmax 101.3 at OSH, 99 here BP: 140/90  HR:80   RR:18
96%rm airO2sat  Weight: 190lbs. pulsus:5

FAMILY HISTORY: father and siblings with prostate cancer

SOCIAL HISTORY: Civil judge.  No smoking, occasional alcohol, no drug use. 

### Response:
{'Acute idiopathic pericarditis,Unspecified pleural effusion,Unspecified disease of pericardium,Other and unspecified hyperlipidemia,Exercise induced bronchospasm,Personal history of urinary calculi'}
