CHIEF COMPLAINT: 

PRESENT ILLNESS: The patient is a 64-year-old
woman who was admitted for an elective cardiac
catheterization.  The patient's cardiac history includes an
anterior MI in [**2153-12-12**] which led to a VF arrest.  On
catheterization lesion was found in the LAD which was
stented.  In [**2154-12-13**] the LAD stent occluded and led
to a recurrent anterior MI.  The patient underwent PTCA of
the LAD.  On catheterization the patient's ejection fraction
was found to be 25% and the post cath course was complicated
by a groin bleed after the patient was discharged home and
the patient was readmitted.  An echocardiogram in [**2154-12-13**] revealed mild MR with severe systolic dysfunction.  On
admission the patient denied any chest pain or pressure or
shortness of breath, no nausea or vomiting since the last
procedure.  She did have severe chest pain with her heart
attacks.  Her cardiac risk factors include hypertension,
hypercholesterolemia, smoking history, but is negative for
diabetes.

MEDICAL HISTORY: Anterior wall MI times two in [**2153**] and
[**2154**], coronary artery disease stenting [**2153**], reocclusion and
PTCA [**2154**].  Upper GI bleed [**2155-3-13**] on Coumadin, requiring
transfusion of three units packed red blood cells.  Subdural
hematoma.  Status post appendectomy.  Status post TAH BSO.
Osteoporosis.  Hiatal hernia.  Esophageal ulcer.

MEDICATION ON ADMISSION: 

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: The patient lives with her sisters and her
brother.  Another brother died one week prior to this
admission.
Coronary atherosclerosis of native coronary artery,Angiodysplasia of stomach and duodenum with hemorrhage,Unspecified essential hypertension,Pure hypercholesterolemia,Iron deficiency anemia secondary to blood loss (chronic),Percutaneous transluminal coronary angioplasty status,Old myocardial infarction,Other primary cardiomyopathies
Crnry athrscl natve vssl,Angio stm/dudn w hmrhg,Hypertension NOS,Pure hypercholesterolem,Chr blood loss anemia,Status-post ptca,Old myocardial infarct,Prim cardiomyopathy NEC
Admission Date:  [**2155-7-10**]     Discharge Date:  [**2155-7-13**]

Date of Birth:                  Sex:  F

Service:

HISTORY OF PRESENT ILLNESS:  The patient is a 64-year-old
woman who was admitted for an elective cardiac
catheterization.  The patient's cardiac history includes an
anterior MI in [**2153-12-12**] which led to a VF arrest.  On
catheterization lesion was found in the LAD which was
stented.  In [**2154-12-13**] the LAD stent occluded and led
to a recurrent anterior MI.  The patient underwent PTCA of
the LAD.  On catheterization the patient's ejection fraction
was found to be 25% and the post cath course was complicated
by a groin bleed after the patient was discharged home and
the patient was readmitted.  An echocardiogram in [**2154-12-13**] revealed mild MR with severe systolic dysfunction.  On
admission the patient denied any chest pain or pressure or
shortness of breath, no nausea or vomiting since the last
procedure.  She did have severe chest pain with her heart
attacks.  Her cardiac risk factors include hypertension,
hypercholesterolemia, smoking history, but is negative for
diabetes.

PAST MEDICAL HISTORY:  Anterior wall MI times two in [**2153**] and
[**2154**], coronary artery disease stenting [**2153**], reocclusion and
PTCA [**2154**].  Upper GI bleed [**2155-3-13**] on Coumadin, requiring
transfusion of three units packed red blood cells.  Subdural
hematoma.  Status post appendectomy.  Status post TAH BSO.
Osteoporosis.  Hiatal hernia.  Esophageal ulcer.

SOCIAL HISTORY:  The patient lives with her sisters and her
brother.  Another brother died one week prior to this
admission.

ALLERGIES:  No known drug allergies.

MEDICATIONS:  The patient is in the [**Last Name (un) 27029**] study (Captopril
vs Captopril and Valsartan tid).  Aspirin 81 mg po q d,
Prilosec 20 mg po bid, Plavix 75 mg po q d, Lipitor 10 mg po
q d, Lopressor 12.5 mg po q d, Calcium 1500 mg po q d,
Multivitamin.

LABORATORY DATA:  Pending on admission.  Chest x-ray revealed
no infiltrate or failure and question hiatal hernia vs
post-op changes in the retrocardiac region.

HOSPITAL COURSE:  The patient underwent elective coronary
cardiac catheterization on [**7-10**].  Her post catheterization
course was complicated by GI bleed.

1.  Cardiovascular:  The patient was admitted on the [**Last Name (un) 27029**]
study drug.  She had a history of two anterior wall MIs and
LAD stenting in [**2153-12-12**] and repeat PTCA in [**2154-12-13**].  She was admitted for an elective re-look.  On the
catheterization on [**7-10**], the patient was found to have
restenosed and a second stent was placed to the LAD.  Her
ejection fraction on the catheterization was found to be 25%.
The post cath course was complicated by an upper GI bleed and
hypotension requiring transfer to the CCU and support with
intravenous fluids and packed red blood cells.  The patient's
Integrilin was discontinued, however, she was continued on
Aspirin and Plavix.

2.  GI:  Following the catheterization the patient vomited
black coffee grounds times two.  Her hematocrit fell from an
admission level of 28 to 18.6.  She was supported with IV
fluids and received a total of four units of packed red blood
cells.  She was placed on Protonix IV.  GI was consulted and
an upper endoscopy was performed which revealed a small
hiatal hernia, non bleeding esophageal ulcers, and blood in
the stomach with friable mucosa in the antrum of the stomach
which was electrocauterized.  The patient's hematocrit was
subsequently stable.  The patient was discharged from the CCU
in stable condition with follow-up scheduled with Dr.
[**Last Name (STitle) **].

CONDITION ON DISCHARGE:  Stable.

DISCHARGE DIAGNOSIS:
1.  Restenosis of LAD.
2.  Stent to LAD.
3.  Upper GI bleed.

DISCHARGE MEDICATIONS:  Plavix 75 mg q d, Aspirin 325 mg q d,
Atenolol 25 mg q d, Protonix 40 mg q d, Lipitor 10 mg q d,
[**Last Name (un) 27029**] study drug as directed.




                          [**First Name8 (NamePattern2) 1575**] [**Last Name (NamePattern1) 12203**], MD  [**MD Number(1) 12204**]

Dictated By:[**Last Name (NamePattern1) 11548**]

MEDQUIST36

D:  [**2155-11-22**]  06:33
T:  [**2155-11-23**]  21:23
JOB#:  [**Job Number 27030**]
{'Coronary atherosclerosis of native coronary artery,Angiodysplasia of stomach and duodenum with hemorrhage,Unspecified essential hypertension,Pure hypercholesterolemia,Iron deficiency anemia secondary to blood loss (chronic),Percutaneous transluminal coronary angioplasty status,Old myocardial infarction,Other primary cardiomyopathies'}


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 64-year-old
woman who was admitted for an elective cardiac
catheterization.  The patient's cardiac history includes an
anterior MI in [**2153-12-12**] which led to a VF arrest.  On
catheterization lesion was found in the LAD which was
stented.  In [**2154-12-13**] the LAD stent occluded and led
to a recurrent anterior MI.  The patient underwent PTCA of
the LAD.  On catheterization the patient's ejection fraction
was found to be 25% and the post cath course was complicated
by a groin bleed after the patient was discharged home and
the patient was readmitted.  An echocardiogram in [**2154-12-13**] revealed mild MR with severe systolic dysfunction.  On
admission the patient denied any chest pain or pressure or
shortness of breath, no nausea or vomiting since the last
procedure.  She did have severe chest pain with her heart
attacks.  Her cardiac risk factors include hypertension,
hypercholesterolemia, smoking history, but is negative for
diabetes.

MEDICAL HISTORY: Anterior wall MI times two in [**2153**] and
[**2154**], coronary artery disease stenting [**2153**], reocclusion and
PTCA [**2154**].  Upper GI bleed [**2155-3-13**] on Coumadin, requiring
transfusion of three units packed red blood cells.  Subdural
hematoma.  Status post appendectomy.  Status post TAH BSO.
Osteoporosis.  Hiatal hernia.  Esophageal ulcer.

MEDICATION ON ADMISSION: 

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: The patient lives with her sisters and her
brother.  Another brother died one week prior to this
admission. 

### Response:
{'Coronary atherosclerosis of native coronary artery,Angiodysplasia of stomach and duodenum with hemorrhage,Unspecified essential hypertension,Pure hypercholesterolemia,Iron deficiency anemia secondary to blood loss (chronic),Percutaneous transluminal coronary angioplasty status,Old myocardial infarction,Other primary cardiomyopathies'}
