CHIEF COMPLAINT: 

PRESENT ILLNESS: The patient is a 57-year-old
woman with a left MCA aneurysm who has a past medical history
of myocarditis, with an EF of 35% to 40%, renal artery
stenosis, with congenital single kidney, splenic infarction,
appendectomy, and right knee surgery with reflux disease.

MEDICAL HISTORY: 

MEDICATION ON ADMISSION: Atenolol, Lipitor, Zetia, folic
acid, and multivitamin.

ALLERGIES: 

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: 
Cerebral aneurysm, nonruptured,Iatrogenic cerebrovascular infarction or hemorrhage,Intracerebral hemorrhage,Aphasia,Atherosclerosis of renal artery,Esophageal reflux,Renal agenesis and dysgenesis
Nonrupt cerebral aneurym,Iatrogen CV infarc/hmrhg,Intracerebral hemorrhage,Aphasia,Renal artery atheroscler,Esophageal reflux,Renal agenesis
Admission Date: [**2138-2-25**]        Discharge Date: [**2138-2-28**]

Date of Birth:  [**2080-11-28**]        Sex:  F

Service:  NSU


HISTORY OF PRESENT ILLNESS:  The patient is a 57-year-old
woman with a left MCA aneurysm who has a past medical history
of myocarditis, with an EF of 35% to 40%, renal artery
stenosis, with congenital single kidney, splenic infarction,
appendectomy, and right knee surgery with reflux disease.

MEDICATIONS ON ADMISSION:  Atenolol, Lipitor, Zetia, folic
acid, and multivitamin.

HOSPITAL COURSE:  The patient was admitted status post a left
MCA aneurysmal clipping on [**2138-2-25**] with no
intraoperative complications. Postoperatively, the patient
was monitored in the ICU. Her vital signs remained stable.
She was afebrile. She was awake, alert, and oriented x 3. She
was following commands x 4. Blood pressure was kept less than
130. On postoperative day 1, she was awake, alert, and
oriented x 3. She was moving all extremities with full
strength. Pupils were equal, round, and reactive to light.
EOMs full. Face symmetric. Tongue midline. The patient
underwent a CTA that showed good clipping of the aneurysm.
The patient was transferred to the regular floor where she
was up ambulating, tolerating a regular diet, and voiding
spontaneously. She did have some severe facial swelling over
both sides of her face which was expected after the surgery.
Her vital signs remained stable.

DISCHARGE STATUS:  She was out of bed ambulating and
discharged on postoperative day 2 with followup with Dr.
[**Last Name (STitle) 1132**] in 2 weeks.

MEDICATIONS ON DISCHARGE:
1. Atenolol 25 mg p.o. daily.
2. Ezetimibe 10 mg p.o. daily.
3. Multivitamin 1 p.o. daily.
4. Simvastatin 10 mg 2 tablets p.o. daily.
5. Reglan 10 mg p.o. 4 times daily at mealtime and before
   bedtime.
6. Vitamin E 400 units 1 p.o. daily.
7. Enteric coated aspirin 325 mg daily.
8. Famotidine 20 mg p.o. b.i.d.
9. Percocet 1 to 2 tablets p.o. q.4h. p.r.n.


CONDITION ON DISCHARGE:  The patient's condition was stable
at the time of discharge.



                        [**Name6 (MD) **] [**Last Name (NamePattern4) 1359**], [**MD Number(1) 1360**]

Dictated By:[**Last Name (NamePattern1) **]
MEDQUIST36
D:  [**2138-2-27**] 15:51:22
T:  [**2138-2-27**] 18:35:52
Job#:  [**Job Number 98583**]


Name:  [**Known lastname 15746**], [**Known firstname 540**]             Unit No:  [**Numeric Identifier 15747**]

Admission Date: [**2138-2-25**]        Discharge Date: [**2138-3-6**]

Date of Birth:  [**2080-11-28**]        Sex:  F

Service:  NSU


ADDENDUM:  On the morning of [**2138-2-28**] the patient was
found less awake but moving all extremities spontaneously and
symmetrically. A STAT head CT was obtained which showed a new
epidural blood collection, and the patient was taken
emergently to the OR for evacuation.

Postoperatively, the patient's vital signs were stable. Her
BP was 130/56, heart rate was 74, respiratory rate was 12,
saturations were 95% on 3 liters. The patient was awake and
alert but confused and disoriented. Unable to follow
commands. Unable to assess EOMs. The pupils were equal,
round, and reactive to light bilaterally. The dressing was
dry and intact. She underwent a left frontal craniotomy for
evacuation of an epidural hematoma. She was monitored in the
ICU with q. 1-hour neuro checks. She was awake and alert, but
her speech was inappropriate. She did have a global aphasia.
Her cranial nerves were intact. She was moving all
extremities. Her head CT, status post evacuation, showed a
marked decrease in the midline shift. She remained on q. 2-
hour neuro checks with Dilantin and Decadron. She continued
to remain stable. Her speech eventually improved. She had a
repeat head CT on the 17th which was stable with no
reaccumulation of epidural hematoma.

She remained in the ICU until [**3-4**] when she was
transferred to the regular floor. She was seen by physical
therapy and occupational therapy and felt to be safe for
discharge to home. Neurologically, awake, alert, and oriented
x 3. Speech was fluent. Comprehension was intact. Moving all
four extremities. Ambulating independently.

DISCHARGE DISPOSITION:  The patient was discharged to home on
[**2138-3-6**] with followup with Dr. [**Last Name (STitle) 365**] in 2 weeks with a
repeat head CT.

MEDICATIONS ON DISCHARGE:  Include atenolol 25 mg p.o. daily,
ezetimibe 10 mg p.o. daily, multivitamin 1 p.o. daily,
simvastatin 10 mg 2 tablets p.o. daily, famotidine 20 mg p.o.
b.i.d., Percocet 1 to 2 tablets p.o. q.4.h. p.r.n.

CONDITION ON DISCHARGE:  The patient's condition was stable
at the time of discharge.

DISCHARGE FOLLOWUP:  She will follow up with Dr. [**Last Name (STitle) 365**] in 2
weeks with a repeat head CT.



                        [**Name6 (MD) **] [**Last Name (NamePattern4) 2483**], [**MD Number(1) 2484**]

Dictated By:[**Last Name (NamePattern1) **]
MEDQUIST36
D:  [**2138-3-6**] 10:48:49
T:  [**2138-3-6**] 11:33:26
Job#:  [**Job Number 15748**]
{'Cerebral aneurysm, nonruptured,Iatrogenic cerebrovascular infarction or hemorrhage,Intracerebral hemorrhage,Aphasia,Atherosclerosis of renal artery,Esophageal reflux,Renal agenesis and dysgenesis'}


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: The patient is a 57-year-old
woman with a left MCA aneurysm who has a past medical history
of myocarditis, with an EF of 35% to 40%, renal artery
stenosis, with congenital single kidney, splenic infarction,
appendectomy, and right knee surgery with reflux disease.

MEDICAL HISTORY: 

MEDICATION ON ADMISSION: Atenolol, Lipitor, Zetia, folic
acid, and multivitamin.

ALLERGIES: 

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY:  

### Response:
{'Cerebral aneurysm, nonruptured,Iatrogenic cerebrovascular infarction or hemorrhage,Intracerebral hemorrhage,Aphasia,Atherosclerosis of renal artery,Esophageal reflux,Renal agenesis and dysgenesis'}
