CHIEF COMPLAINT: Coffee ground emesis.

PRESENT ILLNESS: This is an 87 year old man with
a history of ETOH abuse, significant for drinking six or
seven scotches per night, history of dilated cardiomyopathy,
ejection fraction of 30 percent.  He awoke two nights prior
to admission, had four episodes of brownish ground coffee
emesis.  The patient was admitted on [**2197-6-23**].  No complaints
of abdominal pain or retching.  He also noted bright red
blood, some dizziness, no shortness of breath and no
weakness.  He went to his primary care physician who sent the
patient to the Emergency Department.  In the Emergency
Department, he had two more episodes of coffee ground emesis.
Nasogastric lavage attempted but it was aborted secondary to
a nosebleed.  The patient's hematocrit had dropped from 44.0
percent to 35.0 percent.  The patient was therefore admitted
to the unit for evaluation of upper gastrointestinal bleed.

MEDICAL HISTORY: ETOH history.

MEDICATION ON ADMISSION: 1. Toprol XL 12.5 mg p.o. once daily.
2. Digoxin 0.125 mg p.o. once daily.
3. Hydrochlorothiazide 25 mg once daily.
4. Allopurinol 300 mg once daily.
5. Mysoline 250 mg once daily.
6. Multivitamin.

ALLERGIES: Aspirin sensitivity, nosebleeds.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: The patient lives with wife, retired,
history of multiple jobs.  History of drinking six or seven
scotches per day.  Nonsmoker.
Barrett's esophagus,Alcohol abuse, continuous,Other primary cardiomyopathies,Other convulsions,Congestive heart failure, unspecified,Acute kidney failure, unspecified,Gout, unspecified,Other specified cardiac dysrhythmias,Unspecified essential hypertension
Barrett's esophagus,Alcohol abuse-continuous,Prim cardiomyopathy NEC,Convulsions NEC,CHF NOS,Acute kidney failure NOS,Gout NOS,Cardiac dysrhythmias NEC,Hypertension NOS
Name:  [**Known lastname 4348**], [**Known firstname 6712**]              Unit No:  [**Numeric Identifier 18171**]

Admission Date: [**2197-6-23**]        Discharge Date: [**2197-6-25**]

Date of Birth:  [**2109-10-28**]        Sex:  M

Service:  MED


ADDENDUM:  The patient was admitted on [**2197-6-23**], and
discharged on [**2197-6-25**].



                        [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 18172**], MD [**MD Number(2) 18173**]

Dictated By:[**Doctor Last Name 5951**]
MEDQUIST36
D:  [**2197-6-25**] 11:19:39
T:  [**2197-6-25**] 12:24:38
Job#:  [**Job Number 18174**]


Admission Date: [**2197-6-24**]        Discharge Date:


Service:  MED


CHIEF COMPLAINT:  Coffee ground emesis.

HISTORY OF PRESENT ILLNESS:  This is an 87 year old man with
a history of ETOH abuse, significant for drinking six or
seven scotches per night, history of dilated cardiomyopathy,
ejection fraction of 30 percent.  He awoke two nights prior
to admission, had four episodes of brownish ground coffee
emesis.  The patient was admitted on [**2197-6-23**].  No complaints
of abdominal pain or retching.  He also noted bright red
blood, some dizziness, no shortness of breath and no
weakness.  He went to his primary care physician who sent the
patient to the Emergency Department.  In the Emergency
Department, he had two more episodes of coffee ground emesis.
Nasogastric lavage attempted but it was aborted secondary to
a nosebleed.  The patient's hematocrit had dropped from 44.0
percent to 35.0 percent.  The patient was therefore admitted
to the unit for evaluation of upper gastrointestinal bleed.

PAST MEDICAL HISTORY:  ETOH history.

Hypertension.

Chronic atrial tachycardia with a baseline heart rate of 100
to 110.

Gout.

Questionable atypical seizure disorder.

Dementia.

ALLERGIES:  Aspirin sensitivity, nosebleeds.

MEDICATIONS ON ADMISSION:
1. Toprol XL 12.5 mg p.o. once daily.
2. Digoxin 0.125 mg p.o. once daily.
3. Hydrochlorothiazide 25 mg once daily.
4. Allopurinol 300 mg once daily.
5. Mysoline 250 mg once daily.
6. Multivitamin.


SOCIAL HISTORY:  The patient lives with wife, retired,
history of multiple jobs.  History of drinking six or seven
scotches per day.  Nonsmoker.

PHYSICAL EXAMINATION:  The patient's vital signs are
unremarkable except for heart rate of 108.  Physical
examination is notable for positive Dupuytren's contracture.
No evidence of hepatosplenomegaly on examination.

HOSPITAL COURSE:  The patient was admitted for observation.
Hematocrit was stable in the mid 30s overnight.  He underwent
esophagogastroduodenoscopy which was negative for any source
of acute bleed.  It was positive for what appeared to be
friable esophageal mucosa consistent with Barrett's
esophagitis as well as a C line which was displaced
proximally.  No biopsies were taken.  At this point, the
patient was treated with Protonix and discharged home on p.o.
Protonix with follow-up with his primary care physician in
one to two weeks with plans for referral for an outpatient
esophagogastroduodenoscopy for biopsies to confirm the visual
appearance of Barrett's esophagitis.  The patient is to
follow-up in six to eight weeks.

MEDICATIONS ON DISCHARGE:  The patient will be discharged on
all his original outpatient medications in stable condition
with addition of Protonix 40 mg once daily.
1. Toprol XL 12.5 mg p.o. once daily.
2. Digoxin 0.125 mg p.o. once daily.
3. Hydrochlorothiazide 25 mg once daily.
4. Allopurinol 300 mg once daily.
5. Mysoline 250 mg once daily.
6. Multivitamin.
7. Protonix 40 mg p.o. once daily.


DISCHARGE DIAGNOSIS:  Barrett's esophagitis.


MAJOR PROCEDURES:  Esophagogastroduodenoscopy.




                        [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern1) **], [**MD Number(1) 18138**]

Dictated By:[**Doctor Last Name 12733**]
MEDQUIST36
D:  [**2197-6-25**] 11:18:25
T:  [**2197-6-25**] 12:02:22
Job#:  [**Job Number 110950**]
{"Barrett's esophagus,Alcohol abuse, continuous,Other primary cardiomyopathies,Other convulsions,Congestive heart failure, unspecified,Acute kidney failure, unspecified,Gout, unspecified,Other specified cardiac dysrhythmias,Unspecified essential hypertension"}


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: Coffee ground emesis.

PRESENT ILLNESS: This is an 87 year old man with
a history of ETOH abuse, significant for drinking six or
seven scotches per night, history of dilated cardiomyopathy,
ejection fraction of 30 percent.  He awoke two nights prior
to admission, had four episodes of brownish ground coffee
emesis.  The patient was admitted on [**2197-6-23**].  No complaints
of abdominal pain or retching.  He also noted bright red
blood, some dizziness, no shortness of breath and no
weakness.  He went to his primary care physician who sent the
patient to the Emergency Department.  In the Emergency
Department, he had two more episodes of coffee ground emesis.
Nasogastric lavage attempted but it was aborted secondary to
a nosebleed.  The patient's hematocrit had dropped from 44.0
percent to 35.0 percent.  The patient was therefore admitted
to the unit for evaluation of upper gastrointestinal bleed.

MEDICAL HISTORY: ETOH history.

MEDICATION ON ADMISSION: 1. Toprol XL 12.5 mg p.o. once daily.
2. Digoxin 0.125 mg p.o. once daily.
3. Hydrochlorothiazide 25 mg once daily.
4. Allopurinol 300 mg once daily.
5. Mysoline 250 mg once daily.
6. Multivitamin.

ALLERGIES: Aspirin sensitivity, nosebleeds.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: The patient lives with wife, retired,
history of multiple jobs.  History of drinking six or seven
scotches per day.  Nonsmoker. 

### Response:
{"Barrett's esophagus,Alcohol abuse, continuous,Other primary cardiomyopathies,Other convulsions,Congestive heart failure, unspecified,Acute kidney failure, unspecified,Gout, unspecified,Other specified cardiac dysrhythmias,Unspecified essential hypertension"}
