CHIEF COMPLAINT: Cardiac arrest

PRESENT ILLNESS: Mr. [**Known lastname **] is a 76 year old gentleman with a PMH significant
for DM 2, HTN, and hyperlipidemia transferred from an OSH after
cardiac arrest. The patient initially presented to an OSH last
night after a witnessed cardiac arrest whiel eating dinner.
Bystander CPR was performed and EMS arrived 14 minutes after
receiving the initial 911 call.  Per EMS report, patient was in
PEA with unknown rate on application of AED.  Atropine, 1 mg
1:10,000 epi, 100 mg lidocaine bolus followed by infusion were
given pre-hospital, and the patient was intubated.
Approximately 7 minutes after EMS arrival on-scene, the patient
was noted to be in VF and was defibrillated with 360 J with ROSC
with sinus rythmn.
.
Upon arrival to the OSH ([**Hospital3 **]), the patient was noted
to be in a sinus rhythmn.  Overnight, he required levophed for
hypotension that was weaned off this morning, and was also noted
to be bradycardic to the 40s, and received an IV amiodarone load
and heparin gtt.  He was also noted to have a rectal temperature
of 100 degrees, and remained unresponsive off sedation.  A
non-contrast CTH was negative for acute intracranial process and
a CTA chest was negative for pulmonary emboli.
.
Of note, the patient recently presented to the [**Hospital1 18**] ED with
chest pain and unilateral leg swelling. Due to an elevated
d-dimer, a CTA was performed that was negative for PE.  The
patient then had an ETT that was negative (6.7 METS, 13 minutes
on [**Doctor Last Name 4001**] protocol) and was discharged home.
.
Currently, the patient is intubated and unresponsive.
.
Complete ROS and cardiac ROS unobtainable as patient is
intubated and unresponsive.

MEDICAL HISTORY: 1. CARDIAC RISK FACTORS: DM 2, Hyperlipidemia, Hypertension
2. CARDIAC HISTORY:
- ETT [**7-27**] negative
3. OTHER PAST MEDICAL HISTORY:
Elevatd PSA, not yet worked up but followed by Dr. [**Last Name (STitle) 33427**].
.

MEDICATION ON ADMISSION: Trandolapril 1 mg daily
Atenolol 25 mg daily
Glimepiride 4 mg daily
Simvastatin 10 mg daily
Metformin 1000 mg po bid

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: VS: 101 50 94/49 14 100% 550x14, 5, 50%
Gen: Intubated male, unresponsive
HEENT: Pupils 2mm, sluggish (R more reactive than L), sclerae
anicteric. ETT in place.
CV: Nl S1+S2, no murmurs appreciated. JVP flat. PMI not
laterally displaced, no precordial heave.
Pulm: Decreased breath sounds at right base.
Abd: S/NT/ND +bs
Ext: 1+ edema bilaterally. 1+ dp bilaterally
Neuro: Unresponsive. No corneal reflex. No responsve to painful
stimuli or deep suctioning. Down going toes to babinski
bilaterally.

FAMILY HISTORY: Father with Alzheimer's and mother with [**Name (NI) 5895**].

SOCIAL HISTORY: He is a professor emeritus at [**University/College **]. He lives alone. He quit
smoking tobacco "years ago", but occasionally has a cigar.  He
drinks alcohol occasionally on a social basis.  He denied
illicit drug use.
Other chest pain,Coma,Personal history of sudden cardiac arrest,Edema,Encounter for palliative care,Unspecified essential hypertension,Hypotension, unspecified,Elevated prostate specific antigen [PSA],Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Other and unspecified hyperlipidemia,Anemia, unspecified,Tobacco use disorder
Chest pain NEC,Coma,Hx sudden cardiac arrest,Edema,Encountr palliative care,Hypertension NOS,Hypotension NOS,Elvtd prstate spcf antgn,DMII wo cmp nt st uncntr,Hyperlipidemia NEC/NOS,Anemia NOS,Tobacco use disorder
Admission Date:  [**2163-8-11**]              Discharge Date:   [**2163-8-12**]

Date of Birth:  [**2086-9-2**]             Sex:   M

Service: MEDICINE

Allergies:
Patient recorded as having No Known Allergies to Drugs

Attending:[**First Name3 (LF) 7651**]
Chief Complaint:
Cardiac arrest


Major Surgical or Invasive Procedure:
none

History of Present Illness:
Mr. [**Known lastname **] is a 76 year old gentleman with a PMH significant
for DM 2, HTN, and hyperlipidemia transferred from an OSH after
cardiac arrest. The patient initially presented to an OSH last
night after a witnessed cardiac arrest whiel eating dinner.
Bystander CPR was performed and EMS arrived 14 minutes after
receiving the initial 911 call.  Per EMS report, patient was in
PEA with unknown rate on application of AED.  Atropine, 1 mg
1:10,000 epi, 100 mg lidocaine bolus followed by infusion were
given pre-hospital, and the patient was intubated.
Approximately 7 minutes after EMS arrival on-scene, the patient
was noted to be in VF and was defibrillated with 360 J with ROSC
with sinus rythmn.
.
Upon arrival to the OSH ([**Hospital3 **]), the patient was noted
to be in a sinus rhythmn.  Overnight, he required levophed for
hypotension that was weaned off this morning, and was also noted
to be bradycardic to the 40s, and received an IV amiodarone load
and heparin gtt.  He was also noted to have a rectal temperature
of 100 degrees, and remained unresponsive off sedation.  A
non-contrast CTH was negative for acute intracranial process and
a CTA chest was negative for pulmonary emboli.
.
Of note, the patient recently presented to the [**Hospital1 18**] ED with
chest pain and unilateral leg swelling. Due to an elevated
d-dimer, a CTA was performed that was negative for PE.  The
patient then had an ETT that was negative (6.7 METS, 13 minutes
on [**Doctor Last Name 4001**] protocol) and was discharged home.
.
Currently, the patient is intubated and unresponsive.
.
Complete ROS and cardiac ROS unobtainable as patient is
intubated and unresponsive.


Past Medical History:
1. CARDIAC RISK FACTORS: DM 2, Hyperlipidemia, Hypertension
2. CARDIAC HISTORY:
- ETT [**7-27**] negative
3. OTHER PAST MEDICAL HISTORY:
Elevatd PSA, not yet worked up but followed by Dr. [**Last Name (STitle) 33427**].
.


Social History:
He is a professor emeritus at [**University/College **]. He lives alone. He quit
smoking tobacco "years ago", but occasionally has a cigar.  He
drinks alcohol occasionally on a social basis.  He denied
illicit drug use.


Family History:
Father with Alzheimer's and mother with [**Name (NI) 5895**].


Physical Exam:
VS: 101 50 94/49 14 100% 550x14, 5, 50%
Gen: Intubated male, unresponsive
HEENT: Pupils 2mm, sluggish (R more reactive than L), sclerae
anicteric. ETT in place.
CV: Nl S1+S2, no murmurs appreciated. JVP flat. PMI not
laterally displaced, no precordial heave.
Pulm: Decreased breath sounds at right base.
Abd: S/NT/ND +bs
Ext: 1+ edema bilaterally. 1+ dp bilaterally
Neuro: Unresponsive. No corneal reflex. No responsve to painful
stimuli or deep suctioning. Down going toes to babinski
bilaterally.


Pertinent Results:
On admission:
[**2163-8-11**] 06:02PM BLOOD WBC-6.5# RBC-3.40* Hgb-11.2* Hct-32.4*
MCV-95 MCH-32.8* MCHC-34.5 RDW-13.9 Plt Ct-140*
[**2163-8-11**] 06:02PM BLOOD Neuts-87.0* Lymphs-6.9* Monos-5.8 Eos-0.2
Baso-0.2
[**2163-8-11**] 06:02PM BLOOD PT-14.6* PTT-120.9* INR(PT)-1.3*
[**2163-8-11**] 06:02PM BLOOD Glucose-231* UreaN-12 Creat-0.8 Na-140
K-4.0 Cl-110* HCO3-20* AnGap-14
[**2163-8-11**] 06:02PM BLOOD ALT-82* AST-89* LD(LDH)-205 CK(CPK)-95
AlkPhos-26* TotBili-0.6
[**2163-8-11**] 06:02PM BLOOD Albumin-3.5 Calcium-7.1* Phos-2.5*
Mg-1.0*
[**2163-8-11**] 11:25PM BLOOD Type-ART pO2-115* pCO2-29* pH-7.38
calTCO2-18* Base XS--6

Brief Hospital Course:
Mr. [**Known lastname **] is a 76 year old gentleman with a PMH significant
for DM 2, HTN, and hyperlipidemia transferred from an OSH after
cardiac arrest. He was transferred to [**Hospital1 827**] on [**2163-8-11**]. On [**2163-8-12**],
after extensive discussion with the patient's family and an
explanation of his grim prognosis, Mr. [**Known lastname **] was extubated
and [**Known lastname **] shortly thereafter. His brief hospital course was
notable for:
.
# Cardiac arrest: Patient with significant down time of at least
21 minutes after initial 911 call to schockable rhythmn and ROSC
with bystander CPR performed.  Per report, at the OSH patient
was initially warmed at the OSH, and 24 hours post-arrest he has
a GCS <5, which has a poor prognostic value.  Discussed with
cardiac arrest team, no indication for cooling. The etiology of
Mr. [**Known lastname **] cardiac arrest is not completely clear, and the
differential includeda acute myocardial ischemic event,
arrythmia, and pulmonary embolus. An ischemic event seems less
likely given trends in the patients cardiac biomarkers. During
his stay at [**Hospital3 **], Mr. [**Known lastname **] was unresponsive, did not
follow commands, and did not demonstrate any cortical cerebral
function.  A neurology evaluation with EEG also demonstrated no
cortical function. After discussion with the family about the
patient's grim prognosis without hope for significant recovery
from a persistent vegetative state, the family agreed to have
the patient extubated. Mr. [**Known lastname **] [**Last Name (Titles) **] shortly thereafter
on [**2163-8-12**].

.

Medications on Admission:
Trandolapril 1 mg daily
Atenolol 25 mg daily
Glimepiride 4 mg daily
Simvastatin 10 mg daily
Metformin 1000 mg po bid

Discharge Disposition:
[**Year (4 digits) **]

Discharge Diagnosis:
cardiac arrest

Discharge Condition:
deceased

Discharge Instructions:
none

Followup Instructions:
none
{'Other chest pain,Coma,Personal history of sudden cardiac arrest,Edema,Encounter for palliative care,Unspecified essential hypertension,Hypotension, unspecified,Elevated prostate specific antigen [PSA],Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Other and unspecified hyperlipidemia,Anemia, unspecified,Tobacco use disorder'}


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: Cardiac arrest

PRESENT ILLNESS: Mr. [**Known lastname **] is a 76 year old gentleman with a PMH significant
for DM 2, HTN, and hyperlipidemia transferred from an OSH after
cardiac arrest. The patient initially presented to an OSH last
night after a witnessed cardiac arrest whiel eating dinner.
Bystander CPR was performed and EMS arrived 14 minutes after
receiving the initial 911 call.  Per EMS report, patient was in
PEA with unknown rate on application of AED.  Atropine, 1 mg
1:10,000 epi, 100 mg lidocaine bolus followed by infusion were
given pre-hospital, and the patient was intubated.
Approximately 7 minutes after EMS arrival on-scene, the patient
was noted to be in VF and was defibrillated with 360 J with ROSC
with sinus rythmn.
.
Upon arrival to the OSH ([**Hospital3 **]), the patient was noted
to be in a sinus rhythmn.  Overnight, he required levophed for
hypotension that was weaned off this morning, and was also noted
to be bradycardic to the 40s, and received an IV amiodarone load
and heparin gtt.  He was also noted to have a rectal temperature
of 100 degrees, and remained unresponsive off sedation.  A
non-contrast CTH was negative for acute intracranial process and
a CTA chest was negative for pulmonary emboli.
.
Of note, the patient recently presented to the [**Hospital1 18**] ED with
chest pain and unilateral leg swelling. Due to an elevated
d-dimer, a CTA was performed that was negative for PE.  The
patient then had an ETT that was negative (6.7 METS, 13 minutes
on [**Doctor Last Name 4001**] protocol) and was discharged home.
.
Currently, the patient is intubated and unresponsive.
.
Complete ROS and cardiac ROS unobtainable as patient is
intubated and unresponsive.

MEDICAL HISTORY: 1. CARDIAC RISK FACTORS: DM 2, Hyperlipidemia, Hypertension
2. CARDIAC HISTORY:
- ETT [**7-27**] negative
3. OTHER PAST MEDICAL HISTORY:
Elevatd PSA, not yet worked up but followed by Dr. [**Last Name (STitle) 33427**].
.

MEDICATION ON ADMISSION: Trandolapril 1 mg daily
Atenolol 25 mg daily
Glimepiride 4 mg daily
Simvastatin 10 mg daily
Metformin 1000 mg po bid

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: VS: 101 50 94/49 14 100% 550x14, 5, 50%
Gen: Intubated male, unresponsive
HEENT: Pupils 2mm, sluggish (R more reactive than L), sclerae
anicteric. ETT in place.
CV: Nl S1+S2, no murmurs appreciated. JVP flat. PMI not
laterally displaced, no precordial heave.
Pulm: Decreased breath sounds at right base.
Abd: S/NT/ND +bs
Ext: 1+ edema bilaterally. 1+ dp bilaterally
Neuro: Unresponsive. No corneal reflex. No responsve to painful
stimuli or deep suctioning. Down going toes to babinski
bilaterally.

FAMILY HISTORY: Father with Alzheimer's and mother with [**Name (NI) 5895**].

SOCIAL HISTORY: He is a professor emeritus at [**University/College **]. He lives alone. He quit
smoking tobacco "years ago", but occasionally has a cigar.  He
drinks alcohol occasionally on a social basis.  He denied
illicit drug use. 

### Response:
{'Other chest pain,Coma,Personal history of sudden cardiac arrest,Edema,Encounter for palliative care,Unspecified essential hypertension,Hypotension, unspecified,Elevated prostate specific antigen [PSA],Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Other and unspecified hyperlipidemia,Anemia, unspecified,Tobacco use disorder'}
