CHIEF COMPLAINT: 

PRESENT ILLNESS: This is a 25-year-old female
with a history of acute rheumatic fever at age 3, status post
mitral valve repair with ring angioplasty in [**2150-1-31**],
who was admitted to the Coronary Care Unit after an episode
of sustained ventricular tachycardia.  The patient had acute
rheumatic fever.  Per OMR note, this was diagnosed when
admitted in [**2149-12-31**] for a motor vehicle accident.
Underwent repair in [**2151-2-1**] with angioplasty ring.
The patient has had follow-up echocardiograms with 3+ mitral
regurgitation, normal ejection fraction, myxomatous thickened
mitral valve leaflets.  Latest echocardiogram was done on
[**2151-8-17**].  The patient is followed by cardiologist and
[**Hospital6 733**] primary care physician, [**Name10 (NameIs) **] an ACE
inhibitor.

MEDICAL HISTORY: 1.  Acute rheumatic fever at age 3.
2.  Motor vehicle accident in [**2149-12-31**], found to have
mitral regurgitation on admission.
3.  Mitral valve repair with ring angioplasty in [**2150-1-31**].
4.  Gravida 1 para 1; status post cesarean section in [**2147**].
5.  History of positive purified protein derivative.  The
patient received BCG in [**Country 4194**] growing up.
6.  Echocardiogram in [**2150-11-1**] showing stable mitral
regurgitation, normal ejection fraction.
7.  Echocardiogram on [**8-17**] revealed 3+ mitral
regurgitation, normal ejection fraction, mitral valve
leaflets thickened and myxomatous.

MEDICATION ON ADMISSION: Zestril 5 mg p.o. q.d. and oral
contraceptive pills.

ALLERGIES: PENICILLIN.

PHYSICAL EXAM: 

FAMILY HISTORY: No history of coronary artery disease.

SOCIAL HISTORY: Moved from [**Country 4194**] in [**2149**].  Lives with
family in [**Last Name (un) 813**].  Works as a part-time house cleaner.  No
tobacco.  No alcohol.
Paroxysmal ventricular tachycardia,Mitral stenosis with insufficiency,Other postprocedural status
Parox ventric tachycard,Mitral stenosis w insuff,Post-proc states NEC
Admission Date:  [**2151-8-20**]     Discharge Date:  [**2151-8-26**]

Date of Birth:   [**2126-2-16**]     Sex:  F

Service:  CCU

HISTORY OF PRESENT ILLNESS:  This is a 25-year-old female
with a history of acute rheumatic fever at age 3, status post
mitral valve repair with ring angioplasty in [**2150-1-31**],
who was admitted to the Coronary Care Unit after an episode
of sustained ventricular tachycardia.  The patient had acute
rheumatic fever.  Per OMR note, this was diagnosed when
admitted in [**2149-12-31**] for a motor vehicle accident.
Underwent repair in [**2151-2-1**] with angioplasty ring.
The patient has had follow-up echocardiograms with 3+ mitral
regurgitation, normal ejection fraction, myxomatous thickened
mitral valve leaflets.  Latest echocardiogram was done on
[**2151-8-17**].  The patient is followed by cardiologist and
[**Hospital6 733**] primary care physician, [**Name10 (NameIs) **] an ACE
inhibitor.

The patient reported to the Emergency Room on [**8-20**] with a
3-month episodes of lightheadedness, noticed racing heart.
The patient states the episodes occur during work as house
cleaner, lasted one to two minutes, occurred one to two times
per week.  She did have a Holter study on [**2151-2-22**],
showing asymptomatic nonsustained ventricular tachycardia.

On the morning of admission the patient had an episode of
palpitations with lightheadedness while working and was
brought to the Emergency Room.  Vital signs were blood
pressure 60/40, heart rate of 160s, pulse of 90s, respiratory
rate of 30.  The patient was found to be in monomorphic
ventricular tachycardia, started on a lidocaine drip.

In the Emergency Room the patient complained only of a sore
throat.  No chest pain or shortness of breath.  No nausea,
vomiting or diarrhea.

PAST MEDICAL HISTORY:
1.  Acute rheumatic fever at age 3.
2.  Motor vehicle accident in [**2149-12-31**], found to have
mitral regurgitation on admission.
3.  Mitral valve repair with ring angioplasty in [**2150-1-31**].
4.  Gravida 1 para 1; status post cesarean section in [**2147**].
5.  History of positive purified protein derivative.  The
patient received BCG in [**Country 4194**] growing up.
6.  Echocardiogram in [**2150-11-1**] showing stable mitral
regurgitation, normal ejection fraction.
7.  Echocardiogram on [**8-17**] revealed 3+ mitral
regurgitation, normal ejection fraction, mitral valve
leaflets thickened and myxomatous.

ALLERGIES:  PENICILLIN.

MEDICATIONS ON ADMISSION:  Zestril 5 mg p.o. q.d. and oral
contraceptive pills.

SOCIAL HISTORY:  Moved from [**Country 4194**] in [**2149**].  Lives with
family in [**Last Name (un) 813**].  Works as a part-time house cleaner.  No
tobacco.  No alcohol.

FAMILY HISTORY:   No history of coronary artery disease.

PHYSICAL EXAMINATION ON ADMISSION:  Generally, a pleasant
female in no apparent distress.  Vital signs were pulse
of 79, blood pressure 101/63, respiratory rate of 12, pulse
oximetry of 100% on 2 liters nasal cannula.  HEENT revealed
pupils were equal, round, and reactive to light and
accommodation.  Mild erythema on the back of her throat.
Mucous membranes were moist.  Neck had no lymphadenopathy.
No jugular venous pressure was noted.  No bruits.
Cardiovascular had a regular rate and rhythm, S1/S2, a [**4-6**]
holosystolic murmur at her left lower sternal border
radiating to her axilla.  Lungs were clear bilaterally.
Abdomen was soft, nontender, and nondistended, positive bowel
sounds.  Extremities showed no edema and no calf tenderness.
Neurologic examination revealed the patient was alert and
oriented times three and mentated well.

LABORATORY ON ADMISSION:  She had a white blood cell count
of 7.8, hematocrit of 39.4, platelets of 186.  INR of 1.2,
PT of 13.2, PTT of 32.3.  Chem-7 showed a sodium of 139, a
potassium of 3.8, a chloride of 104, bicarbonate of 22, BUN
of 19, creatinine of 1.1, glucose of 111.

RADIOLOGY/IMAGING:  Electrocardiogram on admission revealed
ventricular tachycardia at 190 beats per minute.

Electrocardiogram after lidocaine drip showed normal sinus
rhythm at a rate of 95, right axis deviation, and frequent
premature ventricular contractions.

HOSPITAL COURSE:  In the Emergency Room the patient was
started on a lidocaine drip and converted to normal sinus
rhythm out of ventricular tachycardia.  The patient was
transferred to the Coronary Care Unit for further management
and telemetry.  The patient was started on sotalol 80 mg p.o.
b.i.d.  Zestril was continued at 5 mg p.o. q.d.  The patient
was also on telemetry, and there was no prolongation of her
QTc interval while on telemetry.

The patient was transferred to the floor on Far Three on
[**2151-8-21**].  She stated she felt well.  She had no chest
pain and no shortness of breath.  Her sotalol and lisinopril
were continued until [**8-23**] when it was stopped.  The
patient was then studied on electrophysiology on Wednesday,
[**8-25**], and had a successful ablation.

The patient was transferred to the floor, put back on
telemetry, and had no more cardiac events.  The patient will
need mitral valve replacement in the future.

Gastrointestinal revealed the patient began tolerating a
regular diet.  The patient was empirically started on
Protonix for prophylaxis.  This was discontinued after she
had begun eating a regular diet for two days.

Hematology revealed the patient had the diagnosis of a
question of anemia.  Throughout her stay, the patient's
hematocrit stayed between 38 to 40 range.

CONDITION AT DISCHARGE:  Stable.

DISCHARGE FOLLOWUP:  The patient was to follow up as an
outpatient with Cardiology and primary care physician,
[**Last Name (NamePattern4) **]. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **].

DISCHARGE STATUS:  The patient had no change in her code
status.  The patient is full code.

DISCHARGE DIAGNOSES:
1.  Monomorphic ventricular tachycardia, now status post
ablation by electrophysiology study.
2.  Mitral regurgitation (3+); the patient will need surgical
replacement of mitral valve in the future.

MEDICATIONS ON DISCHARGE:  The patient was sent home on
lisinopril 5 mg p.o. q.d. and enteric-coated aspirin 81 mg
p.o. q.d.



                          [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 1008**], M.D.  [**MD Number(1) 1009**]

Dictated By:[**Last Name (NamePattern1) 1324**]

MEDQUIST36

D:  [**2151-8-25**]  16:37
T:  [**2151-8-28**]  09:54
JOB#:  [**Job Number 29575**]


Name:  [**Known lastname 5166**], [**Known firstname 5167**]                     Unit No:  [**Numeric Identifier 5168**]

Admission Date:  [**2151-8-20**]     Discharge Date:  [**2151-8-26**]

Date of Birth:   [**2126-2-16**]     Sex:  F

Service:

ADDENDUM:
OUTPATIENT MEDICATIONS:  1) Atenolol 25 mg po q day, 2)
Lisinopril 5.0 mg po q day.  It was decided that the patient
did not need to be placed on Sotalol and thus no [**Doctor Last Name **] of
Hearts was necessary.

OU[**Last Name (STitle) 5169**]NT APPOINTMENTS:
1.  With primary cardiologist, Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **], [**9-1**], at
10:30 AM.
2.  With cardiothoracic surgeon, Dr. [**Last Name (Prefixes) **], Thursday,
[**9-2**], at 10:30 AM.
3.  With primary care physician, [**Last Name (NamePattern4) **]. [**First Name4 (NamePattern1) 80**] [**Last Name (NamePattern1) **], [**9-9**], at
01:30 PM.

Th[**Last Name (STitle) 1293**] is deciding when and whether to have mitral valve
repair which she will need at some point in the future.  This
is being coordinated with her cardiologist, Dr. [**First Name (STitle) **] and her
cardiothoracic surgeon, Dr. [**Last Name (Prefixes) **], as well as her
primary care physician, [**Last Name (NamePattern4) **]. [**First Name4 (NamePattern1) 80**] [**Last Name (NamePattern1) **].



                          [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 297**], M.D.  [**MD Number(1) 298**]

Dictated By:[**Last Name (NamePattern1) 4776**]

MEDQUIST36

D:  [**2151-8-26**]  17:30
T:  [**2151-8-31**]  21:48
JOB#:  [**Job Number 5170**]
{'Paroxysmal ventricular tachycardia,Mitral stenosis with insufficiency,Other postprocedural status'}


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: This is a 25-year-old female
with a history of acute rheumatic fever at age 3, status post
mitral valve repair with ring angioplasty in [**2150-1-31**],
who was admitted to the Coronary Care Unit after an episode
of sustained ventricular tachycardia.  The patient had acute
rheumatic fever.  Per OMR note, this was diagnosed when
admitted in [**2149-12-31**] for a motor vehicle accident.
Underwent repair in [**2151-2-1**] with angioplasty ring.
The patient has had follow-up echocardiograms with 3+ mitral
regurgitation, normal ejection fraction, myxomatous thickened
mitral valve leaflets.  Latest echocardiogram was done on
[**2151-8-17**].  The patient is followed by cardiologist and
[**Hospital6 733**] primary care physician, [**Name10 (NameIs) **] an ACE
inhibitor.

MEDICAL HISTORY: 1.  Acute rheumatic fever at age 3.
2.  Motor vehicle accident in [**2149-12-31**], found to have
mitral regurgitation on admission.
3.  Mitral valve repair with ring angioplasty in [**2150-1-31**].
4.  Gravida 1 para 1; status post cesarean section in [**2147**].
5.  History of positive purified protein derivative.  The
patient received BCG in [**Country 4194**] growing up.
6.  Echocardiogram in [**2150-11-1**] showing stable mitral
regurgitation, normal ejection fraction.
7.  Echocardiogram on [**8-17**] revealed 3+ mitral
regurgitation, normal ejection fraction, mitral valve
leaflets thickened and myxomatous.

MEDICATION ON ADMISSION: Zestril 5 mg p.o. q.d. and oral
contraceptive pills.

ALLERGIES: PENICILLIN.

PHYSICAL EXAM: 

FAMILY HISTORY: No history of coronary artery disease.

SOCIAL HISTORY: Moved from [**Country 4194**] in [**2149**].  Lives with
family in [**Last Name (un) 813**].  Works as a part-time house cleaner.  No
tobacco.  No alcohol. 

### Response:
{'Paroxysmal ventricular tachycardia,Mitral stenosis with insufficiency,Other postprocedural status'}
