CHIEF COMPLAINT: Palpitations, increasing dyspnea on
exertion.

PRESENT ILLNESS: The patient is a 41 year-old
male with no significant past medical history who complains
of a four day history of palpitations, feeling like his heart
is "fluttering."  The patient noted one day before admission
that he had increasing difficulty breathing while walking up
the stairs.  Again noted this to be the case when walking up
the ladder the day of his admission.  He denied any chest
pain, nausea, vomiting or diaphoresis during these episodes.

MEDICAL HISTORY: None.

MEDICATION ON ADMISSION: 

ALLERGIES: None.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: 
Atrial fibrillation,Acute respiratory failure,Congestive heart failure, unspecified,Other primary cardiomyopathies,Urinary tract infection, site not specified,Adjustment disorder with mixed anxiety and depressed mood,Unspecified essential hypertension,Hypopotassemia
Atrial fibrillation,Acute respiratry failure,CHF NOS,Prim cardiomyopathy NEC,Urin tract infection NOS,Adjust dis w anxiety/dep,Hypertension NOS,Hypopotassemia
Name:  [**Known lastname 8047**], [**Known firstname 8048**]                   Unit No:  [**Numeric Identifier 8049**]

Admission Date:  [**2132-6-27**]     Discharge Date:  [**2132-7-1**]

Date of Birth:   [**2089-6-1**]     Sex:  M

Service:

ADDENDUM:

HOSPITAL COURSE:

#2.  INFECTIOUS DISEASE:  The patient was found to have a
urinalysis with green urine.  Urine cultures were negative.
However, the patient was started on Ciprofloxacin for
presumptive urinary tract infection.  The patient did not
have any systemic symptoms or signs of infection aside from a
mild fever to about 99.2 degrees by mouth.

#3.  HEMATOLOGY:  The patient was started on heparin.  The
patient was switched to Lovenox and Coumadin and the patient
will go home with Lovenox.  He will followup with the
[**Hospital 1209**] Clinic in two days post discharge with a goal INR of
2.0 to 3.0.  Followup will be with Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 8050**] in two
weeks, as well as followup echocardiogram and followup
appointment with Dr. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **] for re-evaluation of
atrial fibrillation and its etiology.  Of note, the patient's
followup echocardiogram, two days after the first, showed
improving EF to an EF of 40%.

DISCHARGE DIAGNOSES:  Atrial fibrillation.

CONDITION ON DISCHARGE:  Good.

MEDICATIONS ON DISCHARGE:
1.  Lisinopril 5 mg p.o.q.d.
2.  Ciprofloxacin 200 mg p.o.b.i.d.
3.  Metoprolol 50 mg p.o.b.i.d.
4.  Lansoprazole 30 mg p.o.q.d.
5.  Coumadin 5 mg p.o.q.d.
6.  Lovenox 80 mg subcutaneously b.i.d.

                             DR.[**Last Name (STitle) **],[**First Name3 (LF) 1332**] 12-248

Dictated By:[**Doctor Last Name 8051**]
MEDQUIST36

D:  [**2132-7-3**]  11:59
T:  [**2132-7-3**]  12:11
JOB#:  [**Job Number 8052**]


Admission Date:  [**2132-6-27**]       Discharge Date:  [**2132-7-1**]

Date of Birth:   [**2089-6-1**]       Sex:  M

Service:  MEDICINE

CHIEF COMPLAINT:  Palpitations, increasing dyspnea on
exertion.

HISTORY OF PRESENT ILLNESS:  The patient is a 41 year-old
male with no significant past medical history who complains
of a four day history of palpitations, feeling like his heart
is "fluttering."  The patient noted one day before admission
that he had increasing difficulty breathing while walking up
the stairs.  Again noted this to be the case when walking up
the ladder the day of his admission.  He denied any chest
pain, nausea, vomiting or diaphoresis during these episodes.

REVIEW OF SYSTEMS:  Notable only for a mild febrile illness
with upper respiratory symptoms over the last week.

PAST MEDICAL HISTORY:  None.

ALLERGIES:  None.

MEDICATIONS:  None.

PHYSICAL EXAMINATION ON ADMISSION:  Afebrile.  Tachycardic to
the 150s.  Blood pressure 110/60.  O2 sat low 90% on room
air.  General, well appearing and in no acute distress.
Cardiovascular examination irregularly irregular rhythm.
Normal S1 and S2.  No murmurs, rubs or gallops.  Lungs
bilateral basilar crackles.  Abdomen soft, nontender,
nondistended.  Normoactive bowel sounds.  Extremities warm.
No clubbing, cyanosis or edema.

LABORATORIES ON ADMISSION:  White blood cell count 10.5,
hemoglobin 13.3, hematocrit 38.4.  Diff 72.5 neutrophils,
platelets 277, INR 1.3, PTT 27.7.






                            [**Doctor First Name 900**] [**Name8 (MD) 901**], M.D.  [**MD Number(1) 2144**]

Dictated By:[**Doctor Last Name 9869**]
MEDQUIST36

D:  [**2132-7-3**]  10:46
T:  [**2132-7-3**]  11:22
JOB#:  [**Job Number **]


Admission Date:  [**2132-6-27**]       Discharge Date:  [**2132-7-1**]

Date of Birth:   [**2089-6-1**]       Sex:  M

Service:  MEDICINE

IMPRESSION:  The patient is a 41 year-old male with new onset
atrial fibrillation of unknown origin with rapid ventricular
response.

HOSPITAL COURSE:  1.  Cardiovascular:  The patient was
transferred from the Emergency Department to the Coronary
Care Unit for rate control of his atrial fibrillation.  He
was started on intravenous Lopressor 20 mg with no effect and
Diltiazem drip of 15 mg per hour with no effect.  He was then
started on an Esmolol drip also with no effect.  In this
setting he had O2 sats of 85 to 93% on 4 liters nasal cannula
up to 10 liters on face mask and chest x-ray with evidence of
congestive heart failure.  Throughout this period the patient
was continuously normotensive, but due to his increasing
hypoxia was urgently intubated.  Also he underwent a CT
angiogram, which was negative for pulmonary embolism and an
echocardiogram, which revealed an left ventricular ejection
fraction of 30% consistent with tachycardia induced
cardiomyopathy.  He was then loaded with Digoxin, Lopressor
50 mg b.i.d. and continued on Esmolol drip and was scheduled
for a transesophageal echocardiogram followed by
cardioversion.  The night of [**2132-6-29**] the patient
spontaneously converted into normal sinus rhythm with no
further episodes of atrial fibrillation and was not DC
cardioverted for this reason.  The following morning he was
extubated without complications.

Workup for his cardiomyopathy has been inconclusive so far
including a TSH that was normal and HIV serologies were sent
as were SPEP and UPEP, which are pending at the time of
discharge.  Hemochromatosis workup was also negative.






                            [**Doctor First Name 900**] [**Name8 (MD) 901**], M.D.  [**MD Number(1) 2144**]

Dictated By:[**Doctor Last Name 9869**]
MEDQUIST36

D:  [**2132-7-3**]  11:02
T:  [**2132-7-3**]  11:26
JOB#:  [**Job Number 44180**]
{'Atrial fibrillation,Acute respiratory failure,Congestive heart failure, unspecified,Other primary cardiomyopathies,Urinary tract infection, site not specified,Adjustment disorder with mixed anxiety and depressed mood,Unspecified essential hypertension,Hypopotassemia'}


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: Palpitations, increasing dyspnea on
exertion.

PRESENT ILLNESS: The patient is a 41 year-old
male with no significant past medical history who complains
of a four day history of palpitations, feeling like his heart
is "fluttering."  The patient noted one day before admission
that he had increasing difficulty breathing while walking up
the stairs.  Again noted this to be the case when walking up
the ladder the day of his admission.  He denied any chest
pain, nausea, vomiting or diaphoresis during these episodes.

MEDICAL HISTORY: None.

MEDICATION ON ADMISSION: 

ALLERGIES: None.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY:  

### Response:
{'Atrial fibrillation,Acute respiratory failure,Congestive heart failure, unspecified,Other primary cardiomyopathies,Urinary tract infection, site not specified,Adjustment disorder with mixed anxiety and depressed mood,Unspecified essential hypertension,Hypopotassemia'}
