CHIEF COMPLAINT: 

PRESENT ILLNESS: This is a 76 year old man who is
status post a right upper extremity AV fistula three days
prior to admission, who now presents with right upper
extremity swelling.  This swelling is associated with
significant pain of his right arm and the patient does report
that prior to the surgery his arms were of similar caliber.

MEDICAL HISTORY: 1.  Diabetes mellitus.
2.  Peripheral vascular disease.
3.  End-stage renal disease on hemodialysis.
4.  Congestive heart failure.
5.  Coronary artery disease.
6.  Pulmonary hypertension.
7.  Benign prostatic hypertrophy.
8.  Sleep apnea.

MEDICATION ON ADMISSION: 

ALLERGIES: 

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: 
Other complications due to renal dialysis device, implant, and graft,Chronic diastolic heart failure,Ventricular fibrillation,Hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage V or end stage renal disease,Acute respiratory failure,Pneumonitis due to inhalation of food or vomitus,Anoxic brain damage,Hyposmolality and/or hyponatremia
Comp-ren dialys dev/grft,Chr diastolic hrt fail,Ventricular fibrillation,Hyp kid NOS w cr kid V,Acute respiratry failure,Food/vomit pneumonitis,Anoxic brain damage,Hyposmolality
Admission Date:  [**2139-10-23**]     Discharge Date:  [**2139-10-31**]

Date of Birth:   [**2063-1-13**]     Sex:  M

Service:  TRANS [**Doctor First Name 147**]

HISTORY OF PRESENT ILLNESS:  This is a 76 year old man who is
status post a right upper extremity AV fistula three days
prior to admission, who now presents with right upper
extremity swelling.  This swelling is associated with
significant pain of his right arm and the patient does report
that prior to the surgery his arms were of similar caliber.

He denies fevers or chills, shortness of breath or abdominal
pain.

PAST MEDICAL HISTORY:
1.  Diabetes mellitus.
2.  Peripheral vascular disease.
3.  End-stage renal disease on hemodialysis.
4.  Congestive heart failure.
5.  Coronary artery disease.
6.  Pulmonary hypertension.
7.  Benign prostatic hypertrophy.
8.  Sleep apnea.

PAST SURGICAL HISTORY:
1.  Right radius cephalic AV fistula in 06/[**2137**].
2.  Right lobectomy for benign lung tumor in [**2085**].
3.  Revision of the right upper extremity AV fistula three
days prior to admission.

MEDICATIONS AT HOME:
1.  Enteric coated aspirin 325.
2.  Lipitor 40 mg once a day.
3.  Colace 100 mg twice a day.
4.  Nephrocaps, one tablet once a day.
5.  Lopressor.
6.  Magnesium 125 mg once a day.
7.  Imdur 60 mg once a day.
8.  CPAP.
9.  Insulin Humulin, 70/30, 33 units with breakfast and 14
units with dinner.

PHYSICAL EXAMINATION:  Vital signs were temperature of 99.7
F.; pulse 101; blood pressure 109/58; respiratory rate 22;
91% on room air.  In general, he is an uncomfortable man.
Lungs clear to auscultation bilaterally.  Heart is regular
rate and rhythm.  Abdomen is soft and obese.  His right upper
extremity has severe edema.  Motor is intact but limited by
the pain.  There is no palpable thrill overlying the AV
fistula.

An ultrasound in the Emergency Room showed a patent AV
fistula and no deep venous thrombosis of the right upper
extremity.

HOSPITAL COURSE:   The patient was admitted to the Transplant
Surgery Service.  A renal consultation was obtained for
hemodialysis and he was put on the Operating Room schedule
for the next day.  After being consented, the patient was
taken to the Operating Room on [**10-24**], where he tolerated
a ligation of the AV fistula for venous hypertension without
complication.  Please refer to the previously dictated
Operating Note by Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **] for the specifics of this
surgery.

Postoperatively, the patient was doing well, both during his
initial postoperative check on the night of surgery as well
as the morning after surgery on a.m. rounds.  On a.m. rounds,
he was saying his pain was much decreased.  The surgical
sites were without any exudate or signs of infection and his
tenderness in his right upper extremity was markedly
decreased.

However, at approximately 09:45 on [**10-25**], which was
postoperative day one, the patient was found blue and
unresponsive by his nurse and the CPR protocol was initiated.
The patient was intubated.  He was put on a monitor where he
was noted to have pulseless electrical activity.  After being
shocked several times, he went into a ventricular
fibrillation and ultimately was stabilized with several doses
of Atropine and several doses of epinephrine and then being
put on a dopamine drip.  He was transferred to the Medical
Intensive Care Unit for further care following this
unfortunate event.

Cardiac enzymes were sent; however, these were negative.  A
right upper extremity ultrasound was also performed.  In the
next few days, the following tests were performed:  A right
upper extremity ultrasound which did not show any evidence of
a deep venous thrombosis; a CT scan of the chest did not show
any evidence of a pulmonary embolism, and a chest x-ray,
although showing left heart failure and pulmonary edema, did
not show any evidence of aspiration.

At this point, on [**10-26**], the situation was re-evaluated
and the patient was still nonresponsive despite having
minimal sedative doses on board.

A Neurology consultation was obtained and because of the
patient's unresponsiveness, a brain death protocol was
established.  An MRI of the head was obtained which, although
did not show any acute infarction, showed evidence of chronic
microvascular ischemia within the cerebellum and basal
ganglion.

On physical examination over the next few days, the patient
still was not responsive.  There was no improvement in his
neurologic examination.  A family meeting was done on [**10-28**] where the patient's grim prognosis was discussed with his
wife and children and the family decided that according to
Mr. [**Known lastname 1175**] wishes, that he would not want to be
maintained in a comatose state, and thus, the patient was
made "DO NOT RESUSCITATE"  and ultimately Intensive Care Unit
level care was going to be discontinued.

On [**10-31**], Mr. [**Known lastname **] was extubated and he passed
away.  His family at this point refused an autopsy.

DISPOSITION:   Death.

                          [**First Name8 (NamePattern2) 1176**] [**Name8 (MD) 1177**], M.D.  [**MD Number(1) 1178**]

Dictated By:[**Last Name (NamePattern1) 1179**]

MEDQUIST36

D:  [**2139-12-1**]  12:30
T:  [**2139-12-1**]  16:19
JOB#:  [**Job Number 1180**]
{'Other complications due to renal dialysis device, implant, and graft,Chronic diastolic heart failure,Ventricular fibrillation,Hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage V or end stage renal disease,Acute respiratory failure,Pneumonitis due to inhalation of food or vomitus,Anoxic brain damage,Hyposmolality and/or hyponatremia'}


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 76 year old man who is
status post a right upper extremity AV fistula three days
prior to admission, who now presents with right upper
extremity swelling.  This swelling is associated with
significant pain of his right arm and the patient does report
that prior to the surgery his arms were of similar caliber.

MEDICAL HISTORY: 1.  Diabetes mellitus.
2.  Peripheral vascular disease.
3.  End-stage renal disease on hemodialysis.
4.  Congestive heart failure.
5.  Coronary artery disease.
6.  Pulmonary hypertension.
7.  Benign prostatic hypertrophy.
8.  Sleep apnea.

MEDICATION ON ADMISSION: 

ALLERGIES: 

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY:  

### Response:
{'Other complications due to renal dialysis device, implant, and graft,Chronic diastolic heart failure,Ventricular fibrillation,Hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage V or end stage renal disease,Acute respiratory failure,Pneumonitis due to inhalation of food or vomitus,Anoxic brain damage,Hyposmolality and/or hyponatremia'}
