CHIEF COMPLAINT: 

PRESENT ILLNESS: This is an 89-year-old
Russian woman with coronary artery disease, hypertension, and
dementia, who was observed sometime between noon and 1 p.m.
to become unresponsive with eyes deviating to the left.  The
[**Hospital3 **] Staff stated that she was in her usual
She was evaluated at 3 p.m. by the on-call physician, [**Name10 (NameIs) 1023**]
found the blood pressure of 146/84.  She was transferred and
arrived to [**Hospital1 69**] at 4 p.m.

MEDICAL HISTORY: 1.  Hypertension.
2.  Coronary artery disease.
4.  Osteoarthritis.
5.  Osteoporosis.

MEDICATION ON ADMISSION: 1.  Aricept 5 mg q.h.s.
2.  Atenolol 25 q.d.
3.  Lasix 20 q.d.
4.  Isordil 10 t.i.d.

ALLERGIES: The patient has no known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: The patient was living at [**Hospital3 1761**] and born in the [**Location (un) 3156**].  The patient worked
as a secretary and a tailor.
Cerebral artery occlusion, unspecified with cerebral infarction,Unspecified essential hypertension,Coronary atherosclerosis of native coronary artery,Other persistent mental disorders due to conditions classified elsewhere,Osteoporosis, unspecified
Crbl art ocl NOS w infrc,Hypertension NOS,Crnry athrscl natve vssl,Mental disor NEC oth dis,Osteoporosis NOS
Admission Date:                   Discharge Date:

Date of Birth:                    Sex:

Service: Neurology
HISTORY OF THE PRESENT ILLNESS:  This is an 89-year-old
Russian woman with coronary artery disease, hypertension, and
dementia, who was observed sometime between noon and 1 p.m.
to become unresponsive with eyes deviating to the left.  The
[**Hospital3 **] Staff stated that she was in her usual
She was evaluated at 3 p.m. by the on-call physician, [**Name10 (NameIs) 1023**]
found the blood pressure of 146/84.  She was transferred and
arrived to [**Hospital1 69**] at 4 p.m.

PAST MEDICAL HISTORY:
1.  Hypertension.
2.  Coronary artery disease.
4.  Osteoarthritis.
5.  Osteoporosis.

MEDICATIONS ON ADMISSION:
1.  Aricept 5 mg q.h.s.
2.  Atenolol 25 q.d.
3.  Lasix 20 q.d.
4.  Isordil 10 t.i.d.

ALLERGIES:  The patient has no known drug allergies.

SOCIAL HISTORY:  The patient was living at [**Hospital3 1761**] and born in the [**Location (un) 3156**].  The patient worked
as a secretary and a tailor.

PHYSICAL EXAMINATION:  On physical examination, initially in
the ED, the blood pressure was 260/diastolic of 103.  Heart
rate 88.  On neurological examination, the patient was awake,
moving all extremities, responds to her name by looking at
the examiner.  She grumbles and withdraws to pain, but,
otherwise, she does not answer questions when spoken to in
Russian.  She is not following commands in Russian.  Pupils
are reactive.  Left gaze preference.  Visual fields were full
to confrontation, grossly; decreased right nasolabial folds.
Toe was upgoing on the right.

LABORATORY DATA:  Laboratory studies revealed the following:
White blood cell count 8.6, hematocrit 38.9, platelet count
279, sodium 141, potassium 4.3, chloride 104, bicarbonate 27,
BUN 18, creatinine 0.8.  Glucose 90.  INR 1.0.  Urinalysis
positive nitrites, 6 to 10 WBCs, 3 to 5 epithelial cells.

HOSPITAL COURSE:  She had a stat MRI with MRA as well.  The
MRI showed a stroke in the left MCA superior division; no
hemorrhage.  MRA quality was poor, but M1 appeared patent.
As there was no definite time for onset of stroke and the
patient appeared to be outside the 3 hour time window, TPA could
not be given.

She was admitted to the ICU for neurological checks since she
had a high risk of swelling and edema from the stroke.  She
was put on a nitrite drip for blood-pressure control at that
time.  She was also ruled out for MI.

Overnight, in the unit, she did well with regard to
blood pressure control.  Vital signs remained stable.  On the
following day she was transferred to the floor.  Upon
transfer to the floor, she had a carotid study done, which
showed minimal plaque and no appreciable stenosis.  NG tube
was placed.  She was continued on aspirin, Aricept, and
Lopressor 25 mg p.o. b.i.d.  She had a TTE to evaluate her
cardiac status.  The TTE showed a left atrium size normal,
left ventricular wall thickness and cavity size normal, mild
hypokinesis of the inferior free wall with overall well-
preserved ejection fraction of 60%.  The RV chamber size and
free-wall motion are normal.  The aortic valve leaflets are
mildly thickened.  There was no aortic valve stenosis; mild
aortic regurgitation.  The mitral valve leaflets are mildly
thickened.  The tricuspid valve leaflets are mildly
thickened.  Moderate pulmonary artery systolic hypertension,
no pericardiac effusion.  No atrial or ventricular septal
defects seen on color-flow imaging.  No mass, thrombus, or
vegetation seen.

Urine culture, from the initial UTI came back with no growth.
Thus, the Cipro, which was started, was stopped.  The Foley
was discontinued.  The patient actually discontinued her NG
tube, but she was able to swallow on a bed-side evaluation
thin liquids.  She will have a speech and swallow evaluation
prior to discharge.  In addition, Captopril was added to her
anti-hypertensive regimen with good blood pressure control.














DISCHARGE MEDICATIONS:
1.  Aspirin 325.
2.  Lopressor 25 mg.
3.  Zantac 150 mg b.i.d.
4.  Captopril 25 mg t.i.d.
5.  Heparin 5000 units subcutaneously.




                            DR.[**Last Name (STitle) **],[**First Name3 (LF) **] 13-279


Dictated By:[**Last Name (NamePattern1) 8853**]
MEDQUIST36

D:  [**2105-1-7**]  11:55
T:  [**2105-1-7**]  13:01
JOB#:  [**Job Number **]
{'Cerebral artery occlusion, unspecified with cerebral infarction,Unspecified essential hypertension,Coronary atherosclerosis of native coronary artery,Other persistent mental disorders due to conditions classified elsewhere,Osteoporosis, unspecified'}


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 an 89-year-old
Russian woman with coronary artery disease, hypertension, and
dementia, who was observed sometime between noon and 1 p.m.
to become unresponsive with eyes deviating to the left.  The
[**Hospital3 **] Staff stated that she was in her usual
She was evaluated at 3 p.m. by the on-call physician, [**Name10 (NameIs) 1023**]
found the blood pressure of 146/84.  She was transferred and
arrived to [**Hospital1 69**] at 4 p.m.

MEDICAL HISTORY: 1.  Hypertension.
2.  Coronary artery disease.
4.  Osteoarthritis.
5.  Osteoporosis.

MEDICATION ON ADMISSION: 1.  Aricept 5 mg q.h.s.
2.  Atenolol 25 q.d.
3.  Lasix 20 q.d.
4.  Isordil 10 t.i.d.

ALLERGIES: The patient has no known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: The patient was living at [**Hospital3 1761**] and born in the [**Location (un) 3156**].  The patient worked
as a secretary and a tailor. 

### Response:
{'Cerebral artery occlusion, unspecified with cerebral infarction,Unspecified essential hypertension,Coronary atherosclerosis of native coronary artery,Other persistent mental disorders due to conditions classified elsewhere,Osteoporosis, unspecified'}
