CHIEF COMPLAINT: SOB

PRESENT ILLNESS: Mr. [**Known lastname 43921**] is a 72 year old man with a history of [**Last Name (un) 43922**]
cancern s/p resection/xrt and HTN who presetned with new onset
aflutter and SOB with a mildly productive cough and chills/fever
to the ED via PCP.  [**Name10 (NameIs) **] was found to be in new onset aflutter
with variable block and had a mild troponin leak (.04).  He
underwent suboptimal ETT [**8-21**] secondary to fatigue and was sent
home [**8-21**] on atenolol and coumadin.  Less than 12h post DC, he
woke with acute onset SOB, slightly productive cough,
diaphoresis and mild nauseau and presented to the ED.

MEDICAL HISTORY: HTN, AA s/p repair [**2111**], NIDDM X2y, s/p bil TKR, colon ca [**2099**]
s/p divert colostomy w/ XRT (last scope [**2112**], no recurrence),
aflutter w/variable block, s/p ETTR 8/4-6min [**Doctor First Name **], 54% MHRA
stopped [**2-18**] fatigue and tachypnea, no EKG changes

MEDICATION ON ADMISSION: Atenolol 25 mg once per day
glucotrol 2.5mg twice per day
lisinopril
coumadin 5 mg per day

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: [**2115-8-26**]

FAMILY HISTORY: Father died of prostate cancer, mother died at 89

SOCIAL HISTORY: Widow, lives alone, korean vet, no tob, occ etoh, regular
exercise
Congestive heart failure, unspecified,Urinary tract infection, site not specified,Atrial fibrillation,Unspecified essential hypertension,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Anemia, unspecified,Knee joint replacement
CHF NOS,Urin tract infection NOS,Atrial fibrillation,Hypertension NOS,DMII wo cmp nt st uncntr,Anemia NOS,Joint replaced knee
Admission Date:  [**2115-8-22**]              Discharge Date:   [**2115-8-26**]

Date of Birth:  [**2043-5-20**]             Sex:   M

Service: MED

Allergies:
Patient recorded as having No Known Allergies to Drugs

Attending:[**First Name3 (LF) 14037**]
Chief Complaint:
SOB

Major Surgical or Invasive Procedure:
None; placement RIJ and its subsequent removal

History of Present Illness:
Mr. [**Known lastname 43921**] is a 72 year old man with a history of [**Last Name (un) 43922**]
cancern s/p resection/xrt and HTN who presetned with new onset
aflutter and SOB with a mildly productive cough and chills/fever
to the ED via PCP.  [**Name10 (NameIs) **] was found to be in new onset aflutter
with variable block and had a mild troponin leak (.04).  He
underwent suboptimal ETT [**8-21**] secondary to fatigue and was sent
home [**8-21**] on atenolol and coumadin.  Less than 12h post DC, he
woke with acute onset SOB, slightly productive cough,
diaphoresis and mild nauseau and presented to the ED.


Past Medical History:
HTN, AA s/p repair [**2111**], NIDDM X2y, s/p bil TKR, colon ca [**2099**]
s/p divert colostomy w/ XRT (last scope [**2112**], no recurrence),
aflutter w/variable block, s/p ETTR 8/4-6min [**Doctor First Name **], 54% MHRA
stopped [**2-18**] fatigue and tachypnea, no EKG changes

Social History:
Widow, lives alone, korean vet, no tob, occ etoh, regular
exercise

Family History:
Father died of prostate cancer, mother died at 89

Physical Exam:
[**2115-8-26**]

99.2 98.7  130/70 64-82(82) 20 95RA
Gen: Lying in bed in NAD
HEENT: PERRLA, neck supple, EOMI, mouth and oropharynx clear, no
sinus tenderness
Chest: CTAB
CV: Nl S1/s2, no S3/4, no murmurs
Abd: Soft, NT, ND, No organomegaly, NBS
Ext: Warm X 4 with pulses X4, 1+ bil pedal edema decreased from
2+
Neuro: A&O X 3, CN II-XII intact, appropriate complex
conversation, nl gait, 2+ DTRs, 4/5 strength throughout,
sensation intact throughout

Pertinent Results:
[**2115-8-26**] 05:34AM BLOOD WBC-6.3 RBC-3.47* Hgb-10.9* Hct-30.8*
MCV-89 MCH-31.4 MCHC-35.3* RDW-12.6 Plt Ct-276
[**2115-8-26**] 05:34AM BLOOD Neuts-71.5* Lymphs-18.3 Monos-5.5 Eos-4.0
Baso-0.7
[**2115-8-26**] 05:34AM BLOOD Plt Ct-276
[**2115-8-26**] 05:34AM BLOOD PT-13.3 PTT-28.0 INR(PT)-1.2
[**2115-8-26**] 05:34AM BLOOD Glucose-185* UreaN-23* Creat-1.1 Na-138
K-4.4 Cl-104 HCO3-27 AnGap-11
[**2115-8-23**] 04:03AM BLOOD CK(CPK)-73
[**2115-8-22**] 11:36PM BLOOD CK(CPK)-89
[**2115-8-22**] 07:15PM BLOOD ALT-18 AST-19 CK(CPK)-85 AlkPhos-110
Amylase-46 TotBili-1.3
[**2115-8-21**] 06:35AM BLOOD CK(CPK)-108
[**2115-8-23**] 04:03AM BLOOD CK-MB-NotDone cTropnT-0.04*
[**2115-8-22**] 11:36PM BLOOD CK-MB-NotDone cTropnT-0.07*
[**2115-8-22**] 07:15PM BLOOD CK-MB-NotDone cTropnT-0.04*
[**2115-8-21**] 06:35AM BLOOD CK-MB-3
[**2115-8-21**] 06:35AM BLOOD cTropnT-0.04*
[**2115-8-26**] 05:34AM BLOOD Calcium-8.3* Phos-3.7 Mg-1.9
[**2115-8-23**] 04:03AM BLOOD Triglyc-90 HDL-32 CHOL/HD-3.4 LDLcalc-60
[**2115-8-22**] 07:15PM BLOOD TSH-0.88
[**2115-8-22**] 07:15PM BLOOD Cortsol-29.1*
[**2115-8-22**] 03:41PM BLOOD Lactate-5.2*
[**2115-8-22**] 07:39PM BLOOD Lactate-1.4
Echo:
1. The left atrium is moderately dilated.
2. The left ventricular cavity is mildly dilated. There is
moderate global left ventricular hypokinesis. Overall left
ventricular systolic function is difficult to assess but is
probably moderately depressed.
3. The aortic valve leaflets are mildly thickened.
4. The mitral valve leaflets are mildly thickened. Mild (1+)
mitral regurgitation is seen.


Brief Hospital Course:
In the ED, he was febrile, had an increased WBC to 16.7, and a
lactate of 5.4  His UA on [**8-22**] showed 30 of protein, >50WBC and
few bacteria.  He received levo/flagly/vanco and was admitted to
the MICU with urosepsis; 1/4 bottles bcx grew out GNR.  He was
transferred to the floor where he received ceftaz/levo for four
days (until day of discharge) when speciation demonstrated E.
Coli sensitive to levoquine.

On discharge, he has been afebrile for two and half days and his
WBC is 6.3.  He is asymptomatic and has been normotensive
through his time on the floor.  He will follow up in several
days with his PCP.

Medications on Admission:
Atenolol 25 mg once per day
glucotrol 2.5mg twice per day
lisinopril
coumadin 5 mg per day

Discharge Medications:
1. Zolpidem Tartrate 5 mg Tablet Sig: 1-2 Tablets PO HS (at
bedtime) as needed.
Disp:*20 Tablet(s)* Refills:*0*
2. Levofloxacin 500 mg Tablet Sig: One (1) Tablet PO Q24H (every
24 hours) for 10 days.
Disp:*10 Tablet(s)* Refills:*0*
3. Aspirin 81 mg Tablet, Delayed Release (E.C.) Sig: One (1)
Tablet, Delayed Release (E.C.) PO QD (once a day).
4. Albuterol Sulfate 0.083 % Solution Sig: 1-2 Puffs Inhalation
Q4-6H (every 4 to 6 hours) as needed.
Disp:*1 puffer* Refills:*0*
5. Lisinopril 20 mg Tablet Sig: One (1) Tablet PO QD (once a
day).
Disp:*30 Tablet(s)* Refills:*2*
6. Metoprolol Tartrate 50 mg Tablet Sig: 0.5 Tablet PO BID (2
times a day).
Disp:*30 Tablet(s)* Refills:*2*
7. Warfarin Sodium 7.5 mg Tablet Sig: One (1) Tablet PO QD (once
a day).
Disp:*30 Tablet(s)* Refills:*0*
8. Glucotrol 5 mg Tablet Sig: [**1-18**] Tablet PO twice a day.
Disp:*30 Tablet(s)* Refills:*2*


Discharge Disposition:
Home

Discharge Diagnosis:
Urosepsis

Discharge Condition:
Good.

Discharge Instructions:
Return to your primary care doctor or the emergency room if you
experience recurrent shortness of breath, chest pain, urinary
pain, increased frequency of urination, increased urgency to
urinate, fever, chills, night-sweats or any other symptoms of
concern to you.

Followup Instructions:
Call your primary care doctor for a followup appointment after
Thursday.
{'Congestive heart failure, unspecified,Urinary tract infection, site not specified,Atrial fibrillation,Unspecified essential hypertension,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Anemia, unspecified,Knee joint replacement'}


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: SOB

PRESENT ILLNESS: Mr. [**Known lastname 43921**] is a 72 year old man with a history of [**Last Name (un) 43922**]
cancern s/p resection/xrt and HTN who presetned with new onset
aflutter and SOB with a mildly productive cough and chills/fever
to the ED via PCP.  [**Name10 (NameIs) **] was found to be in new onset aflutter
with variable block and had a mild troponin leak (.04).  He
underwent suboptimal ETT [**8-21**] secondary to fatigue and was sent
home [**8-21**] on atenolol and coumadin.  Less than 12h post DC, he
woke with acute onset SOB, slightly productive cough,
diaphoresis and mild nauseau and presented to the ED.

MEDICAL HISTORY: HTN, AA s/p repair [**2111**], NIDDM X2y, s/p bil TKR, colon ca [**2099**]
s/p divert colostomy w/ XRT (last scope [**2112**], no recurrence),
aflutter w/variable block, s/p ETTR 8/4-6min [**Doctor First Name **], 54% MHRA
stopped [**2-18**] fatigue and tachypnea, no EKG changes

MEDICATION ON ADMISSION: Atenolol 25 mg once per day
glucotrol 2.5mg twice per day
lisinopril
coumadin 5 mg per day

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: [**2115-8-26**]

FAMILY HISTORY: Father died of prostate cancer, mother died at 89

SOCIAL HISTORY: Widow, lives alone, korean vet, no tob, occ etoh, regular
exercise 

### Response:
{'Congestive heart failure, unspecified,Urinary tract infection, site not specified,Atrial fibrillation,Unspecified essential hypertension,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Anemia, unspecified,Knee joint replacement'}
