CHIEF COMPLAINT: Shortness of breath

PRESENT ILLNESS: This 50-year-old patient with shortness of breath and
palpitations was investigated and was found to have severe
mitral regurgitation with a well
preserved left ventricular function and no critical disease in
the coronary arteries. She was electively admitted for mitral
valve repair or replacement

MEDICAL HISTORY: MVP/MR
[**First Name (Titles) **]
[**Last Name (Titles) **]
[**Last Name (Titles) 17005**]
Depression
Headaches
Hiatal hernia

MEDICATION ON ADMISSION: Atenolol 50mg daily
HCTZ 25mg daily
Wellbutrin 100mg daily
Lisinopril 5mg daily
Klonopin

ALLERGIES: Penicillins

PHYSICAL EXAM: 71 SR   14  143/101   140/99   65"   165
GEN: NAD
HEENT: EOMI, PERRL, OP Benign
NECK: Supple, FROM, No JVD
LUNGS: CTA
HEART: RRR, III/VI systolic murmur
ABD: Soft/NT/ND/NABS
EXT: Warm, well perfused
NEURO: MAE, non-focal

FAMILY HISTORY: Mother with MVR/TVR at age 73
Father died of MI at age 50

SOCIAL HISTORY: Volunteer at NEBH. Never smoked. Drinks [**4-30**] ETOH beverages per
week. Lives with mother.
Mitral valve disorders,Ostium secundum type atrial septal defect,Diverticulosis of colon (without mention of hemorrhage),Diaphragmatic hernia without mention of obstruction or gangrene,Unspecified essential hypertension
Mitral valve disorder,Secundum atrial sept def,Dvrtclo colon w/o hmrhg,Diaphragmatic hernia,Hypertension NOS
Admission Date:  [**2150-6-1**]              Discharge Date:   [**2150-6-5**]

Date of Birth:  [**2100-3-3**]             Sex:   F

Service: CARDIOTHORACIC

Allergies:
Penicillins

Attending:[**First Name3 (LF) 1283**]
Chief Complaint:
Shortness of breath

Major Surgical or Invasive Procedure:
[**2150-6-1**] - MV Repair (28mm [**Doctor Last Name 405**] Annuloplasty Band), ASD
Closure.


History of Present Illness:
This 50-year-old patient with shortness of breath and
palpitations was investigated and was found to have severe
mitral regurgitation with a well
preserved left ventricular function and no critical disease in
the coronary arteries. She was electively admitted for mitral
valve repair or replacement


Past Medical History:
MVP/MR
[**First Name (Titles) **]
[**Last Name (Titles) **]
[**Last Name (Titles) 17005**]
Depression
Headaches
Hiatal hernia

Social History:
Volunteer at NEBH. Never smoked. Drinks [**4-30**] ETOH beverages per
week. Lives with mother.

Family History:
Mother with MVR/TVR at age 73
Father died of MI at age 50

Physical Exam:
71 SR   14  143/101   140/99   65"   165
GEN: NAD
HEENT: EOMI, PERRL, OP Benign
NECK: Supple, FROM, No JVD
LUNGS: CTA
HEART: RRR, III/VI systolic murmur
ABD: Soft/NT/ND/NABS
EXT: Warm, well perfused
NEURO: MAE, non-focal

Pertinent Results:
[**2150-6-1**] ECHO
PRE-BYPASS:
1. The left atrium is mildly dilated. No spontaneous echo
contrast is seen in the left atrial appendage. A left-to-right
shunt across the interatrial septum is seen at rest. A small
secundum atrial septal defect is present.
2. Left ventricular wall thicknesses and cavity size are normal.
Regional left ventricular wall motion is normal. Overall left
ventricular systolic function is normal (LVEF>55%).
3. Right ventricular chamber size and free wall motion are
normal.
4. The aortic valve leaflets (3) appear structurally normal with
good leaflet excursion and no aortic regurgitation.
5. The mitral valve leaflets are mildly thickened. There is
moderate mitral valve prolapse of the P2 scallop. The effective
regurgitant orifice is >=0.40cm2. Severe (4+) mitral
regurgitation is seen. The mitral regurgitation jet is eccentric
directed anteriorly.
6. There is no pericardial effusion.

POST-BYPASS: Pt is being a paced and is receiving an infusion of

phenylephrine.
1. An annuloplasty ring is well seated in the mitral position.
No MR is seen. Mean gradient is 6 mm of Hg. Mild chordal [**Male First Name (un) **] is
seen. No turbulence or gradient across the AV.
2. Biventricular function is preserved.
3. No flow is detected across the IAS. Sutures are noted at the
ASD site.
4. Aorta is intact post decannulation.
5. Other findings are unchanged.

[**2150-6-2**] - CXR
Left lower lobe atelectasis and/or small effusion. Stable- sized
right subpulmonic effusion.

[**2150-6-4**] 09:40AM BLOOD WBC-8.5 RBC-2.58* Hgb-8.5* Hct-24.2*
MCV-94 MCH-32.7* MCHC-34.9 RDW-14.0 Plt Ct-220
[**2150-6-2**] 03:16AM BLOOD PT-11.8 PTT-26.7 INR(PT)-1.0
[**2150-6-4**] 09:40AM BLOOD Glucose-120* UreaN-17 Creat-0.5 Na-139
K-3.8 Cl-103 HCO3-29 AnGap-11

Brief Hospital Course:
Ms. [**Known lastname **] was admitted to the [**Hospital1 18**] on [**2150-6-1**] for surgical
management of her mitral valve disease. She was taken directly
to the operating room where a minimally invasive mitral valve
repair was planned however a large atrial septal defect was
noted on TEE thus necessitating a sternotomy for repair. A mini
sternotomy was performed with repair of her mitral valve and
atrial septal defect. Postoperatively she was taken to the
intensive care unit for monitoring. later that day, she awoke
neurologically intact and was extubated. On postoperative day
one, she was transferred to the step down unit for further
recovery. She was gently diuresed towards her preoperative
weight. The physical therapy service was consulted for
assistance with her postoperative strength and mobility. She
continued to progress and was discharged to home in stable
condition on POD#4.

Medications on Admission:
Atenolol 50mg daily
HCTZ 25mg daily
Wellbutrin 100mg daily
Lisinopril 5mg daily
Klonopin

Discharge Medications:
1. Potassium Chloride 10 mEq Capsule, Sustained Release Sig: Two
(2) Capsule, Sustained Release PO Q12H (every 12 hours) for 7
days.
Disp:*28 Capsule, Sustained Release(s)* Refills:*0*
2. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2
times a day).
Disp:*60 Capsule(s)* Refills:*2*
3. Aspirin 81 mg Tablet, Delayed Release (E.C.) Sig: One (1)
Tablet, Delayed Release (E.C.) PO DAILY (Daily).
Disp:*30 Tablet, Delayed Release (E.C.)(s)* Refills:*2*
4. Sertraline 50 mg Tablet Sig: Three (3) Tablet PO DAILY
(Daily).
Disp:*90 Tablet(s)* Refills:*0*
5. Bupropion 100 mg Tablet Sustained Release Sig: One (1) Tablet
Sustained Release PO QAM (once a day (in the morning)).
Disp:*30 Tablet Sustained Release(s)* Refills:*0*
6. Atorvastatin 10 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
Disp:*30 Tablet(s)* Refills:*2*
7. Ferrous Gluconate 300 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
Disp:*30 Tablet(s)* Refills:*2*
8. Ascorbic Acid 500 mg Tablet Sig: One (1) Tablet PO BID (2
times a day).
Disp:*60 Tablet(s)* Refills:*2*
9. Hydromorphone 2 mg Tablet Sig: One (1) Tablet PO Q3-4H (Every
3 to 4 Hours) as needed.
Disp:*50 Tablet(s)* Refills:*0*
10. Metoprolol Tartrate 25 mg Tablet Sig: One (1) Tablet PO BID
(2 times a day).
Disp:*60 Tablet(s)* Refills:*2*
11. Lasix 20 mg Tablet Sig: One (1) Tablet PO twice a day for 7
days.
Disp:*14 Tablet(s)* Refills:*0*
12. Ibuprofen 600 mg Tablet Sig: One (1) Tablet PO Q8H (every 8
hours) as needed.
Disp:*90 Tablet(s)* Refills:*0*


Discharge Disposition:
Home With Service

Facility:
[**Hospital 119**] Homecare

Discharge Diagnosis:
MVP/MR
[**First Name (Titles) **]
[**Last Name (Titles) 17005**]
Depression
Headaches
Hiatal hernia


Discharge Condition:
Good


Discharge Instructions:
1) Monitor wounds for signs of infection. These include redness,
drainage or increased pain.
2) Report any fever greater then 100.5.
3) Report any weight gain of 2 pounds in 24 hours or 5 pounds in
1 week.
4) No lotions, creams or powders to incision until it has
healed. You may shower and wash incision. No bathing or swimming
for 1 month. Use sunscreen on incision if exposed to sun.
5)No lifting greater then 10 pounds for 10 weeks.
6)No driving for 1 month.

Followup Instructions:
Follow-up with Dr. [**Last Name (STitle) 1290**] in 1 month. ([**Telephone/Fax (1) 1504**]
Follow-up with Dr. [**Last Name (STitle) 171**] (cardiologist) in 2 weeks.
[**Telephone/Fax (1) 1989**]
Follow-up with Dr. [**Last Name (STitle) 8682**] (PCP) in [**3-1**] weeks. [**Telephone/Fax (1) 133**]



Completed by:[**2150-6-5**]
{'Mitral valve disorders,Ostium secundum type atrial septal defect,Diverticulosis of colon (without mention of hemorrhage),Diaphragmatic hernia without mention of obstruction or gangrene,Unspecified essential hypertension'}


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: Shortness of breath

PRESENT ILLNESS: This 50-year-old patient with shortness of breath and
palpitations was investigated and was found to have severe
mitral regurgitation with a well
preserved left ventricular function and no critical disease in
the coronary arteries. She was electively admitted for mitral
valve repair or replacement

MEDICAL HISTORY: MVP/MR
[**First Name (Titles) **]
[**Last Name (Titles) **]
[**Last Name (Titles) 17005**]
Depression
Headaches
Hiatal hernia

MEDICATION ON ADMISSION: Atenolol 50mg daily
HCTZ 25mg daily
Wellbutrin 100mg daily
Lisinopril 5mg daily
Klonopin

ALLERGIES: Penicillins

PHYSICAL EXAM: 71 SR   14  143/101   140/99   65"   165
GEN: NAD
HEENT: EOMI, PERRL, OP Benign
NECK: Supple, FROM, No JVD
LUNGS: CTA
HEART: RRR, III/VI systolic murmur
ABD: Soft/NT/ND/NABS
EXT: Warm, well perfused
NEURO: MAE, non-focal

FAMILY HISTORY: Mother with MVR/TVR at age 73
Father died of MI at age 50

SOCIAL HISTORY: Volunteer at NEBH. Never smoked. Drinks [**4-30**] ETOH beverages per
week. Lives with mother. 

### Response:
{'Mitral valve disorders,Ostium secundum type atrial septal defect,Diverticulosis of colon (without mention of hemorrhage),Diaphragmatic hernia without mention of obstruction or gangrene,Unspecified essential hypertension'}
