CHIEF COMPLAINT: 

PRESENT ILLNESS: This is a 79 year-old man with a
history of recent ischemic cerebrovascular accident versus
transient ischemic attack in [**Month (only) 404**] with cardiac risk
presented to an outside hospital on [**1-19**] initially with
lightheadedness, which later progressed to right sided chest
pain.  Electrocardiogram showed inferior ST elevation,
increased anterior progression in the anterior leads with ST
depression anteriorly for presenting posterior Q waves and ST
elevation.  The ST elevation in lead 2 and lead 3 represented
most likely circumflex involvement.  The patient also had T
electrocardiogram.  At the outside hospital he was not
thrombolised, because of this question of a recent
cerebrovascular accident.  He was started on aspirin,
nitroglycerin and heparin and made chest pain free.  They
cycled cardiac enzymes at the outside hospital.  The second
set of CK were greater then 5000.  At the outside hospital
the patient also progressed into congestive heart failure,
which was treated with Lasix.

MEDICAL HISTORY: 

MEDICATION ON ADMISSION: 

ALLERGIES: 

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: 
Acute myocardial infarction of other inferior wall, initial episode of care,Congestive heart failure, unspecified,Cardiogenic shock,Coronary atherosclerosis of native coronary artery,Unspecified essential hypertension,Atrioventricular block, complete,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Hyperpotassemia,Unspecified disorder of kidney and ureter
AMI inferior wall, init,CHF NOS,Cardiogenic shock,Crnry athrscl natve vssl,Hypertension NOS,Atriovent block complete,DMII wo cmp nt st uncntr,Hyperpotassemia,Renal & ureteral dis NOS
Admission Date:  [**2138-1-19**]     Discharge Date:  [**2138-1-21**]


Service:  [**Hospital Unit Name 38208**] COMPLAINT:  Inferior myocardial infarction.

HISTORY OF PRESENT ILLNESS:  This is a 79 year-old man with a
history of recent ischemic cerebrovascular accident versus
transient ischemic attack in [**Month (only) 404**] with cardiac risk
presented to an outside hospital on [**1-19**] initially with
lightheadedness, which later progressed to right sided chest
pain.  Electrocardiogram showed inferior ST elevation,
increased anterior progression in the anterior leads with ST
depression anteriorly for presenting posterior Q waves and ST
elevation.  The ST elevation in lead 2 and lead 3 represented
most likely circumflex involvement.  The patient also had T
electrocardiogram.  At the outside hospital he was not
thrombolised, because of this question of a recent
cerebrovascular accident.  He was started on aspirin,
nitroglycerin and heparin and made chest pain free.  They
cycled cardiac enzymes at the outside hospital.  The second
set of CK were greater then 5000.  At the outside hospital
the patient also progressed into congestive heart failure,
which was treated with Lasix.

After the second set of enzymes the patient was transferred
to [**Hospital1 18**].  He arrived at 11:00 p.m. on the evening of
[**1-19**].  He was chest pain free at that time.  He had no
ST elevations on his electrocardiogram that had progressed to
Q waves at that time.  He was started on Integrilin and
continued on his other medications and went to the [**Hospital Unit Name 196**]
Service for monitoring.  He went for cardiac catheterization
and intervention on [**2138-1-20**].  During the cardiac
catheterization, his PAO2 dropped to 46% and his mixed venous
sat was in the mid 20%.  These numbers prompted intubation
for hypoxia and insertion of a balloon pump and initiation of
pressor support with Dopamine for cardiogenic shock.  The
patient had a ruptured plaque seen in his D dominant left
circumflex at the take off of the OM1.  The circumflex was
angioplastied and stented with two stents.  He was then
brought up to the Coronary Care Unit.

After approximately ten minutes in the Coronary Care Unit the
patient progressed from normal sinus rhythm into complete
heart block.  The patient was transcutaneously paced and then
a transvenous pacing wire was implanted and the patient was
placed on [**Initials (NamePattern4) **] [**Last Name (NamePattern4) **] pacer at a rate of 70.  The patient remained
stable in this condition for the rest of the night.  His
urine output, however, decreased as the patient progressed
into acute renal failure.  the patient had the corresponding
electrolyte abnormalities to go with his acute renal failure.
On [**2138-1-21**] the patient's son and wife visited the
patient at the hospital.  They asserted that the patient did
not want any life support.  He stated this numerous times
over the course of his life and directed that the patient's
wishes compelled them to withdraw life support.  At that time
the medication drips were discontinued.  The pacing was
discontinued.  The patient was transiently maintained on his
native rhythm, but then proceeded to cardiac arrest at
approximately 1:00 p.m. on [**1-21**].  The patient was
pronounced dead.  At that time the son and the wife were with
the patient.  The attending was also notified.  The family
consented to an autopsy.  The patient died of cardiac arrest
secondary to acute myocardial infarction.






                          [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 15176**], M.D.  [**MD Number(1) 15177**]

Dictated By:[**Last Name (NamePattern1) 8228**]

MEDQUIST36

D:  [**2138-1-21**]  15:31
T:  [**2138-1-24**]  06:27
JOB#:  [**Job Number 38209**]
{'Acute myocardial infarction of other inferior wall, initial episode of care,Congestive heart failure, unspecified,Cardiogenic shock,Coronary atherosclerosis of native coronary artery,Unspecified essential hypertension,Atrioventricular block, complete,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Hyperpotassemia,Unspecified disorder of kidney and ureter'}


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 79 year-old man with a
history of recent ischemic cerebrovascular accident versus
transient ischemic attack in [**Month (only) 404**] with cardiac risk
presented to an outside hospital on [**1-19**] initially with
lightheadedness, which later progressed to right sided chest
pain.  Electrocardiogram showed inferior ST elevation,
increased anterior progression in the anterior leads with ST
depression anteriorly for presenting posterior Q waves and ST
elevation.  The ST elevation in lead 2 and lead 3 represented
most likely circumflex involvement.  The patient also had T
electrocardiogram.  At the outside hospital he was not
thrombolised, because of this question of a recent
cerebrovascular accident.  He was started on aspirin,
nitroglycerin and heparin and made chest pain free.  They
cycled cardiac enzymes at the outside hospital.  The second
set of CK were greater then 5000.  At the outside hospital
the patient also progressed into congestive heart failure,
which was treated with Lasix.

MEDICAL HISTORY: 

MEDICATION ON ADMISSION: 

ALLERGIES: 

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY:  

### Response:
{'Acute myocardial infarction of other inferior wall, initial episode of care,Congestive heart failure, unspecified,Cardiogenic shock,Coronary atherosclerosis of native coronary artery,Unspecified essential hypertension,Atrioventricular block, complete,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Hyperpotassemia,Unspecified disorder of kidney and ureter'}
