CHIEF COMPLAINT: Patient returned from [**Hospital3 **] after UE ultrasound
revealed LUE DVT involving entire subclavian. Patient is HIT+
and required tx w/Argatroban and therefore returned to [**Hospital1 18**] for
tx

PRESENT ILLNESS: s/p Asc Ao replacemnt [**4-24**], after complicated postop course
transferred to [**Hospital3 **] [**5-17**]. Returned to [**Hospital1 18**] [**5-18**] for
tx of UE DVT with Argatroban and Coumadin

MEDICAL HISTORY: HTN
hypercholesterolemia
R fem AV fistula
anxiety/depression
osteoporosis
varicose veins
h/o R ankle fx
hard-of-hearing

MEDICATION ON ADMISSION: lorazepam 1mg QID/PRN
Nystatin Susp QID
Ca Acetate 667mg TID
Albuterol MDI 2P Q@/PRN
Metoprolol 100 [**Hospital1 **]
Lisinopril 10 QD
Lansoprazole 30mg QD
Norvasc 10 QD
Amiodarone 200 QD
Dlantin 100 TID
Simvastatin 80 QD
ASA 325 QD
tylenol 650 Q6/PRN

ALLERGIES: Iodine Containing Agents Classifier / Heparin Agents

PHYSICAL EXAM: Admission
Neuro: Awake and responsive
Pulm: BS course w/rhonchi bilat, Trach in place
CV: RRR Sternum stable
Abdm: soft NT/ND NABS. PEG in place
Ext: Warm no pedal edema, + left arm edema

FAMILY HISTORY: Sister with aortic aneurysm.

SOCIAL HISTORY: 3 sons. non-[**Name2 (NI) 1818**]
Other convulsions,Tracheostomy status,Gastrostomy status,Personal history of surgery to heart and great vessels, presenting hazards to health,Encounter for therapeutic drug monitoring,Unspecified essential hypertension,Long-term (current) use of anticoagulants,Anxiety state, unspecified,Personal history of other diseases of circulatory system,Osteoporosis, unspecified
Convulsions NEC,Tracheostomy status,Gastrostomy status,Hx-major cardiovasc surg,Therapeutic drug monitor,Hypertension NOS,Long-term use anticoagul,Anxiety state NOS,Hx-circulatory dis NEC,Osteoporosis NOS
Admission Date:  [**2192-5-18**]              Discharge Date:   [**2192-5-24**]


Service: CARDIOTHORACIC

Allergies:
Iodine Containing Agents Classifier / Heparin Agents

Attending:[**First Name3 (LF) 1283**]
Chief Complaint:
Patient returned from [**Hospital3 **] after UE ultrasound
revealed LUE DVT involving entire subclavian. Patient is HIT+
and required tx w/Argatroban and therefore returned to [**Hospital1 18**] for
tx

Major Surgical or Invasive Procedure:
none


History of Present Illness:
s/p Asc Ao replacemnt [**4-24**], after complicated postop course
transferred to [**Hospital3 **] [**5-17**]. Returned to [**Hospital1 18**] [**5-18**] for
tx of UE DVT with Argatroban and Coumadin

Past Medical History:
HTN
hypercholesterolemia
R fem AV fistula
anxiety/depression
osteoporosis
varicose veins
h/o R ankle fx
hard-of-hearing

Social History:
3 sons. non-[**Name2 (NI) 1818**]


Family History:
Sister with aortic aneurysm.

Physical Exam:
Admission
Neuro: Awake and responsive
Pulm: BS course w/rhonchi bilat, Trach in place
CV: RRR Sternum stable
Abdm: soft NT/ND NABS. PEG in place
Ext: Warm no pedal edema, + left arm edema

Discharge
VS 98.6  81SR  142/50  18  100% on 40%TM
Gen: NAD
Neuro: Alert, responsive follows commands
CV: RRR, sternum stable wound CDI
Pulm: scattered rhonchi w/productive cough
Abdm: soft +BS/PEG site CDI
Ext: Warm no pedal edema, 1+ LUE edema

Pertinent Results:
[**2192-5-17**] 04:48AM   GLUCOSE-187* UREA N-28* CREAT-0.7 SODIUM-145
POTASSIUM-4.4 CHLORIDE-110* TOTAL CO2-27 ANION GAP-12
[**2192-5-17**] 04:48AM   WBC-9.5 RBC-3.68* HGB-10.6* HCT-32.9* MCV-89
MCH-28.7 MCHC-32.2 RDW-15.1
[**2192-5-17**] 04:48AM   PLT COUNT-291
[**2192-5-24**] 08:40AM BLOOD PT-21.1* PTT-41.1* INR(PT)-2.0*

Brief Hospital Course:
Admitted to [**Hospital1 18**] [**5-18**] from [**Hospital3 **] for tx of UE DVT in
HIT+ patient w/Argatroban and transition to Warfarin. Pt begun
on Argatroban shortly after arrival at [**Hospital1 18**]. Over the next
several days her Argatroban dose was titrated up to acheive
therapeudic levels. The patient was also begun on Warfarin and
dose was titrated up while maintaining Argatroba infusion until
[**5-24**] pt had therapeudic INR and Argatroban infusion was stopped.
Her transfer medications  were continued unchanged. The patient
was also begun on Glipizide for persistantly elevated blood
glucose levels. Her blood sugars will need to be monitored for
additional dose adjustments.

Medications on Admission:
lorazepam 1mg QID/PRN
Nystatin Susp QID
Ca Acetate 667mg TID
Albuterol MDI 2P Q@/PRN
Metoprolol 100 [**Hospital1 **]
Lisinopril 10 QD
Lansoprazole 30mg QD
Norvasc 10 QD
Amiodarone 200 QD
Dlantin 100 TID
Simvastatin 80 QD
ASA 325 QD
tylenol 650 Q6/PRN

Discharge Medications:
1. Aspirin 325 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).
2. Miconazole Nitrate 2 % Powder Sig: One (1) Appl Topical  QID
(4 times a day) as needed.
3. Atorvastatin 40 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
4. Amiodarone 200 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
5. Amlodipine 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).

6. Lansoprazole 30 mg Susp,Delayed Release for Recon Sig: Thirty
(30) mg PO DAILY (Daily).
7. Lisinopril 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).

8. Metoprolol Tartrate 50 mg Tablet Sig: Two (2) Tablet PO BID
(2 times a day).
9. Phenytoin 100 mg/4 mL Suspension Sig: Five (5) ml PO Q8H
(every 8 hours): 125mg/TID.
10. Trazodone 50 mg Tablet Sig: 0.5 Tablet PO HS (at bedtime) as
needed.
11. Glyburide 5 mg Tablet Sig: One (1) Tablet PO BID (2 times a
day).
12. Warfarin 2 mg Tablet Sig: as directed Tablet PO once a day:
5mg [**5-24**] then as directed to maintain target INR 2-2.5.
13. Furosemide 20 mg Tablet Sig: One (1) Tablet PO twice a day.



Discharge Disposition:
Extended Care

Facility:
[**Hospital6 85**] - [**Location (un) 86**]

Discharge Diagnosis:
s/p Asc Ao Aneurysm repair
CVA
DVT Lft UE, Tx w/Argatroban and Coumadin
HIT+
s/p retroperitoneal bleed
s/p Trach/PEG
PMH: HTN,^choldepression, Anxiety, Osteoporosis, Varicose veins


Discharge Condition:
good


Discharge Instructions:
keep wounds clean and dry. OK to shower, no bathing or swimming.
Take all medications as prescribed.
Call for any [**Location (un) **], redness or drainage from wounds

Followup Instructions:
Dr [**Last Name (STitle) 141**] upon discharge from rehab
Dr [**Last Name (STitle) **] in 1 month or upon discharge from rehab



Completed by:[**2192-5-24**]
{'Other convulsions,Tracheostomy status,Gastrostomy status,Personal history of surgery to heart and great vessels, presenting hazards to health,Encounter for therapeutic drug monitoring,Unspecified essential hypertension,Long-term (current) use of anticoagulants,Anxiety state, unspecified,Personal history of other diseases of circulatory system,Osteoporosis, 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: Patient returned from [**Hospital3 **] after UE ultrasound
revealed LUE DVT involving entire subclavian. Patient is HIT+
and required tx w/Argatroban and therefore returned to [**Hospital1 18**] for
tx

PRESENT ILLNESS: s/p Asc Ao replacemnt [**4-24**], after complicated postop course
transferred to [**Hospital3 **] [**5-17**]. Returned to [**Hospital1 18**] [**5-18**] for
tx of UE DVT with Argatroban and Coumadin

MEDICAL HISTORY: HTN
hypercholesterolemia
R fem AV fistula
anxiety/depression
osteoporosis
varicose veins
h/o R ankle fx
hard-of-hearing

MEDICATION ON ADMISSION: lorazepam 1mg QID/PRN
Nystatin Susp QID
Ca Acetate 667mg TID
Albuterol MDI 2P Q@/PRN
Metoprolol 100 [**Hospital1 **]
Lisinopril 10 QD
Lansoprazole 30mg QD
Norvasc 10 QD
Amiodarone 200 QD
Dlantin 100 TID
Simvastatin 80 QD
ASA 325 QD
tylenol 650 Q6/PRN

ALLERGIES: Iodine Containing Agents Classifier / Heparin Agents

PHYSICAL EXAM: Admission
Neuro: Awake and responsive
Pulm: BS course w/rhonchi bilat, Trach in place
CV: RRR Sternum stable
Abdm: soft NT/ND NABS. PEG in place
Ext: Warm no pedal edema, + left arm edema

FAMILY HISTORY: Sister with aortic aneurysm.

SOCIAL HISTORY: 3 sons. non-[**Name2 (NI) 1818**] 

### Response:
{'Other convulsions,Tracheostomy status,Gastrostomy status,Personal history of surgery to heart and great vessels, presenting hazards to health,Encounter for therapeutic drug monitoring,Unspecified essential hypertension,Long-term (current) use of anticoagulants,Anxiety state, unspecified,Personal history of other diseases of circulatory system,Osteoporosis, unspecified'}
