CHIEF COMPLAINT: 

PRESENT ILLNESS: This 66-year-old woman with
carcinoma of the esophagus presents with dysphagia.  She has
been having increasing amounts of dysphagia.  She has been
scheduled for surgery but now presents because of difficulty
eating.  An endoscopy done on [**11-18**] showed a mass in the mid
esophagus causing partial obstruction.  Surgery was planned
for [**1-4**], however, she has had difficulty with eating and
taking and keeping down liquids.  The patient does have a
history of coronary disease and has had an exercise thallium
test which shows some ischemia.  The patient is admitted for
hydration and further work-up before surgery.

MEDICAL HISTORY: Notable for hypertension,
hypercholesterolemia and peripheral vascular disease.  She is
status post below knee amputation on the left.

MEDICATION ON ADMISSION: 

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: 
Malignant neoplasm of upper third of esophagus,Secondary and unspecified malignant neoplasm of intrathoracic lymph nodes,Cardiac complications, not elsewhere classified,Acute myocardial infarction of unspecified site, initial episode of care,Unspecified essential hypertension,Pure hypercholesterolemia,Peripheral vascular disease, unspecified
Mal neo upper 3rd esoph,Mal neo lymph-intrathor,Surg compl-heart,AMI NOS, initial,Hypertension NOS,Pure hypercholesterolem,Periph vascular dis NOS
Admission Date:  [**2179-12-30**]     Discharge Date:  [**2180-1-14**]

Date of Birth:                  Sex:  F

Service:  Surgical

HISTORY OF PRESENT ILLNESS:  This 66-year-old woman with
carcinoma of the esophagus presents with dysphagia.  She has
been having increasing amounts of dysphagia.  She has been
scheduled for surgery but now presents because of difficulty
eating.  An endoscopy done on [**11-18**] showed a mass in the mid
esophagus causing partial obstruction.  Surgery was planned
for [**1-4**], however, she has had difficulty with eating and
taking and keeping down liquids.  The patient does have a
history of coronary disease and has had an exercise thallium
test which shows some ischemia.  The patient is admitted for
hydration and further work-up before surgery.

PAST MEDICAL HISTORY:  Notable for hypertension,
hypercholesterolemia and peripheral vascular disease.  She is
status post below knee amputation on the left.

MEDICATIONS:  Include Verapamil 180 mg tid, Lipitor, Zestril,
Amitriptyline, Atenolol 50 mg once per day.

ALLERGIES:  No known drug allergies.

PHYSICAL EXAMINATION:  She is a well developed woman who has
lost some weight recently.  The heart sounds were regular.
The abdomen was soft without masses or tenderness.  Her below
knee amputation site is well healed.

LABORATORY DATA:  Admission laboratory showed hematocrit of
34, white blood cells 6,500, BUN 16, creatinine 1.

HOSPITAL COURSE:  The patient was admitted to the medical
service for cardiology work-up and hydration.  She was
hydrated.  She was seen in consultation by the cardiologist
who thought the patient was an intermediate risk for
perioperative cardiac events and would proceed with surgery
without cardiac catheterization.  She was given beta
blockade.  She was prepared for surgery.  She was placed on
TPN.  On [**2180-1-4**] the patient underwent an Ivor-[**Doctor Last Name **]
esophagogastrectomy with bronchoscopy and feeding
jejunostomy.  Surgery itself was uncomplicated with the
exception of some ST changes when the patient's saturation
dropped.  The patient was admitted to the surgical Intensive
Care Unit and followed closely.  She had a small troponin
leak and elevated MB fraction consistent with a small
perioperative myocardial infarction.  She was seen by
cardiology who recommended Lopressor and Aspirin as soon as
possible.  Her enzymes actually increased to a CPK of 1528
with MB of 32 and MB index of 2.1.  The patient was intubated
and ventilated.  Tube feedings were begun.  She was extubated
on postoperative day #3.  She remained on a small amount of
vasopressors, especially with her epidural in place and
remained in the Intensive Care Unit for observation.  Her
pain was under reasonable control.  The patient had a swallow
which showed no leak.  She was then discharged on [**2180-1-14**].

FINAL DIAGNOSIS:
1.  Esophageal cancer.
2.  Perioperative myocardial infarction.
3.  Hypertension.
4.  Peripheral vascular disease.
5.  Hypercholesterolemia.

SURGICAL PROCEDURES:  Ivor-[**Doctor Last Name **] esophagogastrectomy [**2180-1-4**].

DISCHARGE MEDICATIONS:  Verapamil 180 mg tid, Lipitor,
Zestril, Amitriptyline, Atenolol 50 mg [**Hospital1 **], Percocet for
pain.

DISPOSITION:  The patient was discharged with approval and
will be followed with nursing services.





                          [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) **], M.D.  [**MD Number(1) 6066**]

Dictated By:[**Last Name (NamePattern4) 9706**]

MEDQUIST36

D:  [**2180-7-10**]  11:24
T:  [**2180-7-12**]  10:44
JOB#:  [**Job Number **]
{'Malignant neoplasm of upper third of esophagus,Secondary and unspecified malignant neoplasm of intrathoracic lymph nodes,Cardiac complications, not elsewhere classified,Acute myocardial infarction of unspecified site, initial episode of care,Unspecified essential hypertension,Pure hypercholesterolemia,Peripheral vascular disease, unspecified'}


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 66-year-old woman with
carcinoma of the esophagus presents with dysphagia.  She has
been having increasing amounts of dysphagia.  She has been
scheduled for surgery but now presents because of difficulty
eating.  An endoscopy done on [**11-18**] showed a mass in the mid
esophagus causing partial obstruction.  Surgery was planned
for [**1-4**], however, she has had difficulty with eating and
taking and keeping down liquids.  The patient does have a
history of coronary disease and has had an exercise thallium
test which shows some ischemia.  The patient is admitted for
hydration and further work-up before surgery.

MEDICAL HISTORY: Notable for hypertension,
hypercholesterolemia and peripheral vascular disease.  She is
status post below knee amputation on the left.

MEDICATION ON ADMISSION: 

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY:  

### Response:
{'Malignant neoplasm of upper third of esophagus,Secondary and unspecified malignant neoplasm of intrathoracic lymph nodes,Cardiac complications, not elsewhere classified,Acute myocardial infarction of unspecified site, initial episode of care,Unspecified essential hypertension,Pure hypercholesterolemia,Peripheral vascular disease, unspecified'}
