CHIEF COMPLAINT: 

PRESENT ILLNESS: This is an 85-year-old male who
was transferred from [**Hospital 882**] Hospital.  He has a past
medical history of advancing Alzheimer's.  His baseline
mental status is that he is confused and not conversational.
He also has a past medical history of coronary artery
disease, who was in his usual state of health until [**7-30**]
when his daughter tried to help him out of a chair, and he
could not get up.  Normally he is able to ambulate without
assistance.

MEDICAL HISTORY: 

MEDICATION ON ADMISSION: 

ALLERGIES: 

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: 
Intracerebral hemorrhage,Congestive heart failure, unspecified,Aortocoronary bypass status,Alzheimer's disease,Dementia in conditions classified elsewhere without behavioral disturbance
Intracerebral hemorrhage,CHF NOS,Aortocoronary bypass,Alzheimer's disease,Dementia w/o behav dist
Admission Date:  [**2141-7-31**]       Discharge Date:  [**2141-8-7**]


Service: Neurosurgery

HISTORY OF PRESENT ILLNESS:  This is an 85-year-old male who
was transferred from [**Hospital 882**] Hospital.  He has a past
medical history of advancing Alzheimer's.  His baseline
mental status is that he is confused and not conversational.
He also has a past medical history of coronary artery
disease, who was in his usual state of health until [**7-30**]
when his daughter tried to help him out of a chair, and he
could not get up.  Normally he is able to ambulate without
assistance.

The patient's daughter called 911, and the patient was
brought to the [**Hospital 882**] Hospital Emergency Room.  The patient
was admitted, and later CAT scan of the head showed acute
frontal parietal hemorrhage with extension to the ventricles.
The patient was transferred to [**Hospital6 2018**] for further management.

The patient was confused but alert and talkative, moving all
extremities on arrival.  Pupils were reactive and equal
bilaterally.  Horizontal gaze was intact bilaterally.
Corneal reflexes were intact bilaterally.  Face was
symmetric.  The patient had increased tone in the lower
extremities bilaterally, which was greater than upper
extremities, but he was able to move all extremities well.
He localized to pain.

Head CT showed right frontal parietal lobe hemorrhage with
extension into the right lateral ventricle.  The patient was
admitted to the Trauma SICU for blood pressure monitoring.
The patient's Aspirin was discontinued.  The patient was
placed on a 1 L fluid restriction.  An NG tube was placed for
medication and nutrition.

Bedside swallow done on [**2141-8-1**], revealed the
patient not able to tolerate p.o.  Tube feeds were started.
The patient's neurological status improved slightly, although
the patient remained disoriented, confused, was easily
agitated.

The patient was transferred to the floor on [**2141-8-3**].  On [**2141-8-4**], the patient became more
lethargic and was not following commands.  He had decreased
verbal output.  Head CT was repeated with small increase in
the size of intracerebral hemorrhage.  There was no
significant change in ventricle size.

Fever work-up was sent.  Chest x-ray was negative.  Arterial
blood gas was within normal limits.  Cultures were negative.
The patient's vital signs remained stable.  The patient
remained afebrile.

The patient's prognosis and current condition were discussed
at length with the family, who decided to make the patient
DNR status.  GI consult was called for PEG placement.

The patient's neurological status improved slightly over the
course of the next few days.  The patient received PEG tube
on [**8-7**] without complication.  The patient was
scheduled for rehabilitation placement on [**2141-8-8**].

DISCHARGE MEDICATIONS:  The patient will be discharged to
rehabilitation on sliding scale Insulin coverage, Metoprolol
50 mg p.o. b.i.d., Atorvastatin 10 mg p.o. q.d., Enalapril 20
mg p.o. q.d., Acetaminophen 325-650 mg p.o. q.4-6 hours
p.r.n., Dorzolamide 2%, Timolol 0.5% ophthalmic 1 drop O.U.
b.i.d., Brimonidine Tartrate 0.15% ophthalmic 1 drop O.U. q.8
hours, Bisacodyl 10 mg p.o. p.r. q.d. p.r.n., Milk of
Magnesia 30 ml p.o. q.6 hours p.r.n.

DISCHARGE INSTRUCTIONS:  The patient has a Foley catheter in
place.  The patient is currently on a 1000 ml fluid
restriction.  Tube feed goal is Impact 75 cc/hr.

CONDITION ON DISCHARGE:  The patient is essentially
neurologically unchanged at the time of discharge.

FOLLOW-UP:  The patient is to follow-up with Dr. [**Last Name (STitle) 1327**] in
one month with repeat head CT prior to appointment.






                            [**Name6 (MD) **] [**Last Name (NamePattern4) **], M.D.  [**MD Number(1) 1133**]

Dictated By:[**Last Name (NamePattern1) 27454**]
MEDQUIST36

D:  [**2141-8-7**]  13:57
T:  [**2141-8-7**]  14:03
JOB#:  [**Job Number 39368**]


Name:  [**Known lastname 7108**], [**Known firstname 7109**]                  Unit No:  [**Numeric Identifier 7110**]

Admission Date:  [**2141-7-31**]     Discharge Date:  [**2141-8-9**]

Date of Birth:   [**2055-11-29**]     Sex:  M

Service:

ADDENDUM:  This is an Addendum to the Discharge Summary
originally dictated on [**2141-8-7**].  The patient's
discharge was delayed until [**2141-8-9**] secondary to
the patient having a percutaneous endoscopic gastrostomy tube
placed; which was placed without complications.  The
insertion site was clean, dry, and intact.  The patient was
started on tube feeds and was at full strength and was
tolerating the feedings well without residual.  His
neurologic status was unchanged (he has baseline dementia).
He did open his eyes.  He did mumble words.  He moves
everything.  He did not follow commands.  He was stable and
ready for transfer to rehabilitation.  He was to follow up
with Dr. [**First Name8 (NamePattern2) **] [**Name (STitle) **] in two weeks and receive a repeat head
computed tomography.






                          [**Name6 (MD) 863**] [**Last Name (NamePattern4) 864**], M.D.  [**MD Number(1) 865**]

Dictated By:[**Last Name (NamePattern1) 366**]

MEDQUIST36

D:  [**2141-8-9**]  09:44
T:  [**2141-8-9**]  09:51
JOB#:  [**Job Number 7111**]
{"Intracerebral hemorrhage,Congestive heart failure, unspecified,Aortocoronary bypass status,Alzheimer's disease,Dementia in conditions classified elsewhere without behavioral disturbance"}


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 an 85-year-old male who
was transferred from [**Hospital 882**] Hospital.  He has a past
medical history of advancing Alzheimer's.  His baseline
mental status is that he is confused and not conversational.
He also has a past medical history of coronary artery
disease, who was in his usual state of health until [**7-30**]
when his daughter tried to help him out of a chair, and he
could not get up.  Normally he is able to ambulate without
assistance.

MEDICAL HISTORY: 

MEDICATION ON ADMISSION: 

ALLERGIES: 

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY:  

### Response:
{"Intracerebral hemorrhage,Congestive heart failure, unspecified,Aortocoronary bypass status,Alzheimer's disease,Dementia in conditions classified elsewhere without behavioral disturbance"}
