CHIEF COMPLAINT: s/p right mastectomy

PRESENT ILLNESS: 53 yo F dx'd with right breast CA in 1/[**2178**].  Underwent excision
and complete axillary dissection in 2/[**2178**].  After finding
evidence of perineural invasion and extensive lymphatic
invasion, she underwent total mastectomy on [**2178-10-13**].  She
received AC followed by taxol and herceptin as well as
radiation.  However, at week 37 of Herceptin, was found to have
left ventricular EF of 50% and a right EF of 30%. [**Known firstname **] has
chronic fatigue since beginning chemotherapy, although does not
have orthopnea, paroxysma dyspnea, periph edema, or major
dyspnea on exertion.

MEDICAL HISTORY: 1) right breast CA
2) s/p gastric bypass
3) hysterectomy
4) longstanding essential HTN
5) radiation induced cardiomyopathy

MEDICATION ON ADMISSION: Lisinopril 20mg qd
Atenolol 50mg qd
Arimidex 1 mg qd
Calcium with vit D
MVI
fish oil

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: Gen - well developed, well-nourished, mildly obese woman in no
acute distress
HEENT - NCAT, non-icteric sclera, EOMI
Chest - CTA, s/p right mastectomy
Heart - RRR, no murmurs/rubs, or gallops, PMI non-displaced
Ext - no C/C/E
Neuro - AAOx3, fluently conversant
Skin - no suspicious lesions on gross visual inspection

FAMILY HISTORY: mother with MI at 62

SOCIAL HISTORY: nonsmoker, no EtOH, no illicits
G5/P4 with first childbirth at 19
Hemorrhage complicating a procedure,Personal history of malignant neoplasm of breast,Incisional hernia without mention of obstruction or gangrene,Unspecified essential hypertension,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Intestinal bypass or anastomosis status
Hemorrhage complic proc,Hx of breast malignancy,Incisional hernia,Hypertension NOS,DMII wo cmp nt st uncntr,Intestinal bypass status
Admission Date:  [**2179-7-28**]              Discharge Date:   [**2179-8-2**]

Date of Birth:  [**2126-9-9**]             Sex:   F

Service: PLASTIC

Allergies:
Patient recorded as having No Known Allergies to Drugs

Attending:[**First Name3 (LF) 5883**]
Chief Complaint:
s/p right mastectomy

Major Surgical or Invasive Procedure:
[**Last Name (un) 5884**] flap reconstruction of right breast

History of Present Illness:
53 yo F dx'd with right breast CA in 1/[**2178**].  Underwent excision
and complete axillary dissection in 2/[**2178**].  After finding
evidence of perineural invasion and extensive lymphatic
invasion, she underwent total mastectomy on [**2178-10-13**].  She
received AC followed by taxol and herceptin as well as
radiation.  However, at week 37 of Herceptin, was found to have
left ventricular EF of 50% and a right EF of 30%. [**Known firstname **] has
chronic fatigue since beginning chemotherapy, although does not
have orthopnea, paroxysma dyspnea, periph edema, or major
dyspnea on exertion.

Past Medical History:
1) right breast CA
2) s/p gastric bypass
3) hysterectomy
4) longstanding essential HTN
5) radiation induced cardiomyopathy

Social History:
nonsmoker, no EtOH, no illicits
G5/P4 with first childbirth at 19

Family History:
mother with MI at 62

Physical Exam:
Gen - well developed, well-nourished, mildly obese woman in no
acute distress
HEENT - NCAT, non-icteric sclera, EOMI
Chest - CTA, s/p right mastectomy
Heart - RRR, no murmurs/rubs, or gallops, PMI non-displaced
Ext - no C/C/E
Neuro - AAOx3, fluently conversant
Skin - no suspicious lesions on gross visual inspection

Pertinent Results:
[**2179-7-31**] 05:05AM BLOOD WBC-8.7 RBC-2.82* Hgb-8.2* Hct-23.9*
MCV-85 MCH-29.3 MCHC-34.5 RDW-14.7 Plt Ct-171
[**2179-7-30**] 02:03PM BLOOD Hct-26.9*
[**2179-7-30**] 04:13AM BLOOD WBC-10.3 RBC-2.93* Hgb-8.4* Hct-24.7*
MCV-84 MCH-28.5 MCHC-33.9 RDW-14.9 Plt Ct-169
[**2179-7-30**] 12:23AM BLOOD Hct-26.8*
[**2179-7-29**] 07:36PM BLOOD Hct-30.6*
[**2179-7-29**] 04:30PM BLOOD WBC-12.0* RBC-3.45* Hgb-10.0* Hct-28.5*
MCV-83 MCH-29.1 MCHC-35.2* RDW-14.9 Plt Ct-181
[**2179-7-29**] 01:15PM BLOOD Hct-23.4*
[**2179-7-29**] 11:50AM BLOOD WBC-14.1* RBC-3.11* Hgb-8.5* Hct-25.9*
MCV-83 MCH-27.3 MCHC-32.8 RDW-13.7 Plt Ct-314
[**2179-7-29**] 04:46AM BLOOD WBC-15.2*# RBC-4.06* Hgb-10.9* Hct-32.8*
MCV-81* MCH-26.7* MCHC-33.1 RDW-13.8 Plt Ct-347

Brief Hospital Course:
Pt admitted on [**2179-7-28**] for delayed right [**Last Name (un) 5884**] flap and right
breast reconstruction with secondary abdominopexy and ventral
hernia repair x2.  Pt tolerated the surgery well and pt went to
PACU [**First Name8 (NamePattern2) **] [**Last Name (un) 5884**] protocol at 1800 on [**7-28**]. At approximately 24 hrs
post-op, pt was stood up by nursing staff and lost approx 1000cc
of dark blood from her abdominopexy suture line.  She was
brought back to the OR for evacuation of the hematoma and
tolerated this well.  She received 4u PRBCs and was transferred
to the T/SICU intubated on [**2179-7-29**]. Hct 29.6. She was then
extubated, and received an additional unit of PRBCs to a Hct of
32.8 and was transferred back to CC6. [**Known firstname 102108**] flap remained
well-perfused with Vioptix readings of 60-70% throughout this
course.  On CC6, she progressed well with no acute events.  She
was restarted on all home meds over the course of the next 72
hrs.  Her Carvedilol was held on several occasions due to
asymptomatic hypotension.  Today, she is in good spirits and
ready for d/c home with nursing care.  Flap looks good and all
incisions are healing well.

Medications on Admission:
Lisinopril 20mg qd
Atenolol 50mg qd
Arimidex 1 mg qd
Calcium with vit D
MVI
fish oil

Discharge Medications:
Lisinopril 20mg qd
Atenolol 50mg qd
Arimidex 1 mg qd
Spironolactone 25 mg qd
Cefadroxil 500mg po BID
Famotidine 20 mg PO BID
Carvedilol 25 mg PO BID
Oxycodone-Acetaminophen [**1-27**] TAB PO Q4H:PRN
Docusate Sodium 100 mg PO BID
Aspirin 121.5 mg PO DAILY

Discharge Disposition:
Home With Service

Facility:
[**Last Name (LF) 486**], [**First Name3 (LF) 487**]

Discharge Diagnosis:
s/[**Initials (NamePattern4) **] [**Last Name (NamePattern4) 5884**] flap reconstruction of right breast

Discharge Condition:
stable

Discharge Instructions:
VNA home wound care

Followup Instructions:
f/u with Dr. [**First Name (STitle) **] [**2179-8-6**], call [**Telephone/Fax (1) 4652**] for appt


Completed by:[**2179-8-2**]
{'Hemorrhage complicating a procedure,Personal history of malignant neoplasm of breast,Incisional hernia without mention of obstruction or gangrene,Unspecified essential hypertension,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Intestinal bypass or anastomosis 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: s/p right mastectomy

PRESENT ILLNESS: 53 yo F dx'd with right breast CA in 1/[**2178**].  Underwent excision
and complete axillary dissection in 2/[**2178**].  After finding
evidence of perineural invasion and extensive lymphatic
invasion, she underwent total mastectomy on [**2178-10-13**].  She
received AC followed by taxol and herceptin as well as
radiation.  However, at week 37 of Herceptin, was found to have
left ventricular EF of 50% and a right EF of 30%. [**Known firstname **] has
chronic fatigue since beginning chemotherapy, although does not
have orthopnea, paroxysma dyspnea, periph edema, or major
dyspnea on exertion.

MEDICAL HISTORY: 1) right breast CA
2) s/p gastric bypass
3) hysterectomy
4) longstanding essential HTN
5) radiation induced cardiomyopathy

MEDICATION ON ADMISSION: Lisinopril 20mg qd
Atenolol 50mg qd
Arimidex 1 mg qd
Calcium with vit D
MVI
fish oil

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: Gen - well developed, well-nourished, mildly obese woman in no
acute distress
HEENT - NCAT, non-icteric sclera, EOMI
Chest - CTA, s/p right mastectomy
Heart - RRR, no murmurs/rubs, or gallops, PMI non-displaced
Ext - no C/C/E
Neuro - AAOx3, fluently conversant
Skin - no suspicious lesions on gross visual inspection

FAMILY HISTORY: mother with MI at 62

SOCIAL HISTORY: nonsmoker, no EtOH, no illicits
G5/P4 with first childbirth at 19 

### Response:
{'Hemorrhage complicating a procedure,Personal history of malignant neoplasm of breast,Incisional hernia without mention of obstruction or gangrene,Unspecified essential hypertension,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Intestinal bypass or anastomosis status'}
