CHIEF COMPLAINT: exertional angina, SOB, dizziness

PRESENT ILLNESS: 78 yo female with known AS, now presents with angina and DOE.
Referred for cardiac cath during prior admission in [**5-7**]. Cath
showed LAD 40%, Diag1 and Diag 2 50%, 50-70% CX, [**Location (un) 109**] 0.7cm2.
Prior echo showed EF 60-70%, peak grad 134,[**Location (un) 109**] 0.5cm2, [**1-3**]+ AI,
no MR/TR. Referred for AVR to Dr. [**Last Name (STitle) **].

MEDICAL HISTORY: HTN
dyslipidemia
GERD
osteoporosis
cataracts
bladder prolapse
AS/AI
recent fall
left inguinal hernia
right adnexal cyst
s/p "abdominal suspension" [**2088**]'s
hemorrhoidectomy
remote breast implants
? Spigelian hernia

MEDICATION ON ADMISSION: [**Doctor First Name 130**] 180 mg daily
omeprazole 40 mg daily
nifedical 60 mg daily
HCTZ 25mg daily
caltrate 600 mg [**Hospital1 **]
lipitor 10 mg daily

ALLERGIES: Lisinopril / Diovan / Latex

PHYSICAL EXAM: HR 80  RR 19  127/94   5'0"   61.7 kg
NAD
skin/HEENT unremarkable
neck full ROM with positive carotid bruits
CTAB
RRR 3/6 SEM at LSB
abd soft, NT
extrems well-perfused, warm, no varicosities,no edema
neuro grossly intact
2+ fems/DP/radials
NP[**MD Number(3) **] PT/ 1+ left PT

FAMILY HISTORY: mother died of "heart problems" in her 70's

SOCIAL HISTORY: lives with husband who is in rehab post-CABG
occasional ETOH
no tobacco use
Aortic valve disorders,Osteoporosis, unspecified,Esophageal reflux
Aortic valve disorder,Osteoporosis NOS,Esophageal reflux
Admission Date:  [**2135-6-13**]              Discharge Date:   [**2135-6-18**]

Date of Birth:  [**2057-4-25**]             Sex:   F

Service: CARDIOTHORACIC

Allergies:
Lisinopril / Diovan / Latex

Attending:[**First Name3 (LF) 1505**]
Chief Complaint:
exertional angina, SOB, dizziness

Major Surgical or Invasive Procedure:
[**6-13**] AVR (#19 CE Magna pericardial )/repair of coronary sinus


History of Present Illness:
78 yo female with known AS, now presents with angina and DOE.
Referred for cardiac cath during prior admission in [**5-7**]. Cath
showed LAD 40%, Diag1 and Diag 2 50%, 50-70% CX, [**Location (un) 109**] 0.7cm2.
Prior echo showed EF 60-70%, peak grad 134,[**Location (un) 109**] 0.5cm2, [**1-3**]+ AI,
no MR/TR. Referred for AVR to Dr. [**Last Name (STitle) **].

Past Medical History:
HTN
dyslipidemia
GERD
osteoporosis
cataracts
bladder prolapse
AS/AI
recent fall
left inguinal hernia
right adnexal cyst
s/p "abdominal suspension" [**2088**]'s
hemorrhoidectomy
remote breast implants
? Spigelian hernia

Social History:
lives with husband who is in rehab post-CABG
occasional ETOH
no tobacco use

Family History:
mother died of "heart problems" in her 70's

Physical Exam:
HR 80  RR 19  127/94   5'0"   61.7 kg
NAD
skin/HEENT unremarkable
neck full ROM with positive carotid bruits
CTAB
RRR 3/6 SEM at LSB
abd soft, NT
extrems well-perfused, warm, no varicosities,no edema
neuro grossly intact
2+ fems/DP/radials
NP[**MD Number(3) **] PT/ 1+ left PT

Pertinent Results:
[**2135-6-16**] 01:00PM BLOOD WBC-13.3* RBC-3.57* Hgb-11.3* Hct-31.5*
MCV-88 MCH-31.6 MCHC-35.8* RDW-13.6 Plt Ct-122*
[**2135-6-17**] 06:50AM BLOOD Hct-29.8*
[**2135-6-16**] 01:00PM BLOOD Plt Ct-122*
[**2135-6-15**] 06:45AM BLOOD Glucose-123* UreaN-15 Creat-0.7 Na-142
K-4.3 Cl-103 HCO3-30 AnGap-13
[**2135-6-17**] 06:50AM BLOOD K-4.5
[**2135-6-15**] 06:45AM BLOOD Mg-2.0

FINAL REPORT


HISTORY: Frequent dizziness.

Scattered areas of heterogeneous calcific plaque involving both
internal
carotid arteries. The peak systolic velocities bilaterally,
however, are
within normal limits as are the ICA to CCA ratios. There is
antegrade flow
involving both vertebral arteries.

IMPRESSION: Minimal bilateral ICA plaque, no appreciable
associated stenosis,
however.
DR. [**First Name11 (Name Pattern1) 177**] [**Initial (NamePattern1) **] [**Last Name (NamePattern4) 6888**]

FINAL REPORT


INDICATION: Aortic valve replacement.

COMPARISON: [**2135-6-14**].

PA AND LATERAL VIEWS OF THE CHEST: Patient is status post median
sternotomy
and prosthetic aortic valve replacement. Heart is normal sized,
and the
mediastinal and hilar contours are within normal limits. The
pulmonary
vascularity is normal. Increasing small bilateral pleural
effusions are
present with mild bibasilar atelectasis. There is no
pneumothorax. Diffuse
demineralization of the skeletal structures is identified.

IMPRESSION:
1. Increasing small bilateral pleural effusions with mild
bibasilar
atelectasis.
2. No evidence of congestive heart failure.
THE STUDY AND THE REPORT WERE REVIEWED BY THE STAFF RADIOLOGIST.

DR. [**First Name (STitle) **] [**First Name8 (NamePattern2) 8843**] [**Location (un) **]

DR. [**First Name8 (NamePattern2) 4075**] [**Last Name (NamePattern1) 5999**]


Approved: FRI [**2135-6-17**] 7:52 AM
Procedure Date:[**2135-6-16**]

Approved: FRI [**2135-5-27**] 1:11 PM
Procedure Date:[**2135-5-26**]


Brief Hospital Course:
Admitted [**6-13**] and underwent AVR /repair of coronary sinus with
Dr. [**Last Name (STitle) **]. Transferred to the CSRU in stable condition on a
propofol drip.Extubated that evening, and weaned off nipride
drip on POD #1. Swan and chest tubes removed and beta blockade
started. Transferred to the floor that evening to begin to
increase her activity level. Gentle diuresis started on POD #2
and treated for nausea.Pacing wires removed on POD #3. ACE
inhibitor stopped on POD #4 for questionable allergy, and beta
blockade titrated up for better HR and BP management.Cleared for
discharge home with VNA services on POD #5. Pt. to follow up as
per discharge instructions.

Medications on Admission:
[**Doctor First Name 130**] 180 mg daily
omeprazole 40 mg daily
nifedical 60 mg daily
HCTZ 25mg daily
caltrate 600 mg [**Hospital1 **]
lipitor 10 mg daily

Discharge Medications:
1. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2
times a day).
Disp:*60 Capsule(s)* Refills:*0*
2. Atorvastatin 10 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
Disp:*30 Tablet(s)* Refills:*0*
3. Aspirin 81 mg Tablet, Delayed Release (E.C.) Sig: One (1)
Tablet, Delayed Release (E.C.) PO DAILY (Daily).
Disp:*30 Tablet, Delayed Release (E.C.)(s)* Refills:*0*
4. Acetaminophen-Codeine 300-30 mg Tablet Sig: One (1) Tablet PO
Q4H (every 4 hours) as needed.
Disp:*40 Tablet(s)* Refills:*0*
5. Metoprolol Tartrate 25 mg Tablet Sig: Three (3) Tablet PO BID
(2 times a day).
Disp:*180 Tablet(s)* Refills:*0*
6. Omeprazole 20 mg Capsule, Delayed Release(E.C.) Sig: One (1)
Capsule, Delayed Release(E.C.) PO once a day.
Disp:*30 Capsule, Delayed Release(E.C.)(s)* Refills:*0*
7. Potassium Chloride 20 mEq Packet Sig: One (1) Packet PO Q12H
(every 12 hours) for 10 days.
Disp:*20 Packet(s)* Refills:*0*
8. Furosemide 40 mg Tablet Sig: One (1) Tablet PO Q12H (every 12
hours) for 10 days.
Disp:*20 Tablet(s)* Refills:*0*


Discharge Disposition:
Home With Service

Facility:
[**Hospital 2255**] [**Name (NI) 2256**]

Discharge Diagnosis:
AS
HTN
hyperlipidemia
GERD
osteoporosis
cataracts
bladder prolapse
L inguinal hernia
r adrenal cyst
abdominal resuspension
hemorrhoid repair
breast implant


Discharge Condition:
Good.


Discharge Instructions:
Call with fever, redness or drainage from incision or weight
gain more than 2 pounds in one day or five in one week.
No lifting more than 10 pounds or driving until follow up with
surgeon.
Shower, no baths, no lotions, creams or powders to incisions.

Followup Instructions:
Dr. [**Last Name (STitle) **] 4 weeks
Dr. [**Last Name (STitle) 1683**] 2 weeks



Completed by:[**2135-7-14**]
{'Aortic valve disorders,Osteoporosis, unspecified,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: exertional angina, SOB, dizziness

PRESENT ILLNESS: 78 yo female with known AS, now presents with angina and DOE.
Referred for cardiac cath during prior admission in [**5-7**]. Cath
showed LAD 40%, Diag1 and Diag 2 50%, 50-70% CX, [**Location (un) 109**] 0.7cm2.
Prior echo showed EF 60-70%, peak grad 134,[**Location (un) 109**] 0.5cm2, [**1-3**]+ AI,
no MR/TR. Referred for AVR to Dr. [**Last Name (STitle) **].

MEDICAL HISTORY: HTN
dyslipidemia
GERD
osteoporosis
cataracts
bladder prolapse
AS/AI
recent fall
left inguinal hernia
right adnexal cyst
s/p "abdominal suspension" [**2088**]'s
hemorrhoidectomy
remote breast implants
? Spigelian hernia

MEDICATION ON ADMISSION: [**Doctor First Name 130**] 180 mg daily
omeprazole 40 mg daily
nifedical 60 mg daily
HCTZ 25mg daily
caltrate 600 mg [**Hospital1 **]
lipitor 10 mg daily

ALLERGIES: Lisinopril / Diovan / Latex

PHYSICAL EXAM: HR 80  RR 19  127/94   5'0"   61.7 kg
NAD
skin/HEENT unremarkable
neck full ROM with positive carotid bruits
CTAB
RRR 3/6 SEM at LSB
abd soft, NT
extrems well-perfused, warm, no varicosities,no edema
neuro grossly intact
2+ fems/DP/radials
NP[**MD Number(3) **] PT/ 1+ left PT

FAMILY HISTORY: mother died of "heart problems" in her 70's

SOCIAL HISTORY: lives with husband who is in rehab post-CABG
occasional ETOH
no tobacco use 

### Response:
{'Aortic valve disorders,Osteoporosis, unspecified,Esophageal reflux'}
