CHIEF COMPLAINT: 

PRESENT ILLNESS: The patient is a [**Age over 90 **] year old
female who reports left frontal pain, left eye double vision
and ptosis of the left eye since [**2119-2-20**].  The patient
was diagnosed with a wide-necked left cavernous carotid aneurysm
and is status post diagnostic angiography done two weeks prior to
this admission.  The patient has a past medical history of
valvular heart disease, hypertension, dyspnea with two flights,
breast cancer times three on both sides, also TMJ and thyroid
nodules.

MEDICAL HISTORY: 

MEDICATION ON ADMISSION: 

ALLERGIES: 

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: 
Cerebral aneurysm, nonruptured,Hematoma complicating a procedure,Hyposmolality and/or hyponatremia,Unspecified essential hypertension,Personal history of malignant neoplasm of breast,Acute pharyngitis,Gout, unspecified,Other iatrogenic hypotension
Nonrupt cerebral aneurym,Hematoma complic proc,Hyposmolality,Hypertension NOS,Hx of breast malignancy,Acute pharyngitis,Gout NOS,Iatrogenc hypotnsion NEC
Admission Date: [**2120-2-6**]        Discharge Date: [**2120-2-13**]


Service:  NSU


HISTORY OF PRESENT ILLNESS:  The patient is a [**Age over 90 **] year old
female who reports left frontal pain, left eye double vision
and ptosis of the left eye since [**2119-2-20**].  The patient
was diagnosed with a wide-necked left cavernous carotid aneurysm
and is status post diagnostic angiography done two weeks prior to
this admission.  The patient has a past medical history of
valvular heart disease, hypertension, dyspnea with two flights,
breast cancer times three on both sides, also TMJ and thyroid
nodules.

PHYSICAL EXAMINATION:  On physical examination she is in no
acute distress, awake, alert and oriented times three.
Cardiovascular regular rate and rhythm with a II/VI systolic
murmur, radiating to the left and right carotids.  Lungs were
clear to auscultation.  Abdomen was soft, nontender,
nondistended.  Positive bowel sounds.  Extremities:  No
cyanosis, clubbing or edema.  She has a left eye ptosis.  Her
pupils are 2.5 mm and equally reactive.  Extraocular
movements are full.  She has no nystagmus, smile is
symmetric.  No sensory loss.  Her strength is [**4-25**] in all
muscle groups.  Her visual fields are full.

HOSPITAL COURSE:  Mrs. [**Known lastname 31174**] was admitted and underwent a
cerebral angiogram with a balloon test occlusion (BTO) of the
left internal carotid artery with the assistance of anesthesia.
She tolerated the temporary occlusion for 25 minutes without
neurological deficit.  This included a hypotensive challenge via
intravenous nitroglycerin during which her systolic pressure was
decreased below 100mmHg.  After successful BTO, the wide-necked
aneurysm was coiled loosely using Matrix platinum coils to form a
scaffold and to prevent distal embolization of proximal embolic
materials that would be subsequently used to occlude the parent
vessel proximally.  The left ICA was then occluded from an
endovascular approach.  Post-operatively, she  was admitted to
the ICU for close neurological monitoring. Her vital signs
were stable.  She was afebrile.  She continued with the left
eye ptosis.  The lungs were clear.  Neurologically, awake,
alert and oriented times three, following commands.  Speech
was fluent.  Continues with strength 5/5 in all muscle groups
with no drift.  She was continued to be monitored in the
Intensive Care Unit.  She was kept with strict blood pressure
control to 130 to 160 range at all times, flat bedrest until
the sheath was removed and she was an aspirin
postoperatively.

On postoperative day Number 1, she was oriented times three
moving all extremities, following commands.  Speech intact.
The groin had no hematoma.  She had positive pedal pulses.
She was out of bed, ambulating in the afternoon on
postoperative day Number 1.  She was transferred to the
regular floor, to Stepdown on postoperative day Number 2.
She remained neurologically stable.  She did have a couple of
episodes of hypotension down to the 90s.  She did have her
Foley catheter discontinued on [**2120-12-8**], but was
unable to void.  The new Foley catheter was replaced.  She
did have blood-tinged urine thought to be traumatic and had
problems with hyponatremia and was started on salt tabs 3
grams p.o. t.i.d. for a sodium level of 133.  On [**2120-2-11**], the patient complained of mild erythema, sore throat.
A throat culture was sent and is negative to date.  The
patient has a history of first degree atrioventricular block.
PR interval was elongated.  Blood pressure was running in the
90s to 150s.  Her antihypertensive medication was stopped.
Her intravenous fluids stopped on [**2120-2-12**], and her
blood pressure has been in the normal range 130 to 160.
Vital signs have remained stable.  She has been afebrile.

DISCHARGE MEDICATIONS:  Medications at the time of discharge
include heparin 5000 units subcutaneously b.i.d., Neutra-Phos
2 packages p.o. b.i.d., Colace 100 mg p.o. b.i.d., Famotidine
20 mg p.o. once day, aspirin 325 p.o. q. day.  Currently on
salt tablets 3 grams p.o. t.i.d. to wean off when sodium
normalizes.

CONDITION ON DISCHARGE:  The patient's condition was stable
at the time of discharge.

FOLLOW UP:  She will follow up with Dr. [**Last Name (STitle) 1132**] in two weeks.



                        [**Name6 (MD) **] [**Last Name (NamePattern4) 1359**], [**MD Number(1) 1360**]

Dictated By:[**Last Name (NamePattern1) **]
MEDQUIST36
D:  [**2120-2-12**] 14:39:59
T:  [**2120-2-12**] 15:54:01
Job#:  [**Job Number 31175**]
{'Cerebral aneurysm, nonruptured,Hematoma complicating a procedure,Hyposmolality and/or hyponatremia,Unspecified essential hypertension,Personal history of malignant neoplasm of breast,Acute pharyngitis,Gout, unspecified,Other iatrogenic hypotension'}


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: The patient is a [**Age over 90 **] year old
female who reports left frontal pain, left eye double vision
and ptosis of the left eye since [**2119-2-20**].  The patient
was diagnosed with a wide-necked left cavernous carotid aneurysm
and is status post diagnostic angiography done two weeks prior to
this admission.  The patient has a past medical history of
valvular heart disease, hypertension, dyspnea with two flights,
breast cancer times three on both sides, also TMJ and thyroid
nodules.

MEDICAL HISTORY: 

MEDICATION ON ADMISSION: 

ALLERGIES: 

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY:  

### Response:
{'Cerebral aneurysm, nonruptured,Hematoma complicating a procedure,Hyposmolality and/or hyponatremia,Unspecified essential hypertension,Personal history of malignant neoplasm of breast,Acute pharyngitis,Gout, unspecified,Other iatrogenic hypotension'}
