CHIEF COMPLAINT: unresponsive

PRESENT ILLNESS: 88yo woman with hx of HTN, hyperchol, recurrent UTI, and
osteoporosis found this morning at approx 04:30 unresponsive,
groaning intermittently by staff at her retirement home.  She
was
brought to [**Hospital **] Hospital where some papillary asymmetry was
noted.  She was intubated for unclear reasons and taken to the
CT
scanner where she apparently had some motor movements worrisome
for seizure.  She was loaded with phenytoin and also given
ativan
and then xferred to [**Hospital1 18**] for further care.

MEDICAL HISTORY: -htn
-hypercholesterolemia
-osteoporosis
-UTI

MEDICATION ON ADMISSION: -fosamax
-lipitor
-toprol
-accupril
-ASA 81

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: CV: no pulse, no spontaneous HR
Pulm: no spontaneous respirations.

FAMILY HISTORY: unknown

SOCIAL HISTORY: Moved to nursing home in [**12-29**]; health care proxy and next-of-[**Doctor First Name **]
is [**Name (NI) **] [**Name (NI) 61258**], [**First Name3 (LF) **] 82yo cousin.
Cerebral artery occlusion, unspecified with cerebral infarction,Atrial fibrillation,Diseases of tricuspid valve,Mitral valve disorders,Pure hypercholesterolemia,Unspecified essential hypertension
Crbl art ocl NOS w infrc,Atrial fibrillation,Tricuspid valve disease,Mitral valve disorder,Pure hypercholesterolem,Hypertension NOS
Admission Date:  [**2191-4-4**]              Discharge Date:   [**2191-4-7**]


Service: NEUROLOGY

Allergies:
Patient recorded as having No Known Allergies to Drugs

Attending:[**First Name3 (LF) 46915**]
Chief Complaint:
unresponsive

Major Surgical or Invasive Procedure:
MRI brain

History of Present Illness:
88yo woman with hx of HTN, hyperchol, recurrent UTI, and
osteoporosis found this morning at approx 04:30 unresponsive,
groaning intermittently by staff at her retirement home.  She
was
brought to [**Hospital **] Hospital where some papillary asymmetry was
noted.  She was intubated for unclear reasons and taken to the
CT
scanner where she apparently had some motor movements worrisome
for seizure.  She was loaded with phenytoin and also given
ativan
and then xferred to [**Hospital1 18**] for further care.


Past Medical History:
-htn
-hypercholesterolemia
-osteoporosis
-UTI

Social History:
Moved to nursing home in [**12-29**]; health care proxy and next-of-[**Doctor First Name **]
is [**Name (NI) **] [**Name (NI) 61258**], [**First Name3 (LF) **] 82yo cousin.

Family History:
unknown

Physical Exam:
CV: no pulse, no spontaneous HR
Pulm: no spontaneous respirations.

Brief Hospital Course:
Pt admitted to teh Neurologic ICU, intubated and without
sedation.  She was minimally responsive.  EEG was performed and
showed no evidence of epileptiform activity.  MRI was performed
showing extensive infract involvoing bilateral thalami, R
midbrain, and R parieto-temporal region, likely ther result of
cardioembolic source.  Pt was noted to be in a-fib on admission
to the ICU and Cardiology team was consulted who suggested rate
control with Digoxin.  Shw converted back to NSR.

Given the extent of her infarct and after lengthy discussion
with [**Hospital 1094**] health care proxy, [**Name (NI) **] [**Name (NI) 61258**], Pt was made comfort
measures only. She was extubated, all lines removed, and she
expired.

Medications on Admission:
-fosamax
-lipitor
-toprol
-accupril
-ASA 81


Discharge Medications:
n/a

Discharge Disposition:
Expired

Discharge Diagnosis:
-bilateral thalamic infract, right midbrain infarct, right
parieto-occipital infarct
-atrial fibrillation
-hypertension
-hypercholesterolemia

Discharge Condition:
deceased

Discharge Instructions:
n/a

Followup Instructions:
n/a

                             [**Name6 (MD) **] [**Name8 (MD) **] MD [**MD Number(2) 46916**]

Completed by:[**2191-4-7**]
{'Cerebral artery occlusion, unspecified with cerebral infarction,Atrial fibrillation,Diseases of tricuspid valve,Mitral valve disorders,Pure hypercholesterolemia,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: unresponsive

PRESENT ILLNESS: 88yo woman with hx of HTN, hyperchol, recurrent UTI, and
osteoporosis found this morning at approx 04:30 unresponsive,
groaning intermittently by staff at her retirement home.  She
was
brought to [**Hospital **] Hospital where some papillary asymmetry was
noted.  She was intubated for unclear reasons and taken to the
CT
scanner where she apparently had some motor movements worrisome
for seizure.  She was loaded with phenytoin and also given
ativan
and then xferred to [**Hospital1 18**] for further care.

MEDICAL HISTORY: -htn
-hypercholesterolemia
-osteoporosis
-UTI

MEDICATION ON ADMISSION: -fosamax
-lipitor
-toprol
-accupril
-ASA 81

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: CV: no pulse, no spontaneous HR
Pulm: no spontaneous respirations.

FAMILY HISTORY: unknown

SOCIAL HISTORY: Moved to nursing home in [**12-29**]; health care proxy and next-of-[**Doctor First Name **]
is [**Name (NI) **] [**Name (NI) 61258**], [**First Name3 (LF) **] 82yo cousin. 

### Response:
{'Cerebral artery occlusion, unspecified with cerebral infarction,Atrial fibrillation,Diseases of tricuspid valve,Mitral valve disorders,Pure hypercholesterolemia,Unspecified essential hypertension'}
