CHIEF COMPLAINT: shortness of breath

PRESENT ILLNESS: 72 year old male with past medical history of COPD on 3L home
oxygen, hypertension, AAA s/p endovascular repair of
abdominal aortic aneurysm c/b STEMI requiring BMS LM, RCA as
well limb ischemia requiring left femoral endarterectomy on
[**2145-5-22**] now presenting with increasing SOB, sputum production
x2days.
.
Patient was in USOH when noted gradual onset increased DOE with
moderate increase in sputum production though no change in
sputum character. Denies associated fever, HA, rhinorrhea, sore
throat, chest pain, pleuritic pain, dysuria, calf
tenderness/swelling, LE edema, PND, orthopenia. No recent sick
contacts, recent travel. Reports complaince with lasix though
notes self-d/c of flovent in recent months. This morning in
setting of worsening SOB with associated wheeze checked O2 on
home pulse oximeter and noted to be 87% on home 3L so called
EMS.
.
On presentation to the ED, initial VS were: T 97.6, HR 102, BP
139/65, RR 17, O2 sat 90% 6L. 100% on NRB. Initial VBG showed
7.26/101/43/47 On exam poor aeration. CXR demonstrated
?pulmonary edema. Placed on noninvasive ventilation with
improvement of symptoms and stabilization of O2 sats. Patient
received levofloxacin 750mg, Lasix 20mg IV, Methylpred 125 IV,
2duonebs in treatment of likely COPD exacerbation as well as
mild volume overload.
.
On arrival to the MICU,  patient reports he is feeling better;
though wheezy, shortness of breath had improved and is again
without complaints of pain.
.
Review of systems:
(+) Per HPI
(-) Denies fever, chills, night sweats, recent weight loss or
gain. Denies headache, sinus tenderness, rhinorrhea or
congestion. Denies chest pain, chest pressure, palpitations, or
weakness. Denies nausea, vomiting, diarrhea, constipation,
abdominal pain, or changes in bowel habits. Denies dysuria,
frequency, or urgency. Denies arthralgias or myalgias. Denies
rashes or skin changes.

MEDICAL HISTORY: - COPD- baseline home O2 3LCN
- Morbid Obesity
- HTN
- HL
- AAA
- Pulm. nodule
- Edema
- S/P abd. hernia repair

MEDICATION ON ADMISSION: Active Medication list: verified ALLOPURINOL -  (Prescribed by
Other Provider) - Dosage uncertain
ENALAPRIL MALEATE -  (Prescribed by Other Provider) - 5 mg
Tablet-
FLUTICASONE [FLOVENT HFA] -  (Prescribed by Other Provider) -
220
mcg Aerosol -
FUROSEMIDE -  (Prescribed by Other Provider) - 20 mg Tablet -
IPRATROPIUM-ALBUTEROL -  (Prescribed by Other Provider) - 0.5
mg-3 mg (2.5 mg base)/3 mL Solution for Nebulization -  prn
SIMVASTATIN -  (Prescribed by Other Provider) - 40 mg Tablet -
TIOTROPIUM BROMIDE [SPIRIVA WITH HANDIHALER] -  (Prescribed by
Other Provider) - 18 mcg Capsule, w/Inhalation Device -  daily

ALLERGIES: scallops

PHYSICAL EXAM: On admission:
General: Alert, oriented, no acute distress, speaking in [**2-7**]
sent3ences before becoming dyspneic
HEENT: Sclera anicteric, MMM, oropharynx clear, EOMI, PERRL
Neck: supple, JVP hard to assess in setting of habitus but not
grossly up, no LAD
CV: quiet HR, Regular rate and rhythm, normal S1 + S2, no
murmurs, rubs, gallops
Lungs: poor - mod aeration bilaterally; decreased bs with
overlying crackles on the right, diffuse inspiratory and
expiratory wheeze
Abdomen: soft, obese non-tender, bowel sounds present, no
organomegaly
GU: no foley
Ext: warm, well perfused, dopplerable pulses, no clubbing,
cyanosis or minimal peripheral edema
Neuro: CNII-XII intact, 5/5 strength upper/lower extremities,
grossly normal sensation, 2+ reflexes bilaterally, gait
deferred, finger-to-nose intact

FAMILY HISTORY: CAD/PVD - father and mother, died in their 70s
CVA - brother in 60s.  Brother diagnosed with alzheimers at age
60.

SOCIAL HISTORY: Lives at home with wife, daughter, son-in-law and 3
grandchildren.  Used to work as a office equipment repairman.
Tobacco - quit [**2136**], was a lifetime smoker - 1-2ppd for 43 years
EtOH - occasional ethanol
drug use - denies.
Acute and chronic respiratory failure,Acute on chronic diastolic heart failure,Obstructive chronic bronchitis with (acute) exacerbation,Other iatrogenic hypotension,Benign essential hypertension,Coronary atherosclerosis of native coronary artery,Edema,Morbid obesity,Other and unspecified hyperlipidemia,Old myocardial infarction,Other dependence on machines, supplemental oxygen,Other postprocedural status,Personal history of tobacco use,Other diuretics causing adverse effects in therapeutic use
Acute & chronc resp fail,Ac on chr diast hrt fail,Obs chr bronc w(ac) exac,Iatrogenc hypotnsion NEC,Benign hypertension,Crnry athrscl natve vssl,Edema,Morbid obesity,Hyperlipidemia NEC/NOS,Old myocardial infarct,Depend-supplement oxygen,Post-proc states NEC,History of tobacco use,Adv eff diuretics NEC
Admission Date:  [**2146-3-21**]              Discharge Date:   [**2146-3-25**]

Date of Birth:  [**2073-9-20**]             Sex:   M

Service: MEDICINE

Allergies:
scallops

Attending:[**Last Name (NamePattern4) 290**]
Chief Complaint:
shortness of breath

Major Surgical or Invasive Procedure:
none

History of Present Illness:
72 year old male with past medical history of COPD on 3L home
oxygen, hypertension, AAA s/p endovascular repair of
abdominal aortic aneurysm c/b STEMI requiring BMS LM, RCA as
well limb ischemia requiring left femoral endarterectomy on
[**2145-5-22**] now presenting with increasing SOB, sputum production
x2days.
.
Patient was in USOH when noted gradual onset increased DOE with
moderate increase in sputum production though no change in
sputum character. Denies associated fever, HA, rhinorrhea, sore
throat, chest pain, pleuritic pain, dysuria, calf
tenderness/swelling, LE edema, PND, orthopenia. No recent sick
contacts, recent travel. Reports complaince with lasix though
notes self-d/c of flovent in recent months. This morning in
setting of worsening SOB with associated wheeze checked O2 on
home pulse oximeter and noted to be 87% on home 3L so called
EMS.
.
On presentation to the ED, initial VS were: T 97.6, HR 102, BP
139/65, RR 17, O2 sat 90% 6L. 100% on NRB. Initial VBG showed
7.26/101/43/47 On exam poor aeration. CXR demonstrated
?pulmonary edema. Placed on noninvasive ventilation with
improvement of symptoms and stabilization of O2 sats. Patient
received levofloxacin 750mg, Lasix 20mg IV, Methylpred 125 IV,
2duonebs in treatment of likely COPD exacerbation as well as
mild volume overload.
.
On arrival to the MICU,  patient reports he is feeling better;
though wheezy, shortness of breath had improved and is again
without complaints of pain.
.
Review of systems:
(+) Per HPI
(-) Denies fever, chills, night sweats, recent weight loss or
gain. Denies headache, sinus tenderness, rhinorrhea or
congestion. Denies chest pain, chest pressure, palpitations, or
weakness. Denies nausea, vomiting, diarrhea, constipation,
abdominal pain, or changes in bowel habits. Denies dysuria,
frequency, or urgency. Denies arthralgias or myalgias. Denies
rashes or skin changes.


Past Medical History:
- COPD- baseline home O2 3LCN
- Morbid Obesity
- HTN
- HL
- AAA
- Pulm. nodule
- Edema
- S/P abd. hernia repair


Social History:
Lives at home with wife, daughter, son-in-law and 3
grandchildren.  Used to work as a office equipment repairman.
Tobacco - quit [**2136**], was a lifetime smoker - 1-2ppd for 43 years
EtOH - occasional ethanol
drug use - denies.


Family History:
CAD/PVD - father and mother, died in their 70s
CVA - brother in 60s.  Brother diagnosed with alzheimers at age
60.


Physical Exam:
On admission:
General: Alert, oriented, no acute distress, speaking in [**2-7**]
sent3ences before becoming dyspneic
HEENT: Sclera anicteric, MMM, oropharynx clear, EOMI, PERRL
Neck: supple, JVP hard to assess in setting of habitus but not
grossly up, no LAD
CV: quiet HR, Regular rate and rhythm, normal S1 + S2, no
murmurs, rubs, gallops
Lungs: poor - mod aeration bilaterally; decreased bs with
overlying crackles on the right, diffuse inspiratory and
expiratory wheeze
Abdomen: soft, obese non-tender, bowel sounds present, no
organomegaly
GU: no foley
Ext: warm, well perfused, dopplerable pulses, no clubbing,
cyanosis or minimal peripheral edema
Neuro: CNII-XII intact, 5/5 strength upper/lower extremities,
grossly normal sensation, 2+ reflexes bilaterally, gait
deferred, finger-to-nose intact


Pertinent Results:
ADMISSION LABS

[**2146-3-21**] 09:20AM BLOOD WBC-10.0 RBC-4.18* Hgb-12.4* Hct-39.9*
MCV-95 MCH-29.7 MCHC-31.2 RDW-14.4 Plt Ct-202
[**2146-3-21**] 09:20AM BLOOD Neuts-75.0* Lymphs-17.3* Monos-6.3
Eos-0.9 Baso-0.4
[**2146-3-21**] 09:20AM BLOOD PT-11.0 PTT-31.1 INR(PT)-1.0
[**2146-3-21**] 09:20AM BLOOD Glucose-124* UreaN-22* Creat-0.9 Na-143
K-4.6 Cl-95* HCO3-39* AnGap-14
[**2146-3-21**] 09:20AM BLOOD CK(CPK)-122
[**2146-3-21**] 04:35PM BLOOD CK(CPK)-118
[**2146-3-21**] 09:20AM BLOOD CK-MB-5 proBNP-3326*
[**2146-3-21**] 09:20AM BLOOD cTropnT-<0.01
[**2146-3-21**] 04:35PM BLOOD CK-MB-7 cTropnT-0.01
[**2146-3-21**] 09:20AM BLOOD Calcium-8.7 Phos-3.6 Mg-2.4
[**2146-3-21**] 09:29AM BLOOD Type-[**Last Name (un) **] pO2-43* pCO2-101* pH-7.26*
calTCO2-47* Base XS-13 Intubat-NOT INTUBA Comment-GREEN TOP
[**2146-3-21**] 09:29AM BLOOD Lactate-1.6

DISCHARGE LABS

[**2146-3-25**] 04:11AM BLOOD WBC-8.9 RBC-4.11* Hgb-12.0* Hct-38.0*
MCV-92 MCH-29.3 MCHC-31.7 RDW-14.4 Plt Ct-217
[**2146-3-25**] 04:11AM BLOOD Glucose-106* UreaN-39* Creat-1.6* Na-141
K-3.4 Cl-86* HCO3-45* AnGap-13
[**2146-3-25**] 04:11AM BLOOD Calcium-8.3* Phos-4.6* Mg-2.5
[**2146-3-21**] 09:44PM BLOOD Type-ART pO2-34* pCO2-83* pH-7.35
calTCO2-48* Base XS-15
[**2146-3-25**] 04:16AM BLOOD Lactate-1.3

LENI NO DVT [**2146-3-20**]
ECHO [**2146-3-21**] The left atrium is elongated. Left ventricular wall
thickness, cavity size, and global systolic function are normal
(LVEF>55%). Due to suboptimal technical quality, a focal wall
motion abnormality cannot be fully excluded. Right ventricular
chamber size and free wall motion are normal. The number of
aortic valve leaflets cannot be determined. There is no aortic
valve stenosis. No aortic regurgitation is seen. The mitral
valve leaflets are not well seen. Physiologic mitral
regurgitation is seen (within normal limits). There is an
anterior space which most likely represents a prominent fat pad.

IMPRESSION: Suboptimal image quality. Normal left ventricular
cavity size and global systolic function.

CT CHEST WITH AND WITHOUT [**2146-3-21**] As compared to the previous
examination, there is slightly improved contrast filling,
currently no evidence of pulmonary embolism, but a filling
inhomogeneity in the lingular artery. Bilateral mild-to-moderate
pleural effusions, bilateral areas of dorsal and perifissural
atelectasis. No evidence of right heart strain. No enlarged
mediastinal lymph nodes.  Saber-sheath trachea.

CXR [**2146-3-20**] Mild congestive heart failure with bibasilar
atelectasis and
small bilateral pleural effusions.cardiomediastinal silhouette
consistent with

CXR [**2146-3-25**] Tip of right PICC terminates in the lower superior
vena cava.
Cardiac silhouette remains enlarged. Improving bilateral lower
lobe
opacities, possibly due to previously provided diagnosis of
aspiration
pneumonia. Vascular congestion has resolved. Pleural effusions
are probably unchanged allowing for incomplete imaging of the
costophrenic angle regions.


Brief Hospital Course:
72 year old male with past medical history of COPD on 3L home
oxygen, hypertension, AAA s/p endovascular repair of abdominal
aortic aneurysm c/b STEMI requiring BMS LM, RCA as well limb
ischemia requiring left femoral endarterectomy on [**2145-5-22**] now
presenting with increasing SOB, sputum production x2days with
e/o hypoxic, hybercarbic respiratory failure.
.
# Hypoxic Hypercarbic Respiratory Failure. Different diagnosis
included acute COPD exacerabtion, heart failure, PE, pneumonia.
History was most consistent with acute COPD flare with increased
sputum production/change in character as well as increasing
dyspnea. Exam with poor air movement, diffuse wheeze. No clear
viral or bacterial URI as nidus to infection, however bilateral
opacities R>L concerning for infection. However history not c/w
PNA as patient lacks robust sputum production/change, fever,
leukocytosis. CXR with increased interstial markings which
raised the question of volume overload; TTE in [**1-17**] with
preserved RV and LV function and patient without worsening
edema, orthopnea, PND. Troponins were negative. Pulmonary
embolus was thought unlikely.
On arrival he required BiPAP, but was able to be weaned to a
face mask the next morning. He was treated with azithromycin for
possible infection and anti-inflammatory properties. He was
diuresed with IV lasix in case of a component of acute on
chronic CHF. He was treated for a COPD exacerbation with
methylprednisone, then converted to PO prednisone. He is being
written for a prednisone taper to be continued at rehab. He
should continue with nebulizers and inhaled fluticasone. His
Oxygen target saturation was 90 to 94% and PaO2 of 60-70 mmHg.
.
# Positive blood culture: patient had a positive blood culture
and was started [**3-23**] on vancomycin. The speciation came back as
coagulase-negative staph epidermis prior to discharge, so the
vancomycin was stopped.
.
# Hypotension: [**3-24**] the patient had an asymptomatic, transient
episode of hypotension that may have been due to over-diuresis.
The IV furosemide was held, and his pressures improved. He
continues to be total-body fluid overloaded and the furosemide
can be restarted at rehab.
.
# Lower extremity edema. Appears to be a chronic problem as
documents in several previous notes including DC summary from
[**1-17**]. LENIs at that time negative. He was monitored clinically
and give IV furosemide as above.
.
# CAD s/p STEMI. Biomarkers negative for ischemia. Patient
without complaints of chest pain. EKG without signs of ischemia.
Continued ASA 325mg; per patient Plavix was stopped as an
outpatient. Continued on home enalapril and statin.
.
# FEN: regular diet
# Prophylaxis: Was on subcutaneous heparin, but was stopped
prior to transfer.
# Access: PICC placed prior to transfer
# Code: Full; confirmed, son is health-care proxy.



Medications on Admission:
Active Medication list: verified ALLOPURINOL -  (Prescribed by
Other Provider) - Dosage uncertain
ENALAPRIL MALEATE -  (Prescribed by Other Provider) - 5 mg
Tablet-
FLUTICASONE [FLOVENT HFA] -  (Prescribed by Other Provider) -
220
mcg Aerosol -
FUROSEMIDE -  (Prescribed by Other Provider) - 20 mg Tablet -
IPRATROPIUM-ALBUTEROL -  (Prescribed by Other Provider) - 0.5
mg-3 mg (2.5 mg base)/3 mL Solution for Nebulization -  prn
SIMVASTATIN -  (Prescribed by Other Provider) - 40 mg Tablet -
TIOTROPIUM BROMIDE [SPIRIVA WITH HANDIHALER] -  (Prescribed by
Other Provider) - 18 mcg Capsule, w/Inhalation Device -  daily


Discharge Medications:
1. enalapril maleate 5 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
2. fluticasone 220 mcg/actuation Aerosol Sig: One (1)
Inhalation once a day.
3. azithromycin 250 mg Tablet Sig: One (1) Tablet PO Q24H (every
24 hours) for 7 days: Complete 10 day course.
4. aspirin 325 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).
5. tiotropium bromide 18 mcg Capsule, w/Inhalation Device Sig:
One (1) Cap Inhalation DAILY (Daily).
6. prednisone 20 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily):
2 tabs daily for 4 days ([**Date range (1) 58796**]);  1 tab daily for 4 days
([**Date range (1) 88139**]); half tab daily for 4 days (2/25-2/29).
7. simvastatin 40 mg Tablet Sig: One (1) Tablet PO once a day.
8. furosemide in 0.9 % NaCl 100 mg/100 mL (1 mg/mL) Solution
Sig: One Hundred (100) mg Intravenous once a day: Please titrate
diuresis to goal euvolemia. Please monitor electrolytes while
the patient is undergoing aggressive diuresis.
9. ipratropium-albuterol 0.5 mg-3 mg(2.5 mg base)/3 mL Solution
for Nebulization Sig: One (1)  Inhalation every six (6) hours as
needed for shortness of breath or wheezing.
10. Outpatient Lab Work
Please monitor daily electrolytes to monitor creatinine,
potassium and bicarbonate while the patient is on high dose
lasix.


Discharge Disposition:
Extended Care

Facility:
[**Hospital3 105**] - [**Location (un) 1121**] - [**Location (un) 1456**]

Discharge Diagnosis:
primary diagnosis:
chronic obstructive pulmonary disease
acute on chronic diastolic heart failure
secondary diagnosis:
coronary artery disease
hypertension
hyperlipidemia
morbid obesity


Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.


Discharge Instructions:
Dear Mr. [**Known lastname 88137**],
You were admitted to the hospital for respiratory difficulties.
You had difficulty breathing but you improved with removal of
excess fluid and with breathing treatments.

Please note the following changes to your medications:
- Azithromycin for 10 days total ([**Date range (1) 88140**])
- START steroid taper: 40mg for 4 days; 20mg for 4 days and 10mg
for 4 days
- START aspirin 325mg daily
- INCREASE lasix, and please call your physician if your weight
increases by 3 lbs. Weigh yourself daily. Please be sure to
monitor your electrolytes while you are on high dose lasix.
- CONTINUE your other medications as prescribed.

Followup Instructions:
When you are discharged from the LTAC, please be sure to see
your primary care physician and your other doctors.


                             [**Initials (NamePattern4) **] [**Last Name (NamePattern4) **] [**Name8 (MD) **] MD [**MD Number(1) 292**]
{'Acute and chronic respiratory failure,Acute on chronic diastolic heart failure,Obstructive chronic bronchitis with (acute) exacerbation,Other iatrogenic hypotension,Benign essential hypertension,Coronary atherosclerosis of native coronary artery,Edema,Morbid obesity,Other and unspecified hyperlipidemia,Old myocardial infarction,Other dependence on machines, supplemental oxygen,Other postprocedural status,Personal history of tobacco use,Other diuretics causing adverse effects in therapeutic use'}


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: 72 year old male with past medical history of COPD on 3L home
oxygen, hypertension, AAA s/p endovascular repair of
abdominal aortic aneurysm c/b STEMI requiring BMS LM, RCA as
well limb ischemia requiring left femoral endarterectomy on
[**2145-5-22**] now presenting with increasing SOB, sputum production
x2days.
.
Patient was in USOH when noted gradual onset increased DOE with
moderate increase in sputum production though no change in
sputum character. Denies associated fever, HA, rhinorrhea, sore
throat, chest pain, pleuritic pain, dysuria, calf
tenderness/swelling, LE edema, PND, orthopenia. No recent sick
contacts, recent travel. Reports complaince with lasix though
notes self-d/c of flovent in recent months. This morning in
setting of worsening SOB with associated wheeze checked O2 on
home pulse oximeter and noted to be 87% on home 3L so called
EMS.
.
On presentation to the ED, initial VS were: T 97.6, HR 102, BP
139/65, RR 17, O2 sat 90% 6L. 100% on NRB. Initial VBG showed
7.26/101/43/47 On exam poor aeration. CXR demonstrated
?pulmonary edema. Placed on noninvasive ventilation with
improvement of symptoms and stabilization of O2 sats. Patient
received levofloxacin 750mg, Lasix 20mg IV, Methylpred 125 IV,
2duonebs in treatment of likely COPD exacerbation as well as
mild volume overload.
.
On arrival to the MICU,  patient reports he is feeling better;
though wheezy, shortness of breath had improved and is again
without complaints of pain.
.
Review of systems:
(+) Per HPI
(-) Denies fever, chills, night sweats, recent weight loss or
gain. Denies headache, sinus tenderness, rhinorrhea or
congestion. Denies chest pain, chest pressure, palpitations, or
weakness. Denies nausea, vomiting, diarrhea, constipation,
abdominal pain, or changes in bowel habits. Denies dysuria,
frequency, or urgency. Denies arthralgias or myalgias. Denies
rashes or skin changes.

MEDICAL HISTORY: - COPD- baseline home O2 3LCN
- Morbid Obesity
- HTN
- HL
- AAA
- Pulm. nodule
- Edema
- S/P abd. hernia repair

MEDICATION ON ADMISSION: Active Medication list: verified ALLOPURINOL -  (Prescribed by
Other Provider) - Dosage uncertain
ENALAPRIL MALEATE -  (Prescribed by Other Provider) - 5 mg
Tablet-
FLUTICASONE [FLOVENT HFA] -  (Prescribed by Other Provider) -
220
mcg Aerosol -
FUROSEMIDE -  (Prescribed by Other Provider) - 20 mg Tablet -
IPRATROPIUM-ALBUTEROL -  (Prescribed by Other Provider) - 0.5
mg-3 mg (2.5 mg base)/3 mL Solution for Nebulization -  prn
SIMVASTATIN -  (Prescribed by Other Provider) - 40 mg Tablet -
TIOTROPIUM BROMIDE [SPIRIVA WITH HANDIHALER] -  (Prescribed by
Other Provider) - 18 mcg Capsule, w/Inhalation Device -  daily

ALLERGIES: scallops

PHYSICAL EXAM: On admission:
General: Alert, oriented, no acute distress, speaking in [**2-7**]
sent3ences before becoming dyspneic
HEENT: Sclera anicteric, MMM, oropharynx clear, EOMI, PERRL
Neck: supple, JVP hard to assess in setting of habitus but not
grossly up, no LAD
CV: quiet HR, Regular rate and rhythm, normal S1 + S2, no
murmurs, rubs, gallops
Lungs: poor - mod aeration bilaterally; decreased bs with
overlying crackles on the right, diffuse inspiratory and
expiratory wheeze
Abdomen: soft, obese non-tender, bowel sounds present, no
organomegaly
GU: no foley
Ext: warm, well perfused, dopplerable pulses, no clubbing,
cyanosis or minimal peripheral edema
Neuro: CNII-XII intact, 5/5 strength upper/lower extremities,
grossly normal sensation, 2+ reflexes bilaterally, gait
deferred, finger-to-nose intact

FAMILY HISTORY: CAD/PVD - father and mother, died in their 70s
CVA - brother in 60s.  Brother diagnosed with alzheimers at age
60.

SOCIAL HISTORY: Lives at home with wife, daughter, son-in-law and 3
grandchildren.  Used to work as a office equipment repairman.
Tobacco - quit [**2136**], was a lifetime smoker - 1-2ppd for 43 years
EtOH - occasional ethanol
drug use - denies. 

### Response:
{'Acute and chronic respiratory failure,Acute on chronic diastolic heart failure,Obstructive chronic bronchitis with (acute) exacerbation,Other iatrogenic hypotension,Benign essential hypertension,Coronary atherosclerosis of native coronary artery,Edema,Morbid obesity,Other and unspecified hyperlipidemia,Old myocardial infarction,Other dependence on machines, supplemental oxygen,Other postprocedural status,Personal history of tobacco use,Other diuretics causing adverse effects in therapeutic use'}
