CHIEF COMPLAINT: 

PRESENT ILLNESS: [**First Name8 (NamePattern2) 5586**] [**Known lastname 64122**] was a 78-year-old
man with a past medical history of diabetes,
hypercholesterolemia, hypertension, AAA repair and colon
cancer, who presented with fatigue and chest pain.  He
initially presented to [**Hospital6 **], where he was
found to have atrial fibrillation and a non-ST elevation
myocardial infarction with a troponin I of 0.91 and a CK of
84.  While at [**Hospital6 **] he developed recurrent
symptoms and was transferred to [**Hospital1 188**] for further care.  Upon his arrival he was found to have
cardiogenic shock and was intubated and taken urgently for
cardiac catheterization.

MEDICAL HISTORY: 

MEDICATION ON ADMISSION: 

ALLERGIES: 

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: 
Subendocardial infarction, initial episode of care,Cardiogenic shock,Atrial fibrillation,Unspecified gastritis and gastroduodenitis, with hemorrhage,Acute respiratory failure,Acidosis,Pneumonitis due to inhalation of food or vomitus,Malignant neoplasm of other parts of bronchus or lung,Secondary malignant neoplasm of bone and bone marrow,Malignant neoplasm of liver, secondary,Iron deficiency anemia secondary to blood loss (chronic),Congestive heart failure, unspecified,Pressure ulcer, buttock,Unspecified septicemia,Sepsis,Coronary atherosclerosis of native coronary artery,Personal history of malignant neoplasm of large intestine,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Unspecified essential hypertension,Hepatomegaly,Angiodysplasia of stomach and duodenum without mention of hemorrhage,Esophageal varices without mention of bleeding,Benign neoplasm of duodenum, jejunum, and ileum,Umbilical hernia without mention of obstruction or gangrene,Asbestosis,Other chronic pulmonary heart diseases,Surgical or other procedure not carried out because of contraindication,Anemia of other chronic disease
Subendo infarct, initial,Cardiogenic shock,Atrial fibrillation,Gstr/ddnts NOS w hmrhg,Acute respiratry failure,Acidosis,Food/vomit pneumonitis,Mal neo bronch/lung NEC,Secondary malig neo bone,Second malig neo liver,Chr blood loss anemia,CHF NOS,Pressure ulcer, buttock,Septicemia NOS,Sepsis,Crnry athrscl natve vssl,Hx of colonic malignancy,DMII wo cmp nt st uncntr,Hypertension NOS,Hepatomegaly,Angio stm/dudn w/o hmrhg,Esoph varices w/o bleed,Benign neoplasm sm bowel,Umbilical hernia,Asbestosis,Chr pulmon heart dis NEC,No proc/contraindication,Anemia-other chronic dis
Unit No:  [**Numeric Identifier 64121**]
Admission Date: [**2179-7-14**]
Discharge Date: [**2179-7-29**]
Date of Birth:  [**2100-10-28**]
Sex: M
Service:


HISTORY OF PRESENT ILLNESS:  [**First Name8 (NamePattern2) 5586**] [**Known lastname 64122**] was a 78-year-old
man with a past medical history of diabetes,
hypercholesterolemia, hypertension, AAA repair and colon
cancer, who presented with fatigue and chest pain.  He
initially presented to [**Hospital6 **], where he was
found to have atrial fibrillation and a non-ST elevation
myocardial infarction with a troponin I of 0.91 and a CK of
84.  While at [**Hospital6 **] he developed recurrent
symptoms and was transferred to [**Hospital1 188**] for further care.  Upon his arrival he was found to have
cardiogenic shock and was intubated and taken urgently for
cardiac catheterization.

PHYSICAL EXAMINATION:  Initial vital signs were temperature
99.4, blood pressure 78/48, heart rate 119, respiratory rate
20.  In general he was intubated and sedated.  His pupils
were equal, round and reactive to light.  He was lying flat
so jugular venous distention could not be evaluated.  There
was no apparent goiter.  His lungs were clear anteriorly.  He
had a regular rhythm and rate with a normal S1 and S2.  There
were no murmurs, rubs or gallops.  The PMI was lateral.  The
abdomen was soft and mildly distended with normal bowel
sounds.  There was no guarding.  His stool was OB positive.
Extremities were cool with dopplerable pulses.  Neurological
exam was limited due to his sedation.

PERTINENT LABORATORY/RADIOLOGY/OTHER FINDINGS:  His initial
ECG on [**2179-7-15**], showed sinus tachycardia at a rate of 110,
there was a late transition consistent with possible prior
anterior infarction, there was left axis deviation,
nonspecific ST-T wave changes.  Cardiac catheterization was
performed on [**2179-7-14**].  This showed severe 3 vessel disease
with severe systolic and diastolic ventricular dysfunction.
An echocardiogram was performed on [**2179-7-15**].  This showed
severe left ventricular systolic dysfunction on a poor
quality study.  A repeat echocardiogram was performed later
that day that confirmed left ventricular systolic dysfunction
and found no significant valvular dysfunction.  He again went
for cardiac catheterization on [**2179-7-15**], during which he
had percutaneous intervention of the left main coronary
artery, the left anterior descending, the left circumflex and
a diagonal branch.  A chest x-ray was performed on [**2179-7-15**]
which showed pulmonary edema and an intra-aortic balloon
pump.  Another echocardiogram was performed on [**2179-7-16**],
which again showed severe systolic dysfunction, with no
significant valvular disease.  On [**2179-7-21**] a CT of the
chest, abdomen and pelvis showed a left upper lobe mass
invading the left superior pulmonary vein, left iliac bone
metastasis and liver lesions, likely metastases, and
borderline thickening of the gallbladder.

HOSPITAL COURSE:  Mr. [**Name14 (STitle) 64123**] initially presented with
cardiogenic shock in the setting of acute coronary syndrome.
He was intubated and taken to the cardiac catheterization
laboratory.  Cardiac catheterization showed severe 3 vessel
disease.  Cardiac surgery consultation was obtained, but it
was determined that he was not a good candidate for surgical
revascularization.  He, therefore, went back to the cardiac
catheterization lab the next day for high-risk intervention
with placement of an intra-aortic balloon pump.  Over the
next several days his cardiogenic shock improved and he was
weaned off the intra-aortic balloon pump and pressors,
however, he remained intubated due to hypoxia and congestive
heart failure.  Pulmonary consultation was obtained.  A CT of
the chest and abdomen was obtained for further evaluation and
demonstrated metastatic cancer.  The decision was made to
treat him medically in consultation with his healthcare
proxy, however, his hypoxia failed to improve.  On [**2184-7-26**]
there was a meeting with the family, the healthcare proxy and
the clinical team, and the decision was made to pursue
comfort measures only.  He was subsequently extubated and
died on [**2179-7-29**] at 4:08 a.m.  Autopsy was declined.

CONDITION ON DISCHARGE:  Expired.

DISCHARGE STATUS:  Expired.

DISCHARGE INSTRUCTIONS:  Not applicable.

DIAGNOSES:
1. Congestive heart failure.
2. Acute myocardial infarction.
3. Metastatic cancer from a probable lung source.



                        [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern1) **], MD

Dictated By:[**Last Name (NamePattern1) 64124**]
MEDQUIST36
D:  [**2184-7-7**] 12:50:33
T:  [**2184-7-7**] 13:38:15
Job#:  [**Job Number 64125**]
{'Subendocardial infarction, initial episode of care,Cardiogenic shock,Atrial fibrillation,Unspecified gastritis and gastroduodenitis, with hemorrhage,Acute respiratory failure,Acidosis,Pneumonitis due to inhalation of food or vomitus,Malignant neoplasm of other parts of bronchus or lung,Secondary malignant neoplasm of bone and bone marrow,Malignant neoplasm of liver, secondary,Iron deficiency anemia secondary to blood loss (chronic),Congestive heart failure, unspecified,Pressure ulcer, buttock,Unspecified septicemia,Sepsis,Coronary atherosclerosis of native coronary artery,Personal history of malignant neoplasm of large intestine,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Unspecified essential hypertension,Hepatomegaly,Angiodysplasia of stomach and duodenum without mention of hemorrhage,Esophageal varices without mention of bleeding,Benign neoplasm of duodenum, jejunum, and ileum,Umbilical hernia without mention of obstruction or gangrene,Asbestosis,Other chronic pulmonary heart diseases,Surgical or other procedure not carried out because of contraindication,Anemia of other chronic disease'}


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: [**First Name8 (NamePattern2) 5586**] [**Known lastname 64122**] was a 78-year-old
man with a past medical history of diabetes,
hypercholesterolemia, hypertension, AAA repair and colon
cancer, who presented with fatigue and chest pain.  He
initially presented to [**Hospital6 **], where he was
found to have atrial fibrillation and a non-ST elevation
myocardial infarction with a troponin I of 0.91 and a CK of
84.  While at [**Hospital6 **] he developed recurrent
symptoms and was transferred to [**Hospital1 188**] for further care.  Upon his arrival he was found to have
cardiogenic shock and was intubated and taken urgently for
cardiac catheterization.

MEDICAL HISTORY: 

MEDICATION ON ADMISSION: 

ALLERGIES: 

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY:  

### Response:
{'Subendocardial infarction, initial episode of care,Cardiogenic shock,Atrial fibrillation,Unspecified gastritis and gastroduodenitis, with hemorrhage,Acute respiratory failure,Acidosis,Pneumonitis due to inhalation of food or vomitus,Malignant neoplasm of other parts of bronchus or lung,Secondary malignant neoplasm of bone and bone marrow,Malignant neoplasm of liver, secondary,Iron deficiency anemia secondary to blood loss (chronic),Congestive heart failure, unspecified,Pressure ulcer, buttock,Unspecified septicemia,Sepsis,Coronary atherosclerosis of native coronary artery,Personal history of malignant neoplasm of large intestine,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Unspecified essential hypertension,Hepatomegaly,Angiodysplasia of stomach and duodenum without mention of hemorrhage,Esophageal varices without mention of bleeding,Benign neoplasm of duodenum, jejunum, and ileum,Umbilical hernia without mention of obstruction or gangrene,Asbestosis,Other chronic pulmonary heart diseases,Surgical or other procedure not carried out because of contraindication,Anemia of other chronic disease'}
