CHIEF COMPLAINT: 

PRESENT ILLNESS: This is a 37-year-old male who
presents to the CCU in arrhythmia, question SVT, question V
tach.  The patient had no significant past medical history
until two months ago when he began experiencing palpitations
and was found to be in arrhythmia, probable SVT, question V
tach.  The patient was converted with a calcium channel
block.  He was discharged home.  The patient had EP study at
[**Location (un) 47**] on [**6-17**] with no ablation.  The patient had 6-7
episodes over the past two months, each time converted on
calcium channel blocker or beta blocker or with vagal
maneuvers.  This a.m. on [**8-23**] the patient awoke tired at noon,
felt fatigued, mildly dyspneic, went to outside hospital,
found to be in cardiac arrhythmia.  The patient received
Adenosine 6 mg IV times one, 12 mg IV times one, Lopressor 5
mg IV times one, Verapamil 5 mg IV times one, with no change.
The patient was then cardioverted 100 joules to normal sinus
rhythm.  He then reverted back to his arrhythmia and was
loaded with Procainamide and converted to normal sinus rhythm
after 1 gm IV over one hour and then started on a drip at 2
mg per minute.  The patient was transferred from outside
hospital and ?????? hour before he arrived he went back into his
arrhythmia.

MEDICAL HISTORY: 1) Cardiac arrhythmia times two
months, status post EP study [**6-17**].  2) Increased cholesterol.
3) Status post vasectomy.

MEDICATION ON ADMISSION: 

ALLERGIES: Penicillin.  The patient gets edematous.

PHYSICAL EXAM: 

FAMILY HISTORY: Father with CAD, with MI in his 60's.

SOCIAL HISTORY: The patient works at [**Company 35082**].  No
alcohol, no tobacco, no drug abuse.  The patient lives at
home in [**Location (un) 17566**] with his parents.
Other specified cardiac dysrhythmias,Other specified complications of procedures not elsewhere classified
Cardiac dysrhythmias NEC,Oth spcf cmplc procd NEC
Admission Date:  [**2185-8-23**]     Discharge Date:  [**2185-8-25**]

Date of Birth:   [**2147-9-19**]     Sex:  M

Service:

HISTORY OF PRESENT ILLNESS:  This is a 37-year-old male who
presents to the CCU in arrhythmia, question SVT, question V
tach.  The patient had no significant past medical history
until two months ago when he began experiencing palpitations
and was found to be in arrhythmia, probable SVT, question V
tach.  The patient was converted with a calcium channel
block.  He was discharged home.  The patient had EP study at
[**Location (un) 47**] on [**6-17**] with no ablation.  The patient had 6-7
episodes over the past two months, each time converted on
calcium channel blocker or beta blocker or with vagal
maneuvers.  This a.m. on [**8-23**] the patient awoke tired at noon,
felt fatigued, mildly dyspneic, went to outside hospital,
found to be in cardiac arrhythmia.  The patient received
Adenosine 6 mg IV times one, 12 mg IV times one, Lopressor 5
mg IV times one, Verapamil 5 mg IV times one, with no change.
The patient was then cardioverted 100 joules to normal sinus
rhythm.  He then reverted back to his arrhythmia and was
loaded with Procainamide and converted to normal sinus rhythm
after 1 gm IV over one hour and then started on a drip at 2
mg per minute.  The patient was transferred from outside
hospital and ?????? hour before he arrived he went back into his
arrhythmia.

At arrival the patient had no complaints, no chest pain,
shortness of breath, no nausea, vomiting, no palpitations, no
lightheadedness.

PAST MEDICAL HISTORY:  1) Cardiac arrhythmia times two
months, status post EP study [**6-17**].  2) Increased cholesterol.
3) Status post vasectomy.

ALLERGIES:  Penicillin.  The patient gets edematous.

MEDICATIONS:  As an outpatient, Lopressor 100 mg [**Hospital1 **],
Propafenone, Asafex 20 mg po q d, Niacin 500 mg po q d.  On
presentation, Procainamide drip at 2.

SOCIAL HISTORY:  The patient works at [**Company 35082**].  No
alcohol, no tobacco, no drug abuse.  The patient lives at
home in [**Location (un) 17566**] with his parents.

FAMILY HISTORY:  Father with CAD, with MI in his 60's.

PHYSICAL EXAMINATION:  On admission, general, pleasant, no
apparent distress.  Vitals, blood pressure 107/59, pulse 172,
pulse ox 97 on two liters, respiratory rate 22.  HEENT:
Anicteric, mucus membranes moist.  Neck, no JVP appreciated,
2+ carotids, no LAD.  Heart, regular rhythm, tachycardic, S1
and S2, no murmurs, rubs or gallops.  Lungs are clear
bilaterally.  Abdomen obese, soft, nontender, non distended,
positive bowel sounds.  Extremities, no edema bilaterally.
Neuro, alert and oriented times three, mentating well.

LABORATORY DATA:  From [**Hospital3 1280**], white count 8,000,
hemoglobin 16.9, hematocrit 48, platelet count 196,000,
sodium 136, potassium 5.0, chloride 96, CO2 28, BUN 15,
creatinine 1.2, glucose 157, total protein 7, albumin 4.4,
calcium 9.3, AST 22, ALT 35, alkaline phosphatase 103, CK 46,
LDH 273, troponin I less than .3, PT 12, INR .98, PTT 36.1.

Chest x-ray, question enlarged cardiac silhouette, no acute
cardiopulmonary process.  EKG, SVT at 174, right bundle
branch block, left axis.  The right bundle branch block is
old.

HOSPITAL COURSE:
1.  Cardiology:  Patient had Procainamide drip stopped as he
was in his cardiac arrhythmia.  He was started on Lidocaine
with 70 mg IV bolus and started at a drip of 1 mg per minute.
He converted to normal sinus rhythm at 90 at 11 p.m. on [**8-23**].
At midnight, however, he went back into his arrhythmia.  He
was given Lido 35 mg IV push.  He did not convert.  He was
converted, however, after removal of his defibrillator pad.
The patient had episodes of cardiac arrhythmia throughout the
night of [**8-23**] into the morning of [**8-24**] and he was converted
these times with vagal maneuvers.  The patient, on the
morning of [**8-24**] had his Lido drip stopped and promptly went
back into his cardiac arrhythmia.  He was subsequently taken
to the EP lab where he had two ablations.  First ablation was
right bundle branch re-entry vs nodofascicular BPT.  Other
ablation was an AV NRT.  The patient did not require pacer
after his AV NRT ablation.  The patient was transferred to
the floor in stable condition after his EP study.  The
patient had episodes of sinus tachycardia on the evening of
[**8-24**] and into the morning of [**8-25**] which was thought related to
his infectious disease issues.  The patient was stopped from
Lopressor and Propafenone and patient was discharged on
Niacin 500 mg extended release q a.m. as his only cardiac
meds.  The patient was to follow-up with Dr. [**First Name (STitle) 1075**], his
cardiologist at [**Location (un) 47**] [**8-26**] at 2:30 p.m.

2.  Infectious Disease:  The patient had a temperature spike
to 102.3 at 7:50 p.m. on [**8-24**].  The patient had urine
cultures, blood cultures, urinalysis and a chest x-ray done.
Chest x-ray showed no acute cardiopulmonary process.  Blood
cultures showed no growth over 24 hours.  Urine culture
showed no growth over 24 hours.  Antibiotics were not
started.  The patient had no focal signs or symptoms
suggestive of bacterial infection.  The patient denied any
chest pain, shortness of breath or urinary symptoms, nausea,
vomiting, diarrhea, headache or stiff neck.  The patient
states he had been around somebody with a viral bronchitis.
Etiology to his fever was thought to be secondary to a viral
process.  The patient was instructed to follow-up with his
primary care physician if any focal symptoms occurred.

3.  GI:  The patient is on a proton pump inhibitor as an
outpatient.  This is followed by his primary care physician
for question GERD.  The patient denies any symptoms of GERD.
The patient was instructed to follow-up with primary care
physician as to whether he would need his proton pump
inhibitor.  The patient was discharged on his outpatient dose
of Asafex 20 mg po q d.

4.  Prophylaxis:  The patient was maintained on Protonix
throughout his stay and discharged home on Asafex 20 mg po q
d.  The patient was also started on subcu Heparin 5000 [**Hospital1 **]
subcu while he was at bedrest post EP study.  This was
stopped upon discharge home.

5.  Fluids, Electrolytes & Nutrition:  The patient was npo
for his EP study.  The patient had q d Lyte checks which
revealed no abnormalities.  The patient was placed on a
regular diet.

DISCHARGE STATUS:  Stable.

DISCHARGE DIAGNOSIS:
1.  Cardiac arrhythmia with successful ablation of
nodofascicular BPT vs RBB reentrant.  The patient also had AV
NRT ablated.
2.  Hypercholesterolemia.
3.  Viral syndrome.
4.  Question GERD.

DISCHARGE MEDICATIONS:  Asafex 20 mg po q d, Niacin extended
release 500 mg po q a.m.

DISCHARGE STATUS:  No change in code status.  The patient is
full code.

DISCHARGE APPOINTMENTS:  The patient is to follow-up with
outpatient cardiologist, Dr. [**First Name (STitle) 1075**], [**8-26**] at 2:30 p.m.




                          [**First Name8 (NamePattern2) 1575**] [**Last Name (NamePattern1) 12203**], MD  [**MD Number(1) 12204**]

Dictated By:[**Last Name (NamePattern1) 1324**]

MEDQUIST36

D:  [**2185-8-25**]  11:13
T:  [**2185-8-30**]  08:55
JOB#:  [**Job Number 35083**]
{'Other specified cardiac dysrhythmias,Other specified complications of procedures not elsewhere classified'}


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: 

PRESENT ILLNESS: This is a 37-year-old male who
presents to the CCU in arrhythmia, question SVT, question V
tach.  The patient had no significant past medical history
until two months ago when he began experiencing palpitations
and was found to be in arrhythmia, probable SVT, question V
tach.  The patient was converted with a calcium channel
block.  He was discharged home.  The patient had EP study at
[**Location (un) 47**] on [**6-17**] with no ablation.  The patient had 6-7
episodes over the past two months, each time converted on
calcium channel blocker or beta blocker or with vagal
maneuvers.  This a.m. on [**8-23**] the patient awoke tired at noon,
felt fatigued, mildly dyspneic, went to outside hospital,
found to be in cardiac arrhythmia.  The patient received
Adenosine 6 mg IV times one, 12 mg IV times one, Lopressor 5
mg IV times one, Verapamil 5 mg IV times one, with no change.
The patient was then cardioverted 100 joules to normal sinus
rhythm.  He then reverted back to his arrhythmia and was
loaded with Procainamide and converted to normal sinus rhythm
after 1 gm IV over one hour and then started on a drip at 2
mg per minute.  The patient was transferred from outside
hospital and ?????? hour before he arrived he went back into his
arrhythmia.

MEDICAL HISTORY: 1) Cardiac arrhythmia times two
months, status post EP study [**6-17**].  2) Increased cholesterol.
3) Status post vasectomy.

MEDICATION ON ADMISSION: 

ALLERGIES: Penicillin.  The patient gets edematous.

PHYSICAL EXAM: 

FAMILY HISTORY: Father with CAD, with MI in his 60's.

SOCIAL HISTORY: The patient works at [**Company 35082**].  No
alcohol, no tobacco, no drug abuse.  The patient lives at
home in [**Location (un) 17566**] with his parents. 

### Response:
{'Other specified cardiac dysrhythmias,Other specified complications of procedures not elsewhere classified'}
