CHIEF COMPLAINT: Abdominal aortic aneurysm.

PRESENT ILLNESS: The patient has been followed
for his abdominal aneurysm and reported onset of abdominal
and back pain. Patient is now admitted for elective abdominal
aortic aneurysm repair and iliac aneurysm repair on the left.

MEDICAL HISTORY: Ischemic heart disease, stable angina,
status post angioplasty in [**2131**], cardiac stress [**2141-7-21**]
showed a fixed inferior septal defect with an ejection
fraction of 50%, dyspnea with one flight of stairs. History
of hiatal hernia. History of right index finger ischemia
secondary to embolus source - unknown. Status post tissue
Plasminogen Activator.

MEDICATION ON ADMISSION: 

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: Significant for current use of tobacco
within the last month. Patient smokes one to two packs per
day for 40 years. Does admit to alcohol 2 to 3 drinks per
day.
Abdominal aneurysm without mention of rupture,Pulmonary collapse,Coronary atherosclerosis of native coronary artery,Other iatrogenic hypotension,Other and unspecified angina pectoris,Percutaneous transluminal coronary angioplasty status
Abdom aortic aneurysm,Pulmonary collapse,Crnry athrscl natve vssl,Iatrogenc hypotnsion NEC,Angina pectoris NEC/NOS,Status-post ptca
Admission Date: [**2141-10-12**]        Discharge Date: [**2141-10-19**]

Date of Birth:  [**2078-1-10**]        Sex:  M

Service:  VSU


CHIEF COMPLAINT:  Abdominal aortic aneurysm.

HISTORY OF PRESENT ILLNESS:  The patient has been followed
for his abdominal aneurysm and reported onset of abdominal
and back pain. Patient is now admitted for elective abdominal
aortic aneurysm repair and iliac aneurysm repair on the left.

ALLERGIES:  No known drug allergies.

MEDICATIONS:  Coumadin 5 mg daily, Pepcid 20 mg b.i.d.,
Lipitor 10 mg daily, Lopressor 25 mg b.i.d.

PAST MEDICAL HISTORY:  Ischemic heart disease, stable angina,
status post angioplasty in [**2131**], cardiac stress [**2141-7-21**]
showed a fixed inferior septal defect with an ejection
fraction of 50%, dyspnea with one flight of stairs. History
of hiatal hernia. History of right index finger ischemia
secondary to embolus source - unknown. Status post tissue
Plasminogen Activator.

SOCIAL HISTORY:  Significant for current use of tobacco
within the last month. Patient smokes one to two packs per
day for 40 years. Does admit to alcohol 2 to 3 drinks per
day.

PHYSICAL EXAMINATION:  General appearance: Is in no acute
distress. Head, eyes, ears, nose and throat examination
without bruits. Heart is regular rate and rhythm without
murmur. Lungs with mild wheezing diffusely bilaterally. The
abdomen is soft, nontender. There are no palpable masses or
bruits, no organomegaly. Extremities: Left leg with edema.
All distal pulses are palpable. Toes and fingers are pink,
warm and brisk capillary refill.

HOSPITAL COURSE:  The patient was admitted to the
preoperative holding area on [**2141-10-12**] and underwent
abdominal aortic repair with an 18 x 9 graft and right iliac
repair and a left femoral graft. Patient tolerated the
procedure and was transferred intubated to the post
anesthesia care unit. He remained intubated secondary to
bilateral lower lobe collapse. His postoperative hematocrit
was 32.0. He remained on Neo-Synephrine drip, maintained his
blood pressure greater than 120. Epidural was placed for
analgesic control intraoperatively. Patient remained in the
post anesthesia care unit overnight intubated and was
transferred to the surgical intensive care unit for continued
ventilatory support. Blood gases were 7.37, 32, 67, 23 and -
2. Patient still continued to require Neo-Synephrine for
vasopressor support. Patient was extubated on postoperative
day 2. Hematocrit remained stable at 30.1. He had palpable
dorsalis pedis and posterior tibial pulses bilaterally. He
was transferred from the thoracic intensive care to Far 9
nursing floor for continued postoperative care. Patient was
started on levofloxacin for positive sputum culture which he
received for a total of 5 days. His epidural was
discontinued. Ambulation was begun. Patient's diet was
progressed as tolerated. On postoperative day 4 physical
therapy was requested to see the patient for evaluation of
discharge planning. Patient was seen by social service for
history of tobacco abuse and patient was amenable to starting
a smoking cessation program and nicotine patch 14 mg q day
was started. Patient was instructed on the imperative
importance of no smoking while wearing the patch. The
remaining hospital course was unremarkable and patient was
discharged when medically stable.

DISCHARGE MEDICATIONS:  Warfarin 5 mg q.h.s., acetaminophen
325 to 650 mg q 4 to 6 hours p.r.n., nicotine patch 14 mg
daily, oxycodone/acetaminophen tablets 1 to 2 q 4 to 6 hours
p.r.n. for pain, metoprolol 25 mg b.i.d. emodin 20 mg b.i.d.,
levofloxacin 500 mg q 24 hours for a total of 5 days. This
was started on [**2141-10-15**] and should continue to
[**2141-10-20**]. Opprobrium bromide nebulizer q 6 hours,
albuterol .083% nebulizer q 6 hours p.r.n.

Patient should follow up with Dr. [**Last Name (STitle) 1391**] in 2 weeks time.
[**Month (only) 116**] ambulate essential distances.

DISCHARGE DIAGNOSES:  Abdominal aortic aneurysm with right
iliac extension status post repair.
History of smoking.
Postoperative bilateral basilar lung collapse, resolved.
Postoperative hypotension requiring vasopressor support,
resolved.



                        [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern1) 2380**], [**MD Number(1) 2381**]

Dictated By:[**Last Name (NamePattern1) 2382**]
MEDQUIST36
D:  [**2141-10-17**] 12:39:30
T:  [**2141-10-17**] 13:23:10
Job#:  [**Job Number 106833**]
{'Abdominal aneurysm without mention of rupture,Pulmonary collapse,Coronary atherosclerosis of native coronary artery,Other iatrogenic hypotension,Other and unspecified angina pectoris,Percutaneous transluminal coronary angioplasty status'}


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: Abdominal aortic aneurysm.

PRESENT ILLNESS: The patient has been followed
for his abdominal aneurysm and reported onset of abdominal
and back pain. Patient is now admitted for elective abdominal
aortic aneurysm repair and iliac aneurysm repair on the left.

MEDICAL HISTORY: Ischemic heart disease, stable angina,
status post angioplasty in [**2131**], cardiac stress [**2141-7-21**]
showed a fixed inferior septal defect with an ejection
fraction of 50%, dyspnea with one flight of stairs. History
of hiatal hernia. History of right index finger ischemia
secondary to embolus source - unknown. Status post tissue
Plasminogen Activator.

MEDICATION ON ADMISSION: 

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: Significant for current use of tobacco
within the last month. Patient smokes one to two packs per
day for 40 years. Does admit to alcohol 2 to 3 drinks per
day. 

### Response:
{'Abdominal aneurysm without mention of rupture,Pulmonary collapse,Coronary atherosclerosis of native coronary artery,Other iatrogenic hypotension,Other and unspecified angina pectoris,Percutaneous transluminal coronary angioplasty status'}
