CHIEF COMPLAINT: Left-sided weakness.

PRESENT ILLNESS: Mrs. [**Known lastname **] is a 75-year-old
right-handed woman with a history of polycythemia [**Doctor First Name **] and
multiple DVTs in the past.  She also has aortic stenosis,
atrial fibrillation, and a prior stroke with some right hand
clumsiness.  She is chronically maintained on Lovenox for
stroke and DVT prophylaxis.  She is not on Coumadin.

MEDICAL HISTORY: 1.  Polycythemia [**Doctor First Name **].
2.  Stroke in [**2175**].
3.  Hypertension.
4.  Coagulopathy with pulmonary emboli and DVTs.
5.  Spastic bladder.
6.  Thyroid nodule.
7.  Coronary artery disease, status post MI.
8.  Peripheral neuropathy.
9.  Status post right hip replacement.
10. Depression.
11. Atrial fibrillation.
12. Aortic stenosis.

MEDICATION ON ADMISSION: 1.  Amiodarone 200 mg p.o. q.d.
2.  Iron 325 mg p.o. q.d.
3.  Hydrochlorothiazide 12.5 mg p.o. q.d.
4.  Zantac 150 mg p.o. b.i.d.
5.  Lopressor 50 mg p.o. b.i.d.
6.  Levothyroxine 150 micrograms per day.
7.  Ditropan 10 micrograms b.i.d.
8.  Lovenox 80 mg subcutaneously q.d.
9.  Zoloft 50 mg p.o. q.d.
10. Trazodone 50 mg q.h.s.
11. Amoxicillin 500 mg p.o. b.i.d. until [**2178-4-14**].
12. Hydroxyurea 1,000 mg p.o. q.d.

ALLERGIES: The patient has an allergy to CT contrast.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: The patient lives with her fiance.  She
denied the use of tobacco or alcohol.  Her daughter is an
Intensive Care Unit nurse [**First Name (Titles) **] [**Hospital3 **].
Intracerebral hemorrhage,Atrial fibrillation,Aortic valve disorders,Urinary tract infection, site not specified,Polycythemia vera,Unspecified essential hypertension,Old myocardial infarction
Intracerebral hemorrhage,Atrial fibrillation,Aortic valve disorder,Urin tract infection NOS,Polycythemia vera,Hypertension NOS,Old myocardial infarct
Admission Date:  [**2178-4-11**]       Discharge Date:  [**2178-4-12**]

Date of Birth:   [**2103-6-17**]       Sex:  F

Service:  NEUROLOGY

CHIEF COMPLAINT:  Left-sided weakness.

HISTORY OF THE PRESENT ILLNESS:  Mrs. [**Known lastname **] is a 75-year-old
right-handed woman with a history of polycythemia [**Doctor First Name **] and
multiple DVTs in the past.  She also has aortic stenosis,
atrial fibrillation, and a prior stroke with some right hand
clumsiness.  She is chronically maintained on Lovenox for
stroke and DVT prophylaxis.  She is not on Coumadin.

She was last seen in her usual state of health on [**2178-4-11**] at
noon.  Her fiance found her in the bathroom around 4:30
unable to get off the toilet.  He could not help her up. In
the Emergency Department, she was found to have a severe left
hemiplegia, head and eye deviation to the right with left
field cut.  CAT scan was obtained showing a moderate right
basal ganglia bleed.  She was then transferred to the
Intensive Care Unit.

PAST MEDICAL HISTORY:
1.  Polycythemia [**Doctor First Name **].
2.  Stroke in [**2175**].
3.  Hypertension.
4.  Coagulopathy with pulmonary emboli and DVTs.
5.  Spastic bladder.
6.  Thyroid nodule.
7.  Coronary artery disease, status post MI.
8.  Peripheral neuropathy.
9.  Status post right hip replacement.
10. Depression.
11. Atrial fibrillation.
12. Aortic stenosis.

MEDICATIONS ON ADMISSION:
1.  Amiodarone 200 mg p.o. q.d.
2.  Iron 325 mg p.o. q.d.
3.  Hydrochlorothiazide 12.5 mg p.o. q.d.
4.  Zantac 150 mg p.o. b.i.d.
5.  Lopressor 50 mg p.o. b.i.d.
6.  Levothyroxine 150 micrograms per day.
7.  Ditropan 10 micrograms b.i.d.
8.  Lovenox 80 mg subcutaneously q.d.
9.  Zoloft 50 mg p.o. q.d.
10. Trazodone 50 mg q.h.s.
11. Amoxicillin 500 mg p.o. b.i.d. until [**2178-4-14**].
12. Hydroxyurea 1,000 mg p.o. q.d.

SOCIAL HISTORY:  The patient lives with her fiance.  She
denied the use of tobacco or alcohol.  Her daughter is an
Intensive Care Unit nurse [**First Name (Titles) **] [**Hospital3 **].

ALLERGIES: The patient has an allergy to CT contrast.

PHYSICAL EXAMINATION ON ADMISSION:  Vital signs: Temperature
97, pulse 64, respirations 18, blood pressure 215/100,
saturation 94% on room air.  HEENT: Dry mucous membranes.
The neck was supple.  No carotid bruits.  Chest:  Clear to
auscultation.  Heart:  The heart rate was regular with a
III/VI systolic ejection murmur at the right upper sternal
border.  Abdomen: Soft, nontender, nondistended.  There was
2+ pitting edema to the midcalves.  Neurologic:  She was
easily arousable to voice and maintained alert while being
spoken to.  She would then drift off to sleep.  She was
cooperative with the examination.  She was oriented to [**Hospital3 **] Hospital, month, and day.  She was able to state her
daughter's name who is present.  She was able to follow
simple commands and had normal spontaneous speech.  She was
unaware that she had a severe left-sided deficit, but thought
that she was hospitalized for just not feeling well in
general.  She had forced deviation of the head and eyes to
the right, but eyes briefly crossed the midline to the left
with dolls maneuver.  There was a dense left hemianopsia.
She had a left facial droop.  She had extensor responses with
the left upper extremity into a painful stimulus.  There was
no withdrawal of the left leg.  Right-sided power was full.
She was able to feel light touch on the left, but
extinguished when given double-simultaneous stimulation.
Plantar response was extensor on the left, flexor on the
right.  Gait was deferred.

HOSPITAL COURSE:  Mrs. [**Known lastname **] is a 74-year-old woman treated
with Lovenox to prevent stroke (atrial fibrillation) as well
as venous thrombosis.  She presented with left hemiparesis,
left-sided field cut, extension of sensory stimulation on the
left and unawareness of her deficit.  She had a 3 x 3 cm
right basal ganglia bleed with no midline shift.  She was
admitted to the Intensive Care Unit for blood pressure
control.  She was also given Protamine in the Emergency Room
to reverse her Lovenox.  Initial PTT was 41, and this lowered
to 36.  Blood pressure was maintained on a nitroglycerin
drip.

Several hours later, in the Intensive Care Unit, she became
less arousable. A repeat CAT scan showed a much larger
extension of the blood, with 17 mm of shift of the septum
pellucidum and complete compression of the right lateral
ventricle.

Given the patient's prior wishes and discussion with her
daughter prior to her deterioration, no aggressive
intervention was to be performed.  At that point, she was
made comfort measures only.  She expired at 12:40 p.m. on
[**2178-4-12**].




                            [**Name6 (MD) 4267**] [**Last Name (NamePattern4) 4268**], M.D.  [**MD Number(1) 4269**]

Dictated By:[**Name8 (MD) 98668**]
MEDQUIST36

D:  [**2178-4-12**]  12:54
T:  [**2178-4-12**]  13:48
JOB#:  [**Job Number 103021**]
{'Intracerebral hemorrhage,Atrial fibrillation,Aortic valve disorders,Urinary tract infection, site not specified,Polycythemia vera,Unspecified essential hypertension,Old myocardial infarction'}


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: Left-sided weakness.

PRESENT ILLNESS: Mrs. [**Known lastname **] is a 75-year-old
right-handed woman with a history of polycythemia [**Doctor First Name **] and
multiple DVTs in the past.  She also has aortic stenosis,
atrial fibrillation, and a prior stroke with some right hand
clumsiness.  She is chronically maintained on Lovenox for
stroke and DVT prophylaxis.  She is not on Coumadin.

MEDICAL HISTORY: 1.  Polycythemia [**Doctor First Name **].
2.  Stroke in [**2175**].
3.  Hypertension.
4.  Coagulopathy with pulmonary emboli and DVTs.
5.  Spastic bladder.
6.  Thyroid nodule.
7.  Coronary artery disease, status post MI.
8.  Peripheral neuropathy.
9.  Status post right hip replacement.
10. Depression.
11. Atrial fibrillation.
12. Aortic stenosis.

MEDICATION ON ADMISSION: 1.  Amiodarone 200 mg p.o. q.d.
2.  Iron 325 mg p.o. q.d.
3.  Hydrochlorothiazide 12.5 mg p.o. q.d.
4.  Zantac 150 mg p.o. b.i.d.
5.  Lopressor 50 mg p.o. b.i.d.
6.  Levothyroxine 150 micrograms per day.
7.  Ditropan 10 micrograms b.i.d.
8.  Lovenox 80 mg subcutaneously q.d.
9.  Zoloft 50 mg p.o. q.d.
10. Trazodone 50 mg q.h.s.
11. Amoxicillin 500 mg p.o. b.i.d. until [**2178-4-14**].
12. Hydroxyurea 1,000 mg p.o. q.d.

ALLERGIES: The patient has an allergy to CT contrast.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: The patient lives with her fiance.  She
denied the use of tobacco or alcohol.  Her daughter is an
Intensive Care Unit nurse [**First Name (Titles) **] [**Hospital3 **]. 

### Response:
{'Intracerebral hemorrhage,Atrial fibrillation,Aortic valve disorders,Urinary tract infection, site not specified,Polycythemia vera,Unspecified essential hypertension,Old myocardial infarction'}
