CHIEF COMPLAINT: 

PRESENT ILLNESS: This is a 79 year old female
with known aortic stenosis for many years.  The patient has
been followed with echocardiogram every three to four months
and on the last echocardiogram in [**2112-3-19**], the patient's
gradient was significantly increased.  The patient was
referred for cardiac catheterization.  Catheterization on the
day of admission showed that the patient had a severe aortic
stenosis and the patient was referred for aortic valve
replacement.

MEDICAL HISTORY: Chronic obstructive pulmonary disease.

MEDICATION ON ADMISSION: 1. Propranolol 40 mg p.o. once daily.
2. Cozaar 100 mg p.o. once daily.
3. Norvasc 5 mg p.o. once daily.
4. Triminol 100 mg p.o. twice a day.
5. Xalatan 0.005 percent one drop q.h.s.
6. Lipitor 20 mg p.o. once daily.
7. Aspirin 325 mg p.o. once daily.
8. Vitamin B12 injection q.month.

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: No coronary artery disease in the family.

SOCIAL HISTORY: The patient lives alone, widowed, and the
patient has family in the area.  The patient quit smoking
approximately ten years ago.  The patient drinks
approximately two to three glasses of wine every night.
Aortic valve disorders,Congestive heart failure, unspecified,Chronic airway obstruction, not elsewhere classified,Pure hypercholesterolemia,Personal history of malignant neoplasm of breast
Aortic valve disorder,CHF NOS,Chr airway obstruct NEC,Pure hypercholesterolem,Hx of breast malignancy
Admission Date: [**2112-5-16**]        Discharge Date: [**2112-5-21**]

Date of Birth:  [**2033-5-21**]        Sex:  F

Service:  CSU


HISTORY OF PRESENT ILLNESS:  This is a 79 year old female
with known aortic stenosis for many years.  The patient has
been followed with echocardiogram every three to four months
and on the last echocardiogram in [**2112-3-19**], the patient's
gradient was significantly increased.  The patient was
referred for cardiac catheterization.  Catheterization on the
day of admission showed that the patient had a severe aortic
stenosis and the patient was referred for aortic valve
replacement.

On catheterization, the patient had no coronary artery
disease.  The patient had severe aortic stenosis with aortic
valve area of 0.6 and gradient of 35, ejection fraction of 60
percent, and no mitral regurgitation.

PAST MEDICAL HISTORY:  Chronic obstructive pulmonary disease.

Asbestosis.

Breast cancer, status post right mastectomy seven years ago.

Diverticulosis.

Glaucoma.

Cataracts, status post surgery.

Cough.

ALLERGIES:  No known drug allergies.

MEDICATIONS ON ADMISSION:
1. Propranolol 40 mg p.o. once daily.
2. Cozaar 100 mg p.o. once daily.
3. Norvasc 5 mg p.o. once daily.
4. Triminol 100 mg p.o. twice a day.
5. Xalatan 0.005 percent one drop q.h.s.
6. Lipitor 20 mg p.o. once daily.
7. Aspirin 325 mg p.o. once daily.
8. Vitamin B12 injection q.month.


SOCIAL HISTORY:  The patient lives alone, widowed, and the
patient has family in the area.  The patient quit smoking
approximately ten years ago.  The patient drinks
approximately two to three glasses of wine every night.

FAMILY HISTORY:  No coronary artery disease in the family.

PHYSICAL EXAMINATION:  Generally, the patient is alert and
oriented times three, appropriate.  The patient's neurologic
examination was grossly intact.  The patient's had III/VI
systolic ejection murmur best heard on the right sternal
border with radiation to the carotids.  The patient's chest
was clear to auscultation.  The patient's abdomen was soft,
round, nontender, nondistended with positive bowel sounds.
Extremities had no varicosities.  There were spider veins,
two plus dorsalis pedis and posterior tibial bilaterally, and
no edema bilaterally and two plus femoral bilaterally.

HOSPITAL COURSE:  The patient was admitted to the Cardiac
Surgery service and the patient underwent an aortic valve
replacement with number 19 [**Company 1543**] mosaic porcine valve on
hospital day number two for severe aortic stenosis and
congestive heart failure.  Please see the dictated operative
note for details of the operation.

Postoperatively, the patient was admitted to the Cardiac
Intensive Care Unit.  The patient had no significant
problems.  Postoperatively, the patient was extubated and the
patient had low cardiac index so the patient received some
fluid boluses to which she responded without any
difficulties.  The patient remained afebrile with stable
vital signs.  The patient's hematocrit was stable at 30.2 and
creatinine was 0.6.  The patient was on no drips and the
patient was transferred to the floor on postoperative day
number one.

On postoperative day number two, the patient remained
afebrile with stable vital signs.  The patient had no
significant issues.  The patient's chest tubes and wires were
removed and the patient's physical therapy was increased.  On
postoperative day number three, the patient had no events.
The patient continued to remain afebrile with stable vital
signs.  The patient continued to work with physical therapy,
being out of bed, ambulating.  The patient's oxygen was
weaned down from three liters.  On postoperative day number
four, the patient remained afebrile with stable vital signs
and the patient was in no apparent distress.  Chest was
clear.  The patient was discharged home in good condition.

DISCHARGE DIAGNOSES:  Chronic obstructive pulmonary disease.

Asbestosis.

Breast cancer, status post mastectomy seven years ago.

Diverticulosis.

Glaucoma.

Cataracts, status post surgery.

Severe aortic stenosis, status post aortic valve replacement.

MEDICATIONS ON DISCHARGE:
1. Lopressor 12.5 mg p.o. twice a day.
2. Lasix 20 mg p.o. twice a day for seven days.
3. Potassium 20 mEq p.o. twice a day for seven days.
4. Colace 100 mg p.o. twice a day.
5. Zantac 150 mg p.o. twice a day.
6. Aspirin 325 mg p.o. once daily.
7. Percocet one to two tablets q4hours p.r.n. pain.
8. Atorvastatin 20 mg p.o. once daily.


DISPOSITION:  The patient was discharged home with VNA
services.

CONDITION ON DISCHARGE:  Stable.


FOLLOW UP:  The patient is to follow-up with Dr. [**Last Name (STitle) **] in
three to four weeks.  Please follow-up with primary care
physician, [**Last Name (NamePattern4) **]. [**Last Name (STitle) **] and her cardiologist Dr [**Last Name (STitle) 13175**], in
three to four weeks.






                        [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern1) 1714**], [**MD Number(1) 1715**]

Dictated By:[**Doctor Last Name 6052**]
MEDQUIST36
D:  [**2112-5-21**] 10:31:43
T:  [**2112-5-21**] 11:33:09
Job#:  [**Job Number **]
{'Aortic valve disorders,Congestive heart failure, unspecified,Chronic airway obstruction, not elsewhere classified,Pure hypercholesterolemia,Personal history of malignant neoplasm of breast'}


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 is a 79 year old female
with known aortic stenosis for many years.  The patient has
been followed with echocardiogram every three to four months
and on the last echocardiogram in [**2112-3-19**], the patient's
gradient was significantly increased.  The patient was
referred for cardiac catheterization.  Catheterization on the
day of admission showed that the patient had a severe aortic
stenosis and the patient was referred for aortic valve
replacement.

MEDICAL HISTORY: Chronic obstructive pulmonary disease.

MEDICATION ON ADMISSION: 1. Propranolol 40 mg p.o. once daily.
2. Cozaar 100 mg p.o. once daily.
3. Norvasc 5 mg p.o. once daily.
4. Triminol 100 mg p.o. twice a day.
5. Xalatan 0.005 percent one drop q.h.s.
6. Lipitor 20 mg p.o. once daily.
7. Aspirin 325 mg p.o. once daily.
8. Vitamin B12 injection q.month.

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: No coronary artery disease in the family.

SOCIAL HISTORY: The patient lives alone, widowed, and the
patient has family in the area.  The patient quit smoking
approximately ten years ago.  The patient drinks
approximately two to three glasses of wine every night. 

### Response:
{'Aortic valve disorders,Congestive heart failure, unspecified,Chronic airway obstruction, not elsewhere classified,Pure hypercholesterolemia,Personal history of malignant neoplasm of breast'}
