CHIEF COMPLAINT: Confusion, slurred speech, facial droop.

PRESENT ILLNESS: 80 year old male with history of CRI, HTN and prostate CA
presents to ED with acute onset of confusion, slurred speech and
increased left facial droop. In ED, Neuro noted left weakness
and facial droop, MRI with new corona radiata stroke without
evidence of bleed. Patient intubated for airway protection. Pt
found to have MI - EKG with depression in v1 and v2, positive
troponin and CK-MB. TTE with intra-atrial masses (tumor w/
thrombosis vs. myxoma vs. atypical veg).  In ED, patient also
incidentally found to have UTI. Patient heparinized for NSTEMI
but developed GIB afterwards, heparin subsequently discontinued.

MEDICAL HISTORY: Seizure
Prostate CA
Glaucoma
CRI
Dementia
HTN

MEDICATION ON ADMISSION: 

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: 
Cerebral embolism with cerebral infarction,Subendocardial infarction, initial episode of care,Other pulmonary insufficiency, not elsewhere classified,Pneumonia, organism unspecified,Urinary tract infection, site not specified,Hemorrhage of gastrointestinal tract, unspecified,Hyperpotassemia,Mitral valve disorders,Acute kidney failure, unspecified
Crbl emblsm w infrct,Subendo infarct, initial,Other pulmonary insuff,Pneumonia, organism NOS,Urin tract infection NOS,Gastrointest hemorr NOS,Hyperpotassemia,Mitral valve disorder,Acute kidney failure NOS
Admission Date:  [**2155-9-10**]              Discharge Date:   [**2155-9-20**]


Service: MED

Allergies:
Patient recorded as having No Known Allergies to Drugs

Attending:[**First Name3 (LF) 30**]
Chief Complaint:
Confusion, slurred speech, facial droop.

Major Surgical or Invasive Procedure:
Endotracheal intubation
EGD

History of Present Illness:
80 year old male with history of CRI, HTN and prostate CA
presents to ED with acute onset of confusion, slurred speech and
increased left facial droop. In ED, Neuro noted left weakness
and facial droop, MRI with new corona radiata stroke without
evidence of bleed. Patient intubated for airway protection. Pt
found to have MI - EKG with depression in v1 and v2, positive
troponin and CK-MB. TTE with intra-atrial masses (tumor w/
thrombosis vs. myxoma vs. atypical veg).  In ED, patient also
incidentally found to have UTI. Patient heparinized for NSTEMI
but developed GIB afterwards, heparin subsequently discontinued.

Past Medical History:
Seizure
Prostate CA
Glaucoma
CRI
Dementia
HTN

Brief Hospital Course:
Patient admitted on [**2155-9-10**] intubated s/p CVA, MI, with UTI and
atrial mass of unkown etiology.  Pt had GI bleed after
heparinization, which was stopped.  Neurology following for
multiple small embolic strokes, thought to be secondary to
emboli from the cardiac mass & recommending anticoagulation -
EEG negative for seizure activity.  Cardiology following for MI
& cardiac mass - thought to be calcified annular mass with
overlying thrombus, needs anticoagulation for stabilization of
clot to prevent further embolization.  CT surgery consulted -
patient not a candidate for surgery.  GI consulted & EGD
performed demonstrating diffuse esophagitis with contact
bleeding & linear ulcerations in duodenal bulb.  After
discussing risks/benefits with family, decision was made to
attempt anticoagulation again - stopped after 2nd GI bleed
requiring blood transfusion.
Patient treated with antibiotics for UTI (ampicillin), and
subsequent pneumonia (vanc & ceftaz).
Over the hospital course, the patient was showing no signs of
making a neurologic recovery, remaining unresponsive.  After
numerous discussions with family, it was decided to place the
patient on comfort measures only.  The patient was then
extubated, and all medications except for morphine were stopped.
 The patient breathed spontaneously at approximately 16 breaths
per minute with o2 sats in the 70's, and sbp's in the 90's.  He
remained stable overnight, and had no change in appearance the
next am, seemed comfortable, with agonal respirations.  At 11:05
am, was called by nurse [**First Name (Titles) **] [**Last Name (Titles) **] -- pupils were fixed and
dilated, no pulse or heart rhythm, no respirations, and patient
was pronounced dead at 11:05 am.  The family was notified and
declined a post-mortem exam.

Discharge Disposition:
Home

Discharge Diagnosis:
Primary:
Cardiopulmonary arrest
Cerebrovascular accident
Myocardial infarction
Secondary:
Prostate cancer
Chronic renal insufficiency
Seizure disorder
Hypertension

Discharge Condition:
Expired
{'Cerebral embolism with cerebral infarction,Subendocardial infarction, initial episode of care,Other pulmonary insufficiency, not elsewhere classified,Pneumonia, organism unspecified,Urinary tract infection, site not specified,Hemorrhage of gastrointestinal tract, unspecified,Hyperpotassemia,Mitral valve disorders,Acute kidney failure, unspecified'}


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: Confusion, slurred speech, facial droop.

PRESENT ILLNESS: 80 year old male with history of CRI, HTN and prostate CA
presents to ED with acute onset of confusion, slurred speech and
increased left facial droop. In ED, Neuro noted left weakness
and facial droop, MRI with new corona radiata stroke without
evidence of bleed. Patient intubated for airway protection. Pt
found to have MI - EKG with depression in v1 and v2, positive
troponin and CK-MB. TTE with intra-atrial masses (tumor w/
thrombosis vs. myxoma vs. atypical veg).  In ED, patient also
incidentally found to have UTI. Patient heparinized for NSTEMI
but developed GIB afterwards, heparin subsequently discontinued.

MEDICAL HISTORY: Seizure
Prostate CA
Glaucoma
CRI
Dementia
HTN

MEDICATION ON ADMISSION: 

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY:  

### Response:
{'Cerebral embolism with cerebral infarction,Subendocardial infarction, initial episode of care,Other pulmonary insufficiency, not elsewhere classified,Pneumonia, organism unspecified,Urinary tract infection, site not specified,Hemorrhage of gastrointestinal tract, unspecified,Hyperpotassemia,Mitral valve disorders,Acute kidney failure, unspecified'}
