CHIEF COMPLAINT: 

PRESENT ILLNESS: This 53 year old male has a
history of type A aortic dissection and is status post AVR
and descending aorta replacement on [**2114-5-12**].  The surgery was
complicated by post-op bleeding and reexploration and post-op
a-fib.  He was discharged home on [**2114-5-21**].  Now patient
reports near syncopal episodes times two, one the night prior
to admission and one the morning of admission.  He describes
eyes crossing.  He denies double vision or amaurosis fugax.
He also states he felt lightheaded near passing out.  He
denies loss of consciousness, chest pain, shortness of
breath, nausea, vomiting, weakness, numbness or abdominal
pain.

MEDICAL HISTORY: Significant for type A aortic
dissection.  History of hypertension.  History of atrial
fibrillation.  Status post AVR with a #25 St. Jude valve and
ascending aorta replacement on [**2114-5-12**].  Status post right
inguinal hernia repair.

MEDICATION ON ADMISSION: Lopressor 100 mg p.o. b.i.d.,
Cozaar 25 mg p.o. q.day, amiodarone 200 mg p.o. q.day,
Coumadin 1.25 mg on [**5-31**] and 2.5 on [**6-1**], aspirin 81 mg p.o.
q.day, Percocet p.r.n.

ALLERGIES: No known allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: 
Dissection of aorta, abdominal,Atrial fibrillation,Stricture of artery,Heart valve replaced by other means,Unspecified essential hypertension
Dsct of abdominal aorta,Atrial fibrillation,Stricture of artery,Heart valve replac NEC,Hypertension NOS
Admission Date:  [**2114-6-2**]       Discharge Date:  [**2114-6-7**]

Date of Birth:   [**2061-2-13**]       Sex:  M

Service:

HISTORY OF PRESENT ILLNESS:  This 53 year old male has a
history of type A aortic dissection and is status post AVR
and descending aorta replacement on [**2114-5-12**].  The surgery was
complicated by post-op bleeding and reexploration and post-op
a-fib.  He was discharged home on [**2114-5-21**].  Now patient
reports near syncopal episodes times two, one the night prior
to admission and one the morning of admission.  He describes
eyes crossing.  He denies double vision or amaurosis fugax.
He also states he felt lightheaded near passing out.  He
denies loss of consciousness, chest pain, shortness of
breath, nausea, vomiting, weakness, numbness or abdominal
pain.

PAST MEDICAL HISTORY:  Significant for type A aortic
dissection.  History of hypertension.  History of atrial
fibrillation.  Status post AVR with a #25 St. Jude valve and
ascending aorta replacement on [**2114-5-12**].  Status post right
inguinal hernia repair.

ALLERGIES:  No known allergies.

MEDICATIONS ON ADMISSION:  Lopressor 100 mg p.o. b.i.d.,
Cozaar 25 mg p.o. q.day, amiodarone 200 mg p.o. q.day,
Coumadin 1.25 mg on [**5-31**] and 2.5 on [**6-1**], aspirin 81 mg p.o.
q.day, Percocet p.r.n.

REVIEW OF SYSTEMS:  As above.

PHYSICAL EXAMINATION:  Vital signs were temperature 98.4,
heart rate 71, blood pressure 126/65, room air sat 98%.  In
general, well-developed, well-nourished white male in no
apparent distress.  HEENT exam normocephalic, atraumatic.
Extraocular movements intact.  Oropharynx benign.  Neck was
soft, supple, full range of motion, no lymphadenopathy or
thyromegaly.  Carotids 2+ and equal bilaterally with
radiation of a systolic murmur bilaterally.  Lungs were clear
to auscultation and percussion.  Cardiovascular exam regular
rate and rhythm, normal S1, S2, with no murmurs, gallops or
rubs.  Abdomen soft, nontender with positive bowel sounds, no
masses or hepatosplenomegaly.  Extremities were without
cyanosis, clubbing or edema.  Pulses were 1+ and equal
bilaterally throughout.  Neuro exam was nonfocal.

HOSPITAL COURSE:  The patient was admitted to the CSRU.
Neurology was consulted.  He was ruled out for an MI.
Neurology recommended imaging of his carotids and MRI and
MRA.  CT was negative.  MRI/MRA showed normal blood flow
through both common carotid arteries through the bifurcation
of the internal and external branches and both vertebral
arteries demonstrate normal flow signal as well.  There is no
evidence of significant stenosis or aneurysmal dilatation.
Carotid study showed no plaque or dissection.  Patient
underwent angiography on [**6-5**] which revealed a large
dissection distally from the repair with a false lumen of 70%
of the overall aortic vessel after the arch.  The DCA has an
original dissection with obliteration of the TL80 and the
left common carotid artery has a dissection of 60% to 70% of
the total lumen.  The brachial cephalic artery was stented
successfully and it was felt he should be reevaluated in one
to two months for question of treatment of the left common
carotid artery.

The patient was anticoagulated on heparin and Coumadin.  On
hospital day five his INR was 2 and he was discharged to home
in stable condition.

Labs on discharge included white count 5000, hematocrit 27.6,
platelets 245,000.  Sodium 139, potassium 4.2, chloride 107,
CO2 22, BUN 6, creatinine 0.9, blood sugar 94.  INR 2.

DISCHARGE MEDICATIONS:
1.  Lopressor 75 mg p.o. b.i.d.
2.  Amiodarone 200 mg p.o. q.day.
3.  Aspirin 81 mg p.o. q.day.
4.  Coumadin 2 mg p.o. tonight and then as per Dr. [**Last Name (STitle) 31072**] for
INR of 2.5 to 3.

FOLLOWUP:  The patient will be seen by Dr. [**Last Name (STitle) **] in one to
two weeks and have his coags drawn on Monday, Wednesday,
Friday.  He will see Dr. [**First Name (STitle) **] in one to two months.
Mr. [**Known lastname 7739**] should have a CT scan of the chest and abdomen
each 6 months to evaluate the progression, if any, of the
dissection. He should contract Dr [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **] if he has any
questions or problems.





                            [**First Name11 (Name Pattern1) 1112**] [**Last Name (NamePattern1) **], M.D.  [**MD Number(1) 3113**]

Dictated By:[**Last Name (NamePattern1) 3116**]
MEDQUIST36

D:  [**2114-6-7**]  13:56
T:  [**2114-6-7**]  15:16
JOB#:  [**Job Number 48077**]
{'Dissection of aorta, abdominal,Atrial fibrillation,Stricture of artery,Heart valve replaced by other means,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: 

PRESENT ILLNESS: This 53 year old male has a
history of type A aortic dissection and is status post AVR
and descending aorta replacement on [**2114-5-12**].  The surgery was
complicated by post-op bleeding and reexploration and post-op
a-fib.  He was discharged home on [**2114-5-21**].  Now patient
reports near syncopal episodes times two, one the night prior
to admission and one the morning of admission.  He describes
eyes crossing.  He denies double vision or amaurosis fugax.
He also states he felt lightheaded near passing out.  He
denies loss of consciousness, chest pain, shortness of
breath, nausea, vomiting, weakness, numbness or abdominal
pain.

MEDICAL HISTORY: Significant for type A aortic
dissection.  History of hypertension.  History of atrial
fibrillation.  Status post AVR with a #25 St. Jude valve and
ascending aorta replacement on [**2114-5-12**].  Status post right
inguinal hernia repair.

MEDICATION ON ADMISSION: Lopressor 100 mg p.o. b.i.d.,
Cozaar 25 mg p.o. q.day, amiodarone 200 mg p.o. q.day,
Coumadin 1.25 mg on [**5-31**] and 2.5 on [**6-1**], aspirin 81 mg p.o.
q.day, Percocet p.r.n.

ALLERGIES: No known allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY:  

### Response:
{'Dissection of aorta, abdominal,Atrial fibrillation,Stricture of artery,Heart valve replaced by other means,Unspecified essential hypertension'}
