CHIEF COMPLAINT: chest/jaw pain

PRESENT ILLNESS: 73 y/o female w/difficulty sleeping due to chest/jaw pain,
nausea, vomiting, diaphoresis, right leg pain. She presented to
outside hospital, CT scan revealed ascending aortic dissection,
also with descending dissection to the iliacs.  She was
transferred to [**Hospital1 18**] for emergent surgery

MEDICAL HISTORY: hypertension
obesity
cataracts

MEDICATION ON ADMISSION: lisinopril

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: RLE cool, pulseless, otherwise exam was unremarkable

FAMILY HISTORY: unknown

SOCIAL HISTORY: lived alone
retired
Thoracic aneurysm without mention of rupture,Subendocardial infarction, initial episode of care,Cardiogenic shock,Cardiac complications, not elsewhere classified,Atrial fibrillation,Coronary atherosclerosis of native coronary artery,Unspecified disease of pericardium,Other chronic pulmonary heart diseases,Unspecified essential hypertension
Thoracic aortic aneurysm,Subendo infarct, initial,Cardiogenic shock,Surg compl-heart,Atrial fibrillation,Crnry athrscl natve vssl,Pericardial disease NOS,Chr pulmon heart dis NEC,Hypertension NOS
Admission Date:  [**2165-8-26**]              Discharge Date:   [**2165-9-1**]

Date of Birth:  [**2091-10-27**]             Sex:   F

Service: CARDIOTHORACIC

Allergies:
Patient recorded as having No Known Allergies to Drugs

Attending:[**First Name3 (LF) 1267**]
Chief Complaint:
chest/jaw pain

Major Surgical or Invasive Procedure:
Emergent repair of ascending aortic aneurysm
Cadriac catheterization with stents


History of Present Illness:
73 y/o female w/difficulty sleeping due to chest/jaw pain,
nausea, vomiting, diaphoresis, right leg pain. She presented to
outside hospital, CT scan revealed ascending aortic dissection,
also with descending dissection to the iliacs.  She was
transferred to [**Hospital1 18**] for emergent surgery

Past Medical History:
hypertension
obesity
cataracts

Social History:
lived alone
retired

Family History:
unknown

Physical Exam:
RLE cool, pulseless, otherwise exam was unremarkable

Brief Hospital Course:
Taken emergently to the operating room on [**2165-8-26**] for repair of
ascending aortic dissection.
Post-op, she was transferred to the CSRU. On POD # 1, she moved
all 4 extrremities, but started to become hypotensive with
waking, she was placed on Neo gtt, she went into AFib, and was
started on Amiodarone.  Diuresis was started.
She had some more problems with AFib, which caused decreased BP
and SVO2.  She was cardioverted, and remained on Amiodarone gtt.
 TEE on [**2165-8-28**] revealed EF 30-35%, depressed bivent. fxn.
Dobutamine was started on [**8-29**] due to worsening cardiac output.
Oxygenation worsened, as did her cardiac status. A cardiology
consult was obtained on [**2165-8-31**].  Echo was essentially unchanged
from TEE done earlier in the week.  She had a sudden drop in BP
and SVO2 around 9:40 pm ([**2165-8-31**]), Neo-Synephrine gtt started,
BP stabilized briefly.  Had significant ST elevations in
anterolateral leads ~ 10:30 pm.  Echo revealed EF 20-25%,
anterior and anteroseptal akinesis (sub-optimal views due to
body habitus).  She was taken urgently to the cath lab, angio
revealed significant distal LM lesion, and totally occluded
proximal LAD.  Two stents were placed (distal LM & LAD), and the
patient was transported back to the CSRU.  She remained stable
for approx. 1 hour, when she again precipitously dropped her BP.
 She proceeded to cardiac arrest at 3:27 am.  ACLS protocol was
initiated.  She did not respond to resuscitative efforts, and
was pronounced at 4:09 am.

Medications on Admission:
lisinopril

Discharge Medications:
none

Discharge Disposition:
Expired

Discharge Diagnosis:
Ascending aortic dissection
hypertension
myocardial infarction


Discharge Condition:
expired


Followup Instructions:
none



Completed by:[**2165-9-1**]
{'Thoracic aneurysm without mention of rupture,Subendocardial infarction, initial episode of care,Cardiogenic shock,Cardiac complications, not elsewhere classified,Atrial fibrillation,Coronary atherosclerosis of native coronary artery,Unspecified disease of pericardium,Other chronic pulmonary heart diseases,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: chest/jaw pain

PRESENT ILLNESS: 73 y/o female w/difficulty sleeping due to chest/jaw pain,
nausea, vomiting, diaphoresis, right leg pain. She presented to
outside hospital, CT scan revealed ascending aortic dissection,
also with descending dissection to the iliacs.  She was
transferred to [**Hospital1 18**] for emergent surgery

MEDICAL HISTORY: hypertension
obesity
cataracts

MEDICATION ON ADMISSION: lisinopril

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: RLE cool, pulseless, otherwise exam was unremarkable

FAMILY HISTORY: unknown

SOCIAL HISTORY: lived alone
retired 

### Response:
{'Thoracic aneurysm without mention of rupture,Subendocardial infarction, initial episode of care,Cardiogenic shock,Cardiac complications, not elsewhere classified,Atrial fibrillation,Coronary atherosclerosis of native coronary artery,Unspecified disease of pericardium,Other chronic pulmonary heart diseases,Unspecified essential hypertension'}
