CHIEF COMPLAINT: cardiac arrest

PRESENT ILLNESS: 52 yo M with reported hx of Cardiomyopathy (EF 35%, etiology
unspecified), morbid obesity, HTN, HLD, and Sleep Apnea who
presents after cardiac arrest in the community. The patient was
found down by a snow plower who had seen the patient brushing
the snow off his car 10 minutes earlier. EMS was called and
arrived approximately 15 minutes later. No compressions were
started at that time. Patient was found to be in Ventricular
Fibrillation. Compressions were started, and the patient was
intubated. He was shocked three times and given Epinephrine 1mg
x 3, Atropine x 3, and Lidocaine 100 mg once with return of
sinus tachycardia. He was taken to [**Hospital3 1443**] where he
was found to be in a wide complex tachycardia at 120, BP 80/50,
agonal, and was placed on a lidocaine drip. A right femoral line
was placed. He was transferred to [**Hospital1 18**] for cardiac evaluation.
.
At [**Hospital1 18**] initial vitals revealed HR 113, BP 116/ 51, Intubated.
Patient was taken to the cath lab where he was found to have
normal coronary arteries.
.
In the CCU, the patient was intubated, sedated. Initial vitals:
113, 133/80, Sat 100% on CMV 500, 26, 5. Artic Sun cooling
protocol for neuroprotection was initiated. It was difficult to
get the patient cooled, which was concerning for an underlying
infection.
.
Unable to perform review of systems

MEDICAL HISTORY: 1. CARDIAC RISK FACTORS: +Diabetes, +Dyslipidemia, +Hypertension

MEDICATION ON ADMISSION: Furosemide 40 mg q am
Lisinopril 40mg Daily
Digitek 0.25mg Daily
Allopurinol [**Age over 90 **]m g Daily
Vicodin 5-500 mg Tabs 1-2 tabs po BID prn severe pain
Econazole Nitrate 1% twice daily
Colchicine 0.6mg one tab PO BIC x 5-7 days prn gout flare
Medrol dose pak
Coumadin 7.5mg mondays, 5 days
Aldactone 25mg Daily
Pravastatin 40mg Daily
Nispan 500mg one tab PO QHS
Toprol 50mg once daily

ALLERGIES: No Known Allergies / Adverse Drug Reactions

PHYSICAL EXAM: Admission PHYSICAL EXAMINATION:
VS: BP= 130/80 HR=108 RR=26 O2 sat= 100% - Fi02 100%
GENERAL: intubated, paralyzed, morbidly obese man
HEENT: NC, sclera anicteric, pupils dilated, not reactive
NECK: unable to appreciated JVP given body habitus
CARDIAC: difficult to auscultate over lung sounds
LUNGS: diffuse coarse rhochorous inspirations
ABDOMEN: enlarged, + BS over lower abdomen, + cooling pads in
place
EXTREMITIES: no edema, +SCDs, DP & PT pulses 1+ bilaterally
.
NEURO ExAM [**2120-1-29**]
VS: T: 98.2 P: 100 BP: 113/67 RR: 22 SaO2: 99% intubated
General: Lying in bed, not arousible to voice or noxious stimuli
MS: No arousal to voice or noxious stimuli.  Not following
commands.
CN: Pupils 4->2mm bilaterally.  Slight skew deviation, with
right
eye elevated a few mm compared to the left. Small lateral
movements noted with oculocephalics.  Negative corneals,
negative
gag.
Motor/Sensory: Very slight extensor movements noted in bilateral
upper extremities in response to pinch bilaterally.  No response
to painful stimuli in bilateral lower extremities.
Reflexes: 2+ and symmetric throughout

FAMILY HISTORY: Family history is sgnificant for cardiovascular disease. (from
records)

SOCIAL HISTORY: On [**Social Security Number 89547**]Social Security Disability. Lives in subsidized housing.
Smoker, Social Drinker. (from records)
Ventricular fibrillation,Acute respiratory failure,Acute and subacute necrosis of liver,Pneumonitis due to inhalation of food or vomitus,Acute kidney failure, unspecified,Body Mass Index 40.0-44.9, adult,Ventilator associated pneumonia,Anoxic brain damage,Other primary cardiomyopathies,Other shock without mention of trauma,Other convulsions,Abnormal coagulation profile,Hypovolemia,Unspecified essential hypertension,Other and unspecified hyperlipidemia,Obstructive sleep apnea (adult)(pediatric),Morbid obesity,Gout, unspecified,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure
Ventricular fibrillation,Acute respiratry failure,Acute necrosis of liver,Food/vomit pneumonitis,Acute kidney failure NOS,BMI 40.0-44.9, adult,Ventltr assoc pneumonia,Anoxic brain damage,Prim cardiomyopathy NEC,Shock w/o trauma NEC,Convulsions NEC,Abnrml coagultion prfile,Hypovolemia,Hypertension NOS,Hyperlipidemia NEC/NOS,Obstructive sleep apnea,Morbid obesity,Gout NOS,DMII wo cmp nt st uncntr,Abn react-procedure NEC
Admission Date:  [**2120-1-24**]              Discharge Date:   [**2120-1-30**]

Date of Birth:  [**2067-9-5**]             Sex:   M

Service: MEDICINE

Allergies:
No Known Allergies / Adverse Drug Reactions

Attending:[**First Name3 (LF) 1145**]
Chief Complaint:
cardiac arrest

Major Surgical or Invasive Procedure:
cardiac catheterization

History of Present Illness:
52 yo M with reported hx of Cardiomyopathy (EF 35%, etiology
unspecified), morbid obesity, HTN, HLD, and Sleep Apnea who
presents after cardiac arrest in the community. The patient was
found down by a snow plower who had seen the patient brushing
the snow off his car 10 minutes earlier. EMS was called and
arrived approximately 15 minutes later. No compressions were
started at that time. Patient was found to be in Ventricular
Fibrillation. Compressions were started, and the patient was
intubated. He was shocked three times and given Epinephrine 1mg
x 3, Atropine x 3, and Lidocaine 100 mg once with return of
sinus tachycardia. He was taken to [**Hospital3 1443**] where he
was found to be in a wide complex tachycardia at 120, BP 80/50,
agonal, and was placed on a lidocaine drip. A right femoral line
was placed. He was transferred to [**Hospital1 18**] for cardiac evaluation.
.
At [**Hospital1 18**] initial vitals revealed HR 113, BP 116/ 51, Intubated.
Patient was taken to the cath lab where he was found to have
normal coronary arteries.
.
In the CCU, the patient was intubated, sedated. Initial vitals:
113, 133/80, Sat 100% on CMV 500, 26, 5. Artic Sun cooling
protocol for neuroprotection was initiated. It was difficult to
get the patient cooled, which was concerning for an underlying
infection.
.
Unable to perform review of systems

Past Medical History:
1. CARDIAC RISK FACTORS: +Diabetes, +Dyslipidemia, +Hypertension

2. OTHER PAST MEDICAL HISTORY:
Diabetes
Obstructive Sleep Apena
Atrial Fibrillation
Depression
Back Pain
Gout
Obesity
Hyperlipidemia
Cardiomyopathy NOS
HTN


Social History:
On [**Social Security Number 89547**]Social Security Disability. Lives in subsidized housing.
Smoker, Social Drinker. (from records)


Family History:
Family history is sgnificant for cardiovascular disease. (from
records)

Physical Exam:
Admission PHYSICAL EXAMINATION:
VS: BP= 130/80 HR=108 RR=26 O2 sat= 100% - Fi02 100%
GENERAL: intubated, paralyzed, morbidly obese man
HEENT: NC, sclera anicteric, pupils dilated, not reactive
NECK: unable to appreciated JVP given body habitus
CARDIAC: difficult to auscultate over lung sounds
LUNGS: diffuse coarse rhochorous inspirations
ABDOMEN: enlarged, + BS over lower abdomen, + cooling pads in
place
EXTREMITIES: no edema, +SCDs, DP & PT pulses 1+ bilaterally
.
NEURO ExAM [**2120-1-29**]
VS: T: 98.2 P: 100 BP: 113/67 RR: 22 SaO2: 99% intubated
General: Lying in bed, not arousible to voice or noxious stimuli
MS: No arousal to voice or noxious stimuli.  Not following
commands.
CN: Pupils 4->2mm bilaterally.  Slight skew deviation, with
right
eye elevated a few mm compared to the left. Small lateral
movements noted with oculocephalics.  Negative corneals,
negative
gag.
Motor/Sensory: Very slight extensor movements noted in bilateral
upper extremities in response to pinch bilaterally.  No response
to painful stimuli in bilateral lower extremities.
Reflexes: 2+ and symmetric throughout


Pertinent Results:
PERTINENT LABS:
[**2120-1-24**] 06:00PM BLOOD WBC-16.0* RBC-4.21* Hgb-14.1 Hct-39.3*
MCV-93 MCH-33.5* MCHC-36.0* RDW-14.4 Plt Ct-301
[**2120-1-24**] 06:00PM BLOOD Neuts-88.9* Lymphs-5.7* Monos-4.6 Eos-0.5
Baso-0.3
[**2120-1-24**] 06:00PM BLOOD PT-23.4* PTT-25.8 INR(PT)-2.2*
[**2120-1-25**] 02:03AM BLOOD Fibrino-648*
[**2120-1-24**] 06:00PM BLOOD Glucose-216* UreaN-20 Creat-1.3* Na-134
K-4.8 Cl-103 HCO3-15* AnGap-21*
[**2120-1-24**] 10:34PM BLOOD ALT-109* AST-130* CK(CPK)-655* AlkPhos-78
TotBili-0.5
[**2120-1-24**] 10:34PM BLOOD CK-MB-26* MB Indx-4.0 cTropnT-0.57*
[**2120-1-24**] 06:00PM BLOOD CK-MB-15* MB Indx-3.8 cTropnT-0.33*
[**2120-1-30**] 04:41AM BLOOD Lipase-27 GGT-58
[**2120-1-24**] 10:34PM BLOOD Calcium-8.2* Phos-5.1* Mg-1.8
[**2120-1-28**] 05:07AM BLOOD calTIBC-204* Hapto-224* Ferritn-1250*
TRF-157*
[**2120-1-25**] 06:07PM BLOOD D-Dimer-3857*
[**2120-1-24**] 06:00PM BLOOD %HbA1c-6.1* eAG-128*
[**2120-1-24**] 06:00PM BLOOD Type-ART O2 Flow-15 pO2-465* pCO2-35
pH-7.31* calTCO2-18* Base XS--7 -ASSIST/CON Intubat-NOT INTUBA
Comment-INTUBATED
[**2120-1-24**] 06:00PM BLOOD Glucose-210* Lactate-2.8* K-4.7
[**2120-1-27**] 08:56PM BLOOD Lactate-3.5*
.
.
STUDIES:
CARDIAC CATH [**2120-1-24**]:
COMMENTS:
1. Selective coronary angiography of this right dominant system
revealed
no angiographically apparent obstructive coronary disease. The
LMCA,
LAD, Lcx and RCA all had no angiographically apparent disease.
2. Limited hemodynamics revealed normal filling pressure with
LVEDP of
8mmHg. There was normotension of 116/63 mmHg. There was no
transaortic
valve gradient on careful pullback from LV to aorta.

FINAL DIAGNOSIS:
1. Coronary arteries are normal.
2. Normal diastolic function.
3. Systemic normotension.
.
TTE [**2120-1-25**]:
Conclusions
The right atrium is moderately dilated. There is mild symmetric
left ventricular hypertrophy. The left ventricular cavity size
is normal. Overall left ventricular systolic function is normal
(LVEF 65%). Right ventricular chamber size and free wall motion
are normal. The aortic valve leaflets (3) appear structurally
normal with good leaflet excursion and no aortic stenosis. Mild
(1+) aortic regurgitation is seen. The mitral valve leaflets are
mildly thickened. The mitral valve leaflets are elongated.
Mitral valve prolapse cannot be excluded. An eccentric,
posteriorly directed jet of Moderate (2+) mitral regurgitation
is seen. There is no pericardial effusion.
.
Chest Xray [**2120-1-24**]
IMPRESSION: Moderate cardiomegaly without evidence of pulmonary
edema,
adequate placement of the endotracheal tube.
.
Chest Xray [**2120-1-30**]
FINDINGS: In comparison with the study of [**1-29**], monitoring and
support devices remain in place. There is again substantial
enlargement of the cardiac silhouette with evidence of increased
pulmonary venous pressure. Retrocardiac and left lower lung
opacification suggests volume loss and possible pleural
effusion.
.
Liver Ultrasound [**2120-1-30**]
1. Equivocally increased liver echogenicity, which may be
technical, though alternatively may suggest a mild degree of
fatty infiltration.
2. Likely segment III hemangioma.
3. No biliary duct dilation. Patent hepatic vasculature.
4. Sludge is seen within the gallbladder.
.
MICRO:
URINE CX [**2120-1-25**]: NO GROWTH
.
BLOOD CX [**2120-1-25**]: PENDING
BLOOD CX [**2120-1-26**]: PENDING
.
[**2120-1-27**] 1:50 pm SPUTUM      Source: Endotracheal.

   GRAM STAIN (Final [**2120-1-27**]):
      >25 PMNs and <10 epithelial cells/100X field.
      4+   (>10 per 1000X FIELD):   GRAM POSITIVE COCCI.
                                    IN PAIRS AND CLUSTERS.

   RESPIRATORY CULTURE (Preliminary):
      Further incubation required to determine the presence or
absence of
      commensal respiratory flora.
      STAPH AUREUS COAG +.    MODERATE GROWTH.

   LEGIONELLA CULTURE (Preliminary):    NO LEGIONELLA ISOLATED.

   FUNGAL CULTURE (Preliminary):
.
                             STAPH AUREUS COAG +
                             |
CLINDAMYCIN-----------   =>8 R
ERYTHROMYCIN----------   =>8 R
GENTAMICIN------------ <=0.5 S
LEVOFLOXACIN----------   =>8 R
OXACILLIN-------------   =>4 R
RIFAMPIN-------------- <=0.5 S
TETRACYCLINE----------     2 S
TRIMETHOPRIM/SULFA---- <=0.5 S
VANCOMYCIN------------     1 S
.
.
URINE CULTURE (Final [**2120-1-29**]):
      PROBABLE ENTEROCOCCUS.    ~6OOO/ML.
.


Brief Hospital Course:
HOSPITAL COURSE
52 yo M with reported hx of cardiomyopathy s/p Ventricular
Fibrillation cardiac arrest in the community, transferred to our
facility, found to have no hemodynamically significant coronary
disease, preserved ejection fraction, who underwent cooling
protocol for neuroprotection. Neurological evaluation revealed
only minimal neurogical brainstem function. Family member
decided to withdraw life sustaining measures and pursue comfort
measures as goals of care.  Organ Donation was contact[**Name (NI) **] and
arrangements were made for organ donation.  The case was
accepted by the Medical Examiner.
.
ACTIVE ISSUES
# Ventricular Fibrillation Cardiac Arrest: Unclear etiology.
Occurred in the community setting, and patient was resuscitated
by EMS (estimated time to perfusion 20-25 minutes). He was
intubated in the field and initially brought to [**Hospital3 19345**], then transferred to [**Hospital1 18**] where he immediately went
for cardiac catheterization, which revealed no significant
coronary artery disease. He was admitted to the Cardiac
Intensive Care Unit and started on the Artic Sun Therapuetic
Cooling Protocol for neuroprotection (detailed below). He was
monitored on telemetry and remained in sinus rhythm. An
echocardiogram obtained the day after admission revealed mild
left ventricular hypertrophy and preserved ejection fraction.
The etiology behind his ventricular fibrillation remained
unclear.
.
# Therapuetic Cooling for Neuroprotection after Cardiac Arrest:
The interval between arrest and initiation of cooling was 5
hours. However, the patient was difficult to cool to optimal
temperature of 33 degrees, which was concerning for underlying
infection. During his cardiac catheterization he showed no signs
of meaningful interaction. He was sedated and paralyzed. His
labs were closely monitored for the expected hypokalemia and
hyperglycemia during cooling and hyperkalemia and hypoglycemia
during rewarming. He was started on insulin sliding scale for
tight glucose control. He received continuous video EEG, which
revealed seizure activity consistent with status epilepticus.
Neurology was consulted and provided recommendations regarding
anti-epileptic agents and dosing. He was started on three
different antiepileptics (phenytoin, valproic acid, and
levetiracetam) in attempt to control his seizure activity. Once
warmed, he did demonstrate preserved brainstem function
evidenced by preserved respiratory drive and pupillary reaction.
Off of sedation he remained non-responsive to stimuli.
Neurological evaluation revealed exam notable only for reactive
pupils, intact reflexes, and very slight extensor posturing of
his upper extremities in response to painful stimuli.  While the
patient was still exhibiting some signs of brainstem activity,
these were all poor prognostic signs for a meaningful recovery.
Given his poor prognosis, his only living family member and
health care proxy decided to withdraw life sustaining care and
focus on comfort measures.
.
# Hypoxic Respiratory Failure: The patient was initially
intubated by EMS secondary to his neurological insult after
cardiac arrest. He was started on Fentanyl and Midazolam for
sedation. We monitored his arterial blood gases and attempted to
wean his FiO2 to prevent free radial formation; however, the
patient began to demonstrate decreased PaO2 requiring higher
PEEP and FiO2 to remain adequate. This was most likely secondary
to a Ventilator Associated Pneumonia, as his PaO2 improved with
aggressive suctioning of thick green secretions that grew
methicillin-resistant staph aureus in culture. He was initially
started on broad antibiotics, which were tapered to Vancomycin
(cefepime and flagyl discontinued) once the speciation data
returned.
.
# Hypotension: The patient had a brief period of hypotension
requiring transient use of pressure support with norepinephrine.
This was likely secondary to hypovolemia, and improved with
fluid boluses.
.
# Coagulopathy: The patient was on coumadin for atrial
fibrillation as an outpatient. He presented with a
supratherapuetic INR, which increased during the cooling
process, but then trended down with vitamin K. Labwork was
negative for DIC. He showed no evidence of active bleeding.
.
# Acute Kidney Injury: Likely pre-renal in etiology as improved
with IV hydration. Enterococcus grew in urine ~6000 units.
Vancomycin for positive sputum culture continued.
.
# Reported History of Cardiomyopathy: The patient presented with
a history of cardiomyopathy, and on an outpatient regimen of
digoxin, toprol, lisinopril, aldactone, aspirin, and lasix. He
was found to have clean coronaries during cardiac
catheterization and preserved ejection fraction without
significant valvular abnormalities on echocardiogram. His
outpatient medications were held during this admission.
.
# Atrial fibrillation: He remained in sinus rhythm. We held his
anticoagulation and rate control agents.
.
# HTN: We held his antihypertensives which were started HD 5
after warming as patient became hypertensive.
.
# HLD: We held his statin.
.
# Goals of Care: After discussion with his Health Care Proxy
(his only living relative, his sister [**Doctor First Name **] it was decided
that goals of care would be switched from providing life
sustaining care to pursuing aggressive comfort measures. His
code status was changed to Do Not Resucitate/Do Not Intubate.
The patient was evaluated for organ donation following the
Health Care Proxy's wishes.  He was terminally extubated in the
operating room.  The case was accepted by the Medical Examiner.


Medications on Admission:
Furosemide 40 mg q am
Lisinopril 40mg Daily
Digitek 0.25mg Daily
Allopurinol [**Age over 90 **]m g Daily
Vicodin 5-500 mg Tabs 1-2 tabs po BID prn severe pain
Econazole Nitrate 1% twice daily
Colchicine 0.6mg one tab PO BIC x 5-7 days prn gout flare
Medrol dose pak
Coumadin 7.5mg mondays, 5 days
Aldactone 25mg Daily
Pravastatin 40mg Daily
Nispan 500mg one tab PO QHS
Toprol 50mg once daily

Discharge Medications:
not applicable

Discharge Disposition:
Expired

Discharge Diagnosis:
Ventricular Fibrillation arrest with anoxic brain injury

Discharge Condition:
Expired

Discharge Instructions:
Expired

Followup Instructions:
Expired
{'Ventricular fibrillation,Acute respiratory failure,Acute and subacute necrosis of liver,Pneumonitis due to inhalation of food or vomitus,Acute kidney failure, unspecified,Body Mass Index 40.0-44.9, adult,Ventilator associated pneumonia,Anoxic brain damage,Other primary cardiomyopathies,Other shock without mention of trauma,Other convulsions,Abnormal coagulation profile,Hypovolemia,Unspecified essential hypertension,Other and unspecified hyperlipidemia,Obstructive sleep apnea (adult)(pediatric),Morbid obesity,Gout, unspecified,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure'}


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: cardiac arrest

PRESENT ILLNESS: 52 yo M with reported hx of Cardiomyopathy (EF 35%, etiology
unspecified), morbid obesity, HTN, HLD, and Sleep Apnea who
presents after cardiac arrest in the community. The patient was
found down by a snow plower who had seen the patient brushing
the snow off his car 10 minutes earlier. EMS was called and
arrived approximately 15 minutes later. No compressions were
started at that time. Patient was found to be in Ventricular
Fibrillation. Compressions were started, and the patient was
intubated. He was shocked three times and given Epinephrine 1mg
x 3, Atropine x 3, and Lidocaine 100 mg once with return of
sinus tachycardia. He was taken to [**Hospital3 1443**] where he
was found to be in a wide complex tachycardia at 120, BP 80/50,
agonal, and was placed on a lidocaine drip. A right femoral line
was placed. He was transferred to [**Hospital1 18**] for cardiac evaluation.
.
At [**Hospital1 18**] initial vitals revealed HR 113, BP 116/ 51, Intubated.
Patient was taken to the cath lab where he was found to have
normal coronary arteries.
.
In the CCU, the patient was intubated, sedated. Initial vitals:
113, 133/80, Sat 100% on CMV 500, 26, 5. Artic Sun cooling
protocol for neuroprotection was initiated. It was difficult to
get the patient cooled, which was concerning for an underlying
infection.
.
Unable to perform review of systems

MEDICAL HISTORY: 1. CARDIAC RISK FACTORS: +Diabetes, +Dyslipidemia, +Hypertension

MEDICATION ON ADMISSION: Furosemide 40 mg q am
Lisinopril 40mg Daily
Digitek 0.25mg Daily
Allopurinol [**Age over 90 **]m g Daily
Vicodin 5-500 mg Tabs 1-2 tabs po BID prn severe pain
Econazole Nitrate 1% twice daily
Colchicine 0.6mg one tab PO BIC x 5-7 days prn gout flare
Medrol dose pak
Coumadin 7.5mg mondays, 5 days
Aldactone 25mg Daily
Pravastatin 40mg Daily
Nispan 500mg one tab PO QHS
Toprol 50mg once daily

ALLERGIES: No Known Allergies / Adverse Drug Reactions

PHYSICAL EXAM: Admission PHYSICAL EXAMINATION:
VS: BP= 130/80 HR=108 RR=26 O2 sat= 100% - Fi02 100%
GENERAL: intubated, paralyzed, morbidly obese man
HEENT: NC, sclera anicteric, pupils dilated, not reactive
NECK: unable to appreciated JVP given body habitus
CARDIAC: difficult to auscultate over lung sounds
LUNGS: diffuse coarse rhochorous inspirations
ABDOMEN: enlarged, + BS over lower abdomen, + cooling pads in
place
EXTREMITIES: no edema, +SCDs, DP & PT pulses 1+ bilaterally
.
NEURO ExAM [**2120-1-29**]
VS: T: 98.2 P: 100 BP: 113/67 RR: 22 SaO2: 99% intubated
General: Lying in bed, not arousible to voice or noxious stimuli
MS: No arousal to voice or noxious stimuli.  Not following
commands.
CN: Pupils 4->2mm bilaterally.  Slight skew deviation, with
right
eye elevated a few mm compared to the left. Small lateral
movements noted with oculocephalics.  Negative corneals,
negative
gag.
Motor/Sensory: Very slight extensor movements noted in bilateral
upper extremities in response to pinch bilaterally.  No response
to painful stimuli in bilateral lower extremities.
Reflexes: 2+ and symmetric throughout

FAMILY HISTORY: Family history is sgnificant for cardiovascular disease. (from
records)

SOCIAL HISTORY: On [**Social Security Number 89547**]Social Security Disability. Lives in subsidized housing.
Smoker, Social Drinker. (from records) 

### Response:
{'Ventricular fibrillation,Acute respiratory failure,Acute and subacute necrosis of liver,Pneumonitis due to inhalation of food or vomitus,Acute kidney failure, unspecified,Body Mass Index 40.0-44.9, adult,Ventilator associated pneumonia,Anoxic brain damage,Other primary cardiomyopathies,Other shock without mention of trauma,Other convulsions,Abnormal coagulation profile,Hypovolemia,Unspecified essential hypertension,Other and unspecified hyperlipidemia,Obstructive sleep apnea (adult)(pediatric),Morbid obesity,Gout, unspecified,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure'}
