CHIEF COMPLAINT: TIA/Palpitations

PRESENT ILLNESS: This 53-year-old with a history of multiple transient ischemic
attacks in the past was investigated and was found to have a
small patent foramen
ovale, and he was electively admitted for closure of the same.
His preoperative investigations with coronary angiogram showed
normal coronary arteries. His left ventricular function was well
preserved. He had no valvular disease.

MEDICAL HISTORY: Right Upper lobe nodule
TIA's
Childhood skull fracture
PFO

MEDICATION ON ADMISSION: Plavix 75mg daily
aspirin 81mg daily

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: Vitals: BP 144/90, HR 64, RR 14
General: well developed male in no acute distress
HEENT: oropharynx benign, poor dental health
Neck: supple, no JVD
Heart: regular rate, normal s1s2, no murmur
Lungs: clear bilaterally
Abdomen: soft, nontender, normoactive bowel sounds
Ext: warm, no edema, no varicosities
Pulses: 2+ distally
Neuro: nonfocal

FAMILY HISTORY: Brother with MI at age 35
Father with MI/CABG died at age 60.

SOCIAL HISTORY: Lives with wife. 1 ETO drink daily. Quit smoking 30 years ago
after smoking 1ppd. Retired.
Ostium secundum type atrial septal defect
Secundum atrial sept def
Admission Date:  [**2159-2-19**]              Discharge Date:   [**2159-2-22**]

Date of Birth:  [**2105-8-27**]             Sex:   M

Service: CARDIOTHORACIC

Allergies:
Patient recorded as having No Known Allergies to Drugs

Attending:[**First Name3 (LF) 1283**]
Chief Complaint:
TIA/Palpitations

Major Surgical or Invasive Procedure:
[**2159-2-19**] - PFO closure via Right mini thoracotomy


History of Present Illness:
This 53-year-old with a history of multiple transient ischemic
attacks in the past was investigated and was found to have a
small patent foramen
ovale, and he was electively admitted for closure of the same.
His preoperative investigations with coronary angiogram showed
normal coronary arteries. His left ventricular function was well
preserved. He had no valvular disease.


Past Medical History:
Right Upper lobe nodule
TIA's
Childhood skull fracture
PFO

Social History:
Lives with wife. 1 ETO drink daily. Quit smoking 30 years ago
after smoking 1ppd. Retired.

Family History:
Brother with MI at age 35
Father with MI/CABG died at age 60.

Physical Exam:
Vitals: BP 144/90, HR 64, RR 14
General: well developed male in no acute distress
HEENT: oropharynx benign, poor dental health
Neck: supple, no JVD
Heart: regular rate, normal s1s2, no murmur
Lungs: clear bilaterally
Abdomen: soft, nontender, normoactive bowel sounds
Ext: warm, no edema, no varicosities
Pulses: 2+ distally
Neuro: nonfocal


Pertinent Results:
[**2159-2-22**] 07:30AM BLOOD Hct-25.9*
[**2159-2-21**] 07:05AM BLOOD WBC-5.9 RBC-2.72* Hgb-8.6* Hct-25.2*
MCV-93 MCH-31.5 MCHC-34.0 RDW-13.0 Plt Ct-150
[**2159-2-21**] 07:05AM BLOOD Plt Ct-150
[**2159-2-22**] 07:30AM BLOOD UreaN-11 Creat-0.8 K-4.4

[**2159-2-19**] ECHO
No spontaneous echo contrast is seen in the body of the left
atrium. No
mass/thrombus is seen in the left atrium or left atrial
appendage. No
spontaneous echo contrast is seen in the body of the right
atrium. A patent foramen ovale/secundum ASD is present. A
left-to-right shunt across the interatrial septum is seen at
rest. A right-to-left shunt across the
interatrial septum is seen at rest with injection of agitated
saline contrast. The inferior vena cava is dilated (>2.5 cm).
Left ventricular wall thickness, cavity size, and systolic
function are normal (LVEF>55%). Left ventricular wall
thicknesses are normal. Regional left ventricular wall motion is
normal. Overall left ventricular systolic function is normal
(LVEF>55%). Right ventricular chamber size and free wall motion
are normal. The ascending, transverse and descending thoracic
aorta are normal in diameter and free of atherosclerotic plaque.
The aortic valve leaflets (3) appear structurally normal with
good leaflet excursion and no aortic regurgitation. No aortic
regurgitation is seen. The mitral valve appears structurally
normal with trivial mitral regurgitation. The mitral valve
leaflets are structurally normal. There is no pericardial
effusion.
POST BYPASS
Flow across the interatrial septum is no longer visualized with
color flow doppler or with injection of agitatated saline at
rest or with valsalva. The study is otherwise unchanged from
pre-bypass.

[**2159-2-20**] CXR
Previous right pneumothorax has resolved except for what is
either a small fissural component or a bulla adjacent to the
minor fissure. [**Month (only) 116**] be a small right pleural effusion. Right
apical pleural tube in place. Left lung clear from basal
atelectasis. Paratracheal mediastinal hematoma is resolving.
Heart size is normal. Tip of the left internal jugular line
projects over the SVC.


[**Last Name (NamePattern4) 4125**]ospital Course:
Mr. [**Known lastname 54558**] was admitted to the [**Hospital1 18**] on [**2159-2-19**] for surgical
management of his PFO. He was taken to the operating room where
he underwent a mini-thoracotomy with closure of his patent
foramen ovale (PFO). Postoperatively he was taken to the cardiac
surgical intensive care unit for monitoring. Within a few hours,
he woke neurologically intact and was extubated. Aspirin was
resumed. On postoperative day one, he was transferred to the
cardiac surgical step down unit. He was gently diuresed towards
his preoperative weight. The physical therapy service was
consulted for assistance with his postoperative strength and
mobility. Iron and vitamin C were started for postoperative
anemia. Mr. [**Known lastname 54558**] maintained stable hemodynamics with a
normal sinus rhythm throughout his postoperative course. He
continued to make steady progress and was discharged home on
postoperative day three. He will follow-up with Dr. [**Last Name (Prefixes) **],
Dr. [**Last Name (STitle) 952**], his cardiologist and his primary care physician as
an outpatient.

Medications on Admission:
Plavix 75mg daily
aspirin 81mg daily

Discharge Medications:
1. Potassium Chloride 10 mEq Capsule, Sustained Release Sig: Two
(2) Capsule, Sustained Release PO Q12H (every 12 hours) for 5
days.
Disp:*10 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:*0*
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. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO
every 4-6 hours as needed for pain.
Disp:*50 Tablet(s)* Refills:*0*
5. Ferrous Sulfate 325 (65) mg Tablet Sig: One (1) Tablet PO
DAILY (Daily): Take for one month then stop.
Disp:*30 Tablet(s)* Refills:*0*
6. Camphor-Menthol 0.5-0.5 % Lotion Sig: One (1) Appl Topical
TID (3 times a day) as needed.
Disp:*qs qs* Refills:*0*
7. Ascorbic Acid 500 mg Tablet Sig: One (1) Tablet PO BID (2
times a day): Take for one month then stop.
Disp:*60 Tablet(s)* Refills:*0*
8. Furosemide 20 mg Tablet Sig: One (1) Tablet PO BID (2 times a
day) for 5 days.
Disp:*10 Tablet(s)* Refills:*0*


Discharge Disposition:
Home With Service

Facility:
TBA

Discharge Diagnosis:
PFO
TIA
lung nodule (followed by Dr. [**Last Name (STitle) 952**]
s/p fissurectomy/skull Fx


Discharge Condition:
Good


Discharge Instructions:
1) Shower, wash incisions with mild soap and water and pat dry.
No lotions, creams or powders to incisions.
2) Call with fever >101, redness or drainage from incision, or
weight gain more than 2 pounds in one day or five pounds in one
week.
3) No driving while on narcotics.
4) Take lasix twice daily with potassium for five days then
stop.
5) Take Vitamin C with iron for one month then stop.
6) Call with any questions or concerns.

Followup Instructions:
Follow up with Dr. [**Last Name (STitle) 1290**] in four weeks, [**Telephone/Fax (1) 170**]
Follow up with Dr. [**Last Name (STitle) 3142**] in [**12-4**] weeks, [**Telephone/Fax (1) 19980**]
Follow up with Dr. [**Last Name (STitle) **] in [**1-5**] weeks, [**Telephone/Fax (1) 4022**]
Call all providers for appointments.
CAT SCAN Phone:[**Telephone/Fax (1) 327**] Date/Time:[**2159-8-16**] 9:15
[**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **], MD Phone:[**0-0-**] Date/Time:[**2159-8-16**] 2:30



Completed by:[**2159-2-22**]
{'Ostium secundum type atrial septal defect'}


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: TIA/Palpitations

PRESENT ILLNESS: This 53-year-old with a history of multiple transient ischemic
attacks in the past was investigated and was found to have a
small patent foramen
ovale, and he was electively admitted for closure of the same.
His preoperative investigations with coronary angiogram showed
normal coronary arteries. His left ventricular function was well
preserved. He had no valvular disease.

MEDICAL HISTORY: Right Upper lobe nodule
TIA's
Childhood skull fracture
PFO

MEDICATION ON ADMISSION: Plavix 75mg daily
aspirin 81mg daily

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: Vitals: BP 144/90, HR 64, RR 14
General: well developed male in no acute distress
HEENT: oropharynx benign, poor dental health
Neck: supple, no JVD
Heart: regular rate, normal s1s2, no murmur
Lungs: clear bilaterally
Abdomen: soft, nontender, normoactive bowel sounds
Ext: warm, no edema, no varicosities
Pulses: 2+ distally
Neuro: nonfocal

FAMILY HISTORY: Brother with MI at age 35
Father with MI/CABG died at age 60.

SOCIAL HISTORY: Lives with wife. 1 ETO drink daily. Quit smoking 30 years ago
after smoking 1ppd. Retired. 

### Response:
{'Ostium secundum type atrial septal defect'}
