CHIEF COMPLAINT: elective pulmonary vein isolation, transferred to the MICU then
the CCU for cardiogenic shock

PRESENT ILLNESS: Mr. [**Known lastname 1637**] is a 71 YOM with atrial fibrilation s/p 7
cardioversions (the last in [**3-13**]) who presented for elective
pulmonary vein isolation on [**2154-4-13**]. He has a past medical
history significant for CABG, ESRD on HD, RCC s/p ablation,
repaired AAA, and previous GIB contraindicating anticoagulation
for his a fib.
.
He underwent successful elective transeptal pulmonary venous
isolation and was cardioverted in to NSR. During the procedure
he was given fentanyl 50mcg, midazolam 2mg, propofol 60mg,
furosemide 20mg, and 4L IVF. Post-op in the PACU he was noted to
have back pain and some agitation and was given 4 mg of haldol,
100mg of neurontin, followed by total of 4mg of morphine for his
back pain. He also developed hypotension to the 70s/50s and
dyspnea. He was bolused another liter of NS and started on
pressors with neosynephrine. He was noted to have atrial
fibrilation with RVR to 140s. An abg showed pH 7.24 and pCO2 42
O2 78. He was evaluated by and transferred to the MICU.
.
Overnight in the MICU the patient was noted to develop a lactic
acidosis of 3.5 --> 11.3. He developed worsened respiratory
failure and was intubated. His pressors were changed to levophed
and vasopressin. Initially he was on propofol and he was
switched to fent/versed for concern for possible propofol
infusion syndrome though it was thought to be unlikely. He had a
brief episode of monomorphic V tach and then later had
polymorphic vtach. He was given Mg and started on amiodarone 150
mg bolus x 2 and 0.5 mg/hr drip. A stat bedside echo showed
regional hypokinesis and EF 40% but no pericardial effusion.
Lenis were attempted, but were aborted due to instability? It
was thought that his hypotension and lactic acidosis were due to
hypovolemia from a retroperitoneal or GI bleed. CT surgery was
called and a CT abdomen was obtained which did not show evidence
of bleed. Infection was in the differential due to elevated WBC,
but this was thought to be less likely. He was pan cultured and
antibiotics were initially held, but then vanc, cefepime, flagyl
were started along with one dose of stress dose steroids.
.
On the morning of transfer, he was started on CVVH for likely
volume overload in the setting of poor oxygenation requiring
fio2 100% and high PEEP. On evaluation, he is intubated and
sedated, lying comfortably in bed.

MEDICAL HISTORY: * PAF s/p 7 CV (most recent CV [**3-13**]) not on warfarin given prior
GIB
* CAD s/p CABG [**2154**] Medical Center
* ESRD on HD s/p left AV fistula
-- on HD MWF, access tunneled line
* HTN
* Hyperlipidemia
* Hypothyroidism
* Abdominal hernia
* Renal carcinoma s/p radiofrequency ablation [**2150**], [**2-/2151**] and

MEDICATION ON ADMISSION: Medications per OMR
Allopurinol 100mg [**Hospital1 **]
Amiodarone 200mg daily
Atorvastatin 20mg daily
Nephrocaps 1 tab daily
Phoslo 667mg TID
Fenofibrate 48mg [**Hospital1 **]
Furosemide 40mg [**Hospital1 **]
Levothyroxine 75mcg daily
Omeprazole 40mg daily

ALLERGIES: Percocet

PHYSICAL EXAM: Vitals 98.6 125 113/68 17 98% on cmv, fio2 60%, peep 15, vt 600

FAMILY HISTORY: non-contributory

SOCIAL HISTORY: Married. ETOH: [**3-6**] glasses of wine/week, no smoking.
Atrial fibrillation,End stage renal disease,Acute myocardial infarction of unspecified site, initial episode of care,Acute edema of lung, unspecified,Acute and subacute necrosis of liver,Acidosis,Paralytic ileus,Delirium due to conditions classified elsewhere,Hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage V or end stage renal disease,Cardiac complications, not elsewhere classified,Cardiogenic shock,Coronary atherosclerosis of unspecified type of vessel, native or graft,Gastroparesis,Unspecified acquired hypothyroidism,Other and unspecified hyperlipidemia,Esophageal reflux,Backache, unspecified,Other chronic pain,Personal history of malignant neoplasm of kidney,Personal history of colonic polyps,Aortocoronary bypass status,Other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure
Atrial fibrillation,End stage renal disease,AMI NOS, initial,Acute lung edema NOS,Acute necrosis of liver,Acidosis,Paralytic ileus,Delirium d/t other cond,Hyp kid NOS w cr kid V,Surg compl-heart,Cardiogenic shock,Cor ath unsp vsl ntv/gft,Gastroparesis,Hypothyroidism NOS,Hyperlipidemia NEC/NOS,Esophageal reflux,Backache NOS,Chronic pain NEC,Hx of kidney malignancy,Prsnl hst colonic polyps,Aortocoronary bypass,Abn react-procedure NEC
Admission Date:  [**2154-5-14**]              Discharge Date:   [**2154-5-19**]

Date of Birth:  [**2083-4-10**]             Sex:   M

Service: MEDICINE

Allergies:
Percocet

Attending:[**First Name3 (LF) 7333**]
Chief Complaint:
elective pulmonary vein isolation, transferred to the MICU then
the CCU for cardiogenic shock

Major Surgical or Invasive Procedure:
Pulmonary vein isolation
CVVH

History of Present Illness:
Mr. [**Known lastname 1637**] is a 71 YOM with atrial fibrilation s/p 7
cardioversions (the last in [**3-13**]) who presented for elective
pulmonary vein isolation on [**2154-4-13**]. He has a past medical
history significant for CABG, ESRD on HD, RCC s/p ablation,
repaired AAA, and previous GIB contraindicating anticoagulation
for his a fib.
.
He underwent successful elective transeptal pulmonary venous
isolation and was cardioverted in to NSR. During the procedure
he was given fentanyl 50mcg, midazolam 2mg, propofol 60mg,
furosemide 20mg, and 4L IVF. Post-op in the PACU he was noted to
have back pain and some agitation and was given 4 mg of haldol,
100mg of neurontin, followed by total of 4mg of morphine for his
back pain. He also developed hypotension to the 70s/50s and
dyspnea. He was bolused another liter of NS and started on
pressors with neosynephrine. He was noted to have atrial
fibrilation with RVR to 140s. An abg showed pH 7.24 and pCO2 42
O2 78. He was evaluated by and transferred to the MICU.
.
Overnight in the MICU the patient was noted to develop a lactic
acidosis of 3.5 --> 11.3. He developed worsened respiratory
failure and was intubated. His pressors were changed to levophed
and vasopressin. Initially he was on propofol and he was
switched to fent/versed for concern for possible propofol
infusion syndrome though it was thought to be unlikely. He had a
brief episode of monomorphic V tach and then later had
polymorphic vtach. He was given Mg and started on amiodarone 150
mg bolus x 2 and 0.5 mg/hr drip. A stat bedside echo showed
regional hypokinesis and EF 40% but no pericardial effusion.
Lenis were attempted, but were aborted due to instability? It
was thought that his hypotension and lactic acidosis were due to
hypovolemia from a retroperitoneal or GI bleed. CT surgery was
called and a CT abdomen was obtained which did not show evidence
of bleed. Infection was in the differential due to elevated WBC,
but this was thought to be less likely. He was pan cultured and
antibiotics were initially held, but then vanc, cefepime, flagyl
were started along with one dose of stress dose steroids.
.
On the morning of transfer, he was started on CVVH for likely
volume overload in the setting of poor oxygenation requiring
fio2 100% and high PEEP. On evaluation, he is intubated and
sedated, lying comfortably in bed.


Past Medical History:
* PAF s/p 7 CV (most recent CV [**3-13**]) not on warfarin given prior
GIB
* CAD s/p CABG [**2154**] Medical Center
* ESRD on HD s/p left AV fistula
-- on HD MWF, access tunneled line
* HTN
* Hyperlipidemia
* Hypothyroidism
* Abdominal hernia
* Renal carcinoma s/p radiofrequency ablation [**2150**], [**2-/2151**] and

[**10/2151**], and
* AAA repair [**6-/2146**]
* Epistaxis requiring packing x 2 in the past year
* Post-polypectomy GIB [**2151**]
* s/p right CEA [**4-/2145**]
* s/p appendectomy [**2131**]
* GERD
.


Social History:
Married. ETOH: [**3-6**] glasses of wine/week, no smoking.

Family History:
 non-contributory

Physical Exam:
Vitals 98.6 125 113/68 17 98% on cmv, fio2 60%, peep 15, vt 600

General: intubated, sedated
HEENT Anicteric, pupils reactive bilaterally
Neck JVP difficult to assess, no jvd
Pulm ctab, no rales
Chest R sided HD catheter
CV Regular S1 S2 II/VI systolic murmur
Abd Soft absent bowel sounds, firm abdomen
Groins with femoral venous sheaths in place, minimal oozing.
Extrem cool cyanotic feet but palpable DPs.
Neuro sedated


Pertinent Results:
Labs on admission:

CBC
[**2154-5-14**] 09:30PM BLOOD WBC-17.4*# RBC-3.81* Hgb-11.4* Hct-36.2*
MCV-95 MCH-29.9 MCHC-31.4 RDW-18.5* Plt Ct-158

Diff
[**2154-5-15**] 02:43AM BLOOD Neuts-89.4* Lymphs-5.5* Monos-4.3 Eos-0.3
Baso-0.5

Coags
[**2154-5-14**] 09:30PM BLOOD PT-19.0* PTT->150* INR(PT)-1.7*

Chemistry
[**2154-5-14**] 09:30PM BLOOD Glucose-88 UreaN-59* Creat-5.2* Na-141
K-4.6 Cl-104 HCO3-20* AnGap-22*

LFTs
[**2154-5-15**] 02:43AM BLOOD ALT-846* AST-3204* CK(CPK)-279 AlkPhos-68
TotBili-4.2*
[**2154-5-15**] 01:33PM BLOOD ALT-2576* AST-[**Numeric Identifier **]* LD(LDH)-4450*
CK(CPK)-532* AlkPhos-81 TotBili-5.8*

Cardiac biomarkers
[**2154-5-14**] 09:30PM BLOOD CK-MB-26* MB Indx-16.6* cTropnT-2.13*
[**2154-5-14**] 11:41PM BLOOD CK-MB-36* MB Indx-17.1* cTropnT-3.32*

Other chemistry
[**2154-5-14**] 09:30PM BLOOD Calcium-8.3* Phos-5.7* Mg-2.2
[**2154-5-15**] 02:43AM BLOOD Cortsol-37.0*
[**2154-5-14**] 09:40PM BLOOD Lactate-3.5*
[**2154-5-15**] 03:20AM BLOOD Lactate-10.3*
[**2154-5-15**] 07:04AM BLOOD freeCa-0.96*

[**2154-5-14**] echocardiogram:
The left atrium is markedly dilated. The right atrium is
moderately dilated. There is mild symmetric left ventricular
hypertrophy. Due to suboptimal technical quality, a focal wall
motion abnormality cannot be fully excluded. LV systolic
function appears at least moderately depressed with preserved
basal function. The right ventricular cavity is markedly dilated
with severe global free wall hypokinesis. There is abnormal
diastolic septal motion/position consistent with right
ventricular volume overload. The number of aortic valve leaflets
cannot be determined. Mild (1+) aortic regurgitation is seen.
The mitral valve leaflets are mildly thickened. Mild to moderate
([**2-2**]+) mitral regurgitation is seen. There is a
trivial/physiologic pericardial effusion.
IMPRESSION: Moderate to severely depressed biventricular
systolic function. Limited views in an emergency echo. Mild
aortic regurgitation. Mild to moderate mitral regurgitation.
Trivial pericardial effusion.
.
.
[**2154-5-15**] echocardiogram:
The left atrium is moderately dilated. A pulmonary arteriovenous
malformation is probably present (due to slow accumulation of
bubbles in the right atrium, a patent foramen ovale cannot be
excluded). There is mild symmetric left ventricular hypertrophy.
The left ventricular cavity is moderately dilated. There is
severe regional left ventricular systolic dysfunction with
akinesis/severe hypokinesis of the mid to distal left ventricle
. Overall left ventricular systolic function is severely
depressed (LVEF= 25-30 %). A left ventricular mass/thrombus
cannot be excluded. The right ventricular cavity is moderately
dilated with moderate global free wall hypokinesis. There is
abnormal septal motion/position consistent with right
ventricular pressure/volume overload. The aortic root is mildly
dilated at the sinus level. The ascending aorta is moderately
dilated. The aortic arch is mildly dilated. The aortic valve
leaflets (3) are mildly thickened but aortic stenosis is not
present. Trace aortic regurgitation is seen. The mitral valve
leaflets are mildly thickened. There is no mitral valve
prolapse. Trivial mitral regurgitation is seen. The left
ventricular inflow pattern suggests a restrictive filling
abnormality, with elevated left atrial pressure. The pulmonary
artery systolic pressure could not be determined. There is a
trivial/physiologic pericardial effusion.
IMPRESSION: Severely depressed left ventricular systolic
function. Moderately depressed right ventricle function.
Pulmonary AVM vs PFO is present.
.
Compared with the prior study (images reviewed) of [**2154-5-14**],
left ventricular function is better assessed and the severity of
aortic and mitral regurgitation has decreased.
.
.
[**2154-5-14**] Chest x ray:
IMPRESSION:
Mild edema and bilateral effusions.
.
[**2154-5-15**] CT abdomen:
IMPRESSION:
1. Apparent wall thickening of the ascending colon and
transverse colon may be secondary to vascular congestion-heart
failure, under-distension or
colitis. Evaluation is limited due to lack of oral contrast.
Ischemic etiology cannot be excluded, however is less likely due
to lack of distention of the bowel.
2. Right heart strain. Severe atherosclerotic calcifications of
Aorta, celiac trunk and SMA, however, appear proximally patent.
The abdominal aorta is diffusely aneurysmally dilated up to
about 3.8 cm.
3. Bilateral moderate pleural effusions and partial collapse of
the left
lower lobe, and almost complete collapse of the right lower
lobe.
4. Moderate intra-abdominal and pelvic free fluid.
5. Multiple renal hypodensities can be further evaluated with
ultrasound or MRI.
6. Cholelithiasis.

[**2154-5-15**] LENIS:
IMPRESSION:
Severely limited study due to lack of ability to image the
common femoral
veins bilaterally due to intravenous catheters. Normal
compressibility of
bilateral superficial femoral and popliteal veins. Lack of
identification of DVT in no way excludes PE.


Brief Hospital Course:
Mr. [**Known lastname 1637**] is a 71M with coronary artery disease status post
CABG, end stage renal disease on hemodialysis, AAA s/p repair,
atrial fibrilation who underwent elective pulmonary vein
isolation on [**2154-5-14**] and subsequently developed hypotension and
shock.

# Hypotension/shock: The patient's hypotension was likely caused
by cardigenic shock in the setting of fluid overload from
peri-procedure IV fluids during his pulmonary vein isolation.
The most likely trigger was a periprocedure ischemic event. The
patient is on HD and likely was not able to tolerate the 5
liters of IV fluids.  This caused him to have decompensated
heart failure which was transferred to the MICU post-procedure
for hypotension, and is now transferred to the CCU for further
management of likely cardiogenic shock.

Unclear etiology. Differential diagnosis included cardiogenic
shock possibly from MI, PE, or decompensated CHF in the setting
of volume overload. No evidence of hemorrhage with stable Hct
and no tamponade on echo. Septic shock also in the differential,
but the rapid onset and temporal relation to post op make this
less likely. Episodes of poly and monoporphic Vtach and
increasing troponin lead one to cardiogenic shock due to
ischemic event. Tachycardia and hypoxia in setting of recent
surgery indicate possible PE.
- continued cvvh at 150 cc/hr fluid removal
- cycled enzymes which started to trend down
- continued levophed/vasporessin
- continued vanc/zosyn for emperic coverage for sepsis
- f/u blood, urine, and urine cx which remained without growth
.
# Tachycardia: Had multiple episodes of monomorphic and
polymorphic VT overnight thought secondary to [**3-5**] ischemia,
given magnesium and started on amiodarone. Currently having
tachycardia, unclear if sinus tach or a fib with abberency.
- continued amio gtt
- EP recs
- trended cardiac enzymes, which were trending down
.
# Metabolic acidosis: Secondary to profoundly elevated lactate
in setting of hypoperfusion and now drifting downward. Abd CT
neg for bowel ischemia and Dr. [**Last Name (STitle) **] following.
- trendd lacate with ABGs which were resolving
- would empirically start thiamine
- med review for agents associated with lactic acidosis
- surgery reccs--did not feel patient has indication for
surgical procedure
.
# Respiratory failure: Likely primarily secondary to volume
overload/pulmonary edema. Oxygenation improving with diuresis
with CVVH. Would also consider PE with INR 1.7 on admission, not
on coumadin b/c of GI bleeds.
- management of heart failure as above
- continued to wean vent settings
- will continue hyperventilation to assist acid-base status
- pt was extubated on [**2154-5-17**] successfully and hypoxia seemed to
improve
.
# Gastroparesis: No bowel sounds. NG lavage revealed stagnant
gastric contents. Medications not likely to be absorbed PO right
now. Pt likely with an ileus in setting of shock.
-- NPO including medications
.
# CAD s/p CABG: holding bb, cont statin, cont asa
.
# Afib: Currently in afib and s/p PVI on [**2154-5-14**] with
complications as described above.
- continued aspirin, amio
- Patient not anticoagulated given history of GIB
.
# ESRD on HD:
- Continue phoslo and nephrocaps (when able to take PO)
- continued cvvh, stopped on Saturday as seemed that pt achieved
relative [**Name (NI) 52753**]
.
# Hypothyroid
- Held levothyroxine as pt was NPO

# Altered mental status: Improving. Thought to be secondary to
weaning of sedation medications now s/p extubation, ICU
delirium, hyponatremia (new).  Pt received zyprexa on the night
of [**2154-5-18**] with little effect. Pt was placed in 4 point
restraints for protection.
- continued soft restraints until improves
- Infectious work up

# elevated liver enzymes: improvement given improving INR.
likely shock liver from poor perfusion.
- held statin
- watched for encephalopath
- monitor INR - started to downtrend
- RUQ U/S planned and zosyn DC'd given rising bili

CODE BLUE on [**2154-5-19**]:

Patient was undergoing a KUB to assess his abdominal pain,
during this film the patient became unresponsive and pulseless
with electrical activity. CPR was immediately initiated with
several rounds of epinephrine and bicarbonate given. The patient
regained his pulse 3 times and each time lost his pulse and went
into PEA. The patient at one point had a wide complex
tachycardia and was shocked to no affect. The patient was
started on a dopamine and epinephrine drip in addition to his
vasopressin and norepinephrine. The patient also received
heparin bolus + gtt for empiric PE tx, bicarb for empiric
acidosis and hyperkalemia tx, empiric insulin/glucagon/calcium
for empiric hyperkalemia treatment. EKG revealed ST elevations
in aVR and V1, V2 consistent with global ischemia. Code STEMI
was called and pt was to be taken to the cath lab until he lost
his pulse again. No reversible cause could be identified. After
the third set of CPR of nearly 60 minutes of a code, the patient
remained pulseless and the code was called as it was deemed that
there was no hope for recovery. The patient expired at 11:55am
on [**2154-5-19**].

Medications on Admission:
Medications per OMR
Allopurinol 100mg [**Hospital1 **]
Amiodarone 200mg daily
Atorvastatin 20mg daily
Nephrocaps 1 tab daily
Phoslo 667mg TID
Fenofibrate 48mg [**Hospital1 **]
Furosemide 40mg [**Hospital1 **]
Levothyroxine 75mcg daily
Omeprazole 40mg daily


Discharge Medications:
Expired

Discharge Disposition:
Expired

Discharge Diagnosis:
Expired

Discharge Condition:
Expired

Discharge Instructions:
Expired

Followup Instructions:
Expired


Completed by:[**2154-5-19**]
{'Atrial fibrillation,End stage renal disease,Acute myocardial infarction of unspecified site, initial episode of care,Acute edema of lung, unspecified,Acute and subacute necrosis of liver,Acidosis,Paralytic ileus,Delirium due to conditions classified elsewhere,Hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage V or end stage renal disease,Cardiac complications, not elsewhere classified,Cardiogenic shock,Coronary atherosclerosis of unspecified type of vessel, native or graft,Gastroparesis,Unspecified acquired hypothyroidism,Other and unspecified hyperlipidemia,Esophageal reflux,Backache, unspecified,Other chronic pain,Personal history of malignant neoplasm of kidney,Personal history of colonic polyps,Aortocoronary bypass status,Other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure'}


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: elective pulmonary vein isolation, transferred to the MICU then
the CCU for cardiogenic shock

PRESENT ILLNESS: Mr. [**Known lastname 1637**] is a 71 YOM with atrial fibrilation s/p 7
cardioversions (the last in [**3-13**]) who presented for elective
pulmonary vein isolation on [**2154-4-13**]. He has a past medical
history significant for CABG, ESRD on HD, RCC s/p ablation,
repaired AAA, and previous GIB contraindicating anticoagulation
for his a fib.
.
He underwent successful elective transeptal pulmonary venous
isolation and was cardioverted in to NSR. During the procedure
he was given fentanyl 50mcg, midazolam 2mg, propofol 60mg,
furosemide 20mg, and 4L IVF. Post-op in the PACU he was noted to
have back pain and some agitation and was given 4 mg of haldol,
100mg of neurontin, followed by total of 4mg of morphine for his
back pain. He also developed hypotension to the 70s/50s and
dyspnea. He was bolused another liter of NS and started on
pressors with neosynephrine. He was noted to have atrial
fibrilation with RVR to 140s. An abg showed pH 7.24 and pCO2 42
O2 78. He was evaluated by and transferred to the MICU.
.
Overnight in the MICU the patient was noted to develop a lactic
acidosis of 3.5 --> 11.3. He developed worsened respiratory
failure and was intubated. His pressors were changed to levophed
and vasopressin. Initially he was on propofol and he was
switched to fent/versed for concern for possible propofol
infusion syndrome though it was thought to be unlikely. He had a
brief episode of monomorphic V tach and then later had
polymorphic vtach. He was given Mg and started on amiodarone 150
mg bolus x 2 and 0.5 mg/hr drip. A stat bedside echo showed
regional hypokinesis and EF 40% but no pericardial effusion.
Lenis were attempted, but were aborted due to instability? It
was thought that his hypotension and lactic acidosis were due to
hypovolemia from a retroperitoneal or GI bleed. CT surgery was
called and a CT abdomen was obtained which did not show evidence
of bleed. Infection was in the differential due to elevated WBC,
but this was thought to be less likely. He was pan cultured and
antibiotics were initially held, but then vanc, cefepime, flagyl
were started along with one dose of stress dose steroids.
.
On the morning of transfer, he was started on CVVH for likely
volume overload in the setting of poor oxygenation requiring
fio2 100% and high PEEP. On evaluation, he is intubated and
sedated, lying comfortably in bed.

MEDICAL HISTORY: * PAF s/p 7 CV (most recent CV [**3-13**]) not on warfarin given prior
GIB
* CAD s/p CABG [**2154**] Medical Center
* ESRD on HD s/p left AV fistula
-- on HD MWF, access tunneled line
* HTN
* Hyperlipidemia
* Hypothyroidism
* Abdominal hernia
* Renal carcinoma s/p radiofrequency ablation [**2150**], [**2-/2151**] and

MEDICATION ON ADMISSION: Medications per OMR
Allopurinol 100mg [**Hospital1 **]
Amiodarone 200mg daily
Atorvastatin 20mg daily
Nephrocaps 1 tab daily
Phoslo 667mg TID
Fenofibrate 48mg [**Hospital1 **]
Furosemide 40mg [**Hospital1 **]
Levothyroxine 75mcg daily
Omeprazole 40mg daily

ALLERGIES: Percocet

PHYSICAL EXAM: Vitals 98.6 125 113/68 17 98% on cmv, fio2 60%, peep 15, vt 600

FAMILY HISTORY: non-contributory

SOCIAL HISTORY: Married. ETOH: [**3-6**] glasses of wine/week, no smoking. 

### Response:
{'Atrial fibrillation,End stage renal disease,Acute myocardial infarction of unspecified site, initial episode of care,Acute edema of lung, unspecified,Acute and subacute necrosis of liver,Acidosis,Paralytic ileus,Delirium due to conditions classified elsewhere,Hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage V or end stage renal disease,Cardiac complications, not elsewhere classified,Cardiogenic shock,Coronary atherosclerosis of unspecified type of vessel, native or graft,Gastroparesis,Unspecified acquired hypothyroidism,Other and unspecified hyperlipidemia,Esophageal reflux,Backache, unspecified,Other chronic pain,Personal history of malignant neoplasm of kidney,Personal history of colonic polyps,Aortocoronary bypass status,Other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure'}
