CHIEF COMPLAINT: 

PRESENT ILLNESS: This is a 53 year old gentleman
who had developed pneumonia in [**2155-4-29**]. A chest x-ray at
that time showed an enlarged aorta. The patient underwent a
CT scan to evaluate his aorta which showed a 5.3 cm ascending
aorta. The patient was referred to Dr. [**Last Name (Prefixes) **] for
operative management. The patient had cardiac catheterization
prior to his surgery which showed an ejection fraction of 65
percent, no significant coronary artery disease and elevated
left-sided filling pressures.

MEDICAL HISTORY: Hypertension.

MEDICATION ON ADMISSION: 

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: The patient lives at home with his wife. [**Name (NI) **]
has a remote history of tobacco and quit smoking 10 years
ago. He works as a Chief Justice of the Probate Family Court.
Thoracic aneurysm without mention of rupture,Cardiac complications, not elsewhere classified,Atrial fibrillation,Unspecified essential hypertension,Esophageal reflux
Thoracic aortic aneurysm,Surg compl-heart,Atrial fibrillation,Hypertension NOS,Esophageal reflux
Admission Date: [**2155-8-22**]        Discharge Date: [**2155-8-27**]

Date of Birth:  [**2091-12-29**]        Sex:  M

Service:  CSU


HI[**Last Name (STitle) 2710**]OF PRESENT ILLNESS:  This is a 53 year old gentleman
who had developed pneumonia in [**2155-4-29**]. A chest x-ray at
that time showed an enlarged aorta. The patient underwent a
CT scan to evaluate his aorta which showed a 5.3 cm ascending
aorta. The patient was referred to Dr. [**Last Name (Prefixes) **] for
operative management. The patient had cardiac catheterization
prior to his surgery which showed an ejection fraction of 65
percent, no significant coronary artery disease and elevated
left-sided filling pressures.

PAST MEDICAL HISTORY:  Hypertension.

Pneumonia as previously stated above.

GERD.

PREOPERATIVE MEDICATIONS:
1. Atenolol 50 mg po Q.D.
2. Prilosec 20 mg po Q.D.


ALLERGIES:  No known drug allergies.

SOCIAL HISTORY:  The patient lives at home with his wife. [**Name (NI) **]
has a remote history of tobacco and quit smoking 10 years
ago. He works as a Chief Justice of the Probate Family Court.

HO[**Last Name (STitle) **] COURSE:  The patient was admitted to [**Hospital1 346**] on [**2155-8-22**] and was taken to the
Operating Room with Dr. [**Last Name (Prefixes) **] for repair of his
ascending aortic aneurysm. The patient had an ascending aorta
and hemi-arch graft with a 26 mm Gelweave graft. Total
cardiopulmonary bypass time was 118 minutes. Cross clamp time
was 81 minutes. Circulatory arrest time was 11 minutes. The
patient tolerated the procedure well and was transferred to
the Intensive Care Unit in stable condition. On postop day 0,
the patient was weaned and extubated from mechanical
ventilation. On postop day 1, he was started on beta blockers
and Lasix. His chest tubes were removed on postoperative day
1. On postoperative day 2, he was transferred from the
Intensive Care Unit to the regular part of the hospital where
he began ambulating with Physical Therapy. His pacing wires
were removed on postoperative day 2 without incident. On the
night of postoperative day 2, the patient developed atrial
fibrillation, rate controlled. He was treated with IV
Lopressor and amiodarone infusion. The patient remained
hemodynamically stable. The patient was seen by the
Electrophysiology Service. They recommended amiodarone 200 mg
tid times two weeks and anticoagulation. The patient
subsequently converted into sinus rhythm. On postoperative
day 3, the patient again had an episode of atrial
fibrillation. The patient was then started on heparin and
Coumadin. On postoperative day 4, after working with Physical
Therapy, the patient was able to ambulate 500 feet and climb
one flight of stairs without difficulty. On postoperative day
5, the patient was cleared for discharge to home.

CONDITION ON DISCHARGE:  Tmax is 99.2. Pulse is 68 and sinus
rhythm. Blood pressure is 114/65. Respiratory rate is 20.
Oxygen saturation is 94 percent on room air. Neurologically,
the patient is awake, alert and oriented times three,
nonfocal. Heart is regular rate and rhythm with no further
atrial fibrillation times 24 hours. Respiratory - breath
sounds on the right are rhonchorous and left side is clear.
The patient reports that that is his baseline since his
history of pneumonia. Abdomen - positive bowel sounds, soft,
nontender and nondistended, tolerating regular diet, having
normal bowel movements. Extremities are warm and well-
perfused with trace edema. Sternal incision is clean, dry and
intact. Steri-Strips were opened to air. There is no erythema
or drainage. The sternum is stable.

LABORATORY DATA:  PT is 17.3, INR 1.9 and PTT 57.0.

DI[**Last Name (STitle) 408**]E INSTRUCTIONS:  The patient is to be discharged to
home in stable condition. He is to follow up with Dr. [**Last Name (Prefixes) **] in one to two weeks. He is to follow up with Dr.
[**Last Name (STitle) **] in four to six weeks and he is to follow up with
his primary care physician, [**Last Name (NamePattern4) **]. [**First Name (STitle) **], by phone on [**8-28**] for
INR results and in the office in one to two weeks. The
patient is to have PT and INR drawn on [**8-28**] by the visiting
nurse.

DISCHARGE MEDICATIONS:
1. Lasix 20 mg po Q.D. times seven days.
2. Colace 100 mg po bid.
3. Percocet 5/325 one to two po q4h prn.
4. Lopressor 25 mg po bid.
5. Aspirin 81 mg po Q.D.
6. Amiodarone 200 mg po Q.D. times one month.
7. Coumadin 2.5 mg po on [**8-27**], then dosing per Dr. [**First Name (STitle) **].
8. Prilosec 20 mg po Q.D.


DISCHARGE DIAGNOSES:  Status post repair of ascending aortic
aneurysm with replacement of ascending aorta and hemi-arch
with a Gelweave graft.

Postoperative atrial fibrillation.

Hypertension.

The patient is to be discharged to home in stable condition.



                        [**Doctor Last Name **] [**Last Name (Prefixes) **], M.D. [**MD Number(1) 1288**]

Dictated By:[**Last Name (NamePattern4) 8524**]
MEDQUIST36
D:  [**2155-8-27**] 16:33:43
T:  [**2155-8-27**] 20:36:17
Job#:  [**Job Number 52355**]
{'Thoracic aneurysm without mention of rupture,Cardiac complications, not elsewhere classified,Atrial fibrillation,Unspecified essential hypertension,Esophageal reflux'}


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 53 year old gentleman
who had developed pneumonia in [**2155-4-29**]. A chest x-ray at
that time showed an enlarged aorta. The patient underwent a
CT scan to evaluate his aorta which showed a 5.3 cm ascending
aorta. The patient was referred to Dr. [**Last Name (Prefixes) **] for
operative management. The patient had cardiac catheterization
prior to his surgery which showed an ejection fraction of 65
percent, no significant coronary artery disease and elevated
left-sided filling pressures.

MEDICAL HISTORY: Hypertension.

MEDICATION ON ADMISSION: 

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: The patient lives at home with his wife. [**Name (NI) **]
has a remote history of tobacco and quit smoking 10 years
ago. He works as a Chief Justice of the Probate Family Court. 

### Response:
{'Thoracic aneurysm without mention of rupture,Cardiac complications, not elsewhere classified,Atrial fibrillation,Unspecified essential hypertension,Esophageal reflux'}
