CHIEF COMPLAINT: Atrial mass.

PRESENT ILLNESS: The patient is a 37-year old
female with a right atrial mass that was found on
echocardiogram.  The patient was hospitalized in [**Month (only) 958**] of
this year for an asthma exacerbation.  The patient underwent
an echocardiogram to follow up for a high-dose steroid use.
The echocardiogram revealed a right atrial mass.  The patient
had reported six to seven weeks of a low-grade fever with a
temperature of 99 to 100.  The patient was placed on Ceftin
for a positive urinary tract infection, and since then she
has had no fevers.  The patient reportedly had received 125
mg of Solu-Medrol two days prior to admission for an asthma
exacerbation.  The patient's Perm-A-Cath (through which she
was receiving gamma globulin) was discontinued under local
anesthetic on Friday - three days prior to admission.  She
complained of no pain since that time.

MEDICAL HISTORY: The patient has a significant history
of asthma, chronic obstructive pulmonary disease,
hypertension, morbid obesity, degenerative disc disease,
systemic lupus erythematosus, sleep apnea, hypoglycemia, skin
cancer, renal calculi, steroid-induced myopathy of the spine,
and rheumatoid arthritis.

MEDICATION ON ADMISSION: 

ALLERGIES: She is allergic to BETADINE, ERYTHROMYCIN, SULFA,
AMOXICILLIN, AUGMENTIN, CIPROFLOXACIN, VASOTEC, BIAXIN,
TETRACYCLINE, XOLAIR, OXYCONTIN, ETODOLAC, PSEUDOEPHEDRINE,
and GUAIFENESIN.

PHYSICAL EXAM: 

FAMILY HISTORY: Mother is alive at the age of 67.  Father
died at the age of 51 - killed in a motor vehicle accident.

SOCIAL HISTORY: The patient denies smoking or the use of
alcohol.  The patient is disabled and lives with her husband.
The denies the use of cocaine or marijuana.
Benign neoplasm of heart,Chronic airway obstruction, not elsewhere classified,Systemic lupus erythematosus,Unspecified essential hypertension,Morbid obesity,Osteoarthrosis, unspecified whether generalized or localized, site unspecified,Rheumatoid arthritis,Toxic myopathy,Adrenal cortical steroids causing adverse effects in therapeutic use
Benign neoplasm heart,Chr airway obstruct NEC,Syst lupus erythematosus,Hypertension NOS,Morbid obesity,Osteoarthros NOS-unspec,Rheumatoid arthritis,Toxic myopathy,Adv eff corticosteroids
Admission Date: [**2127-7-14**]        Discharge Date: [**2127-7-19**]

Date of Birth:  [**2089-12-13**]        Sex:  F

Service:  CSU


CHIEF COMPLAINT:  Atrial mass.

HISTORY OF PRESENT ILLNESS:  The patient is a 37-year old
female with a right atrial mass that was found on
echocardiogram.  The patient was hospitalized in [**Month (only) 958**] of
this year for an asthma exacerbation.  The patient underwent
an echocardiogram to follow up for a high-dose steroid use.
The echocardiogram revealed a right atrial mass.  The patient
had reported six to seven weeks of a low-grade fever with a
temperature of 99 to 100.  The patient was placed on Ceftin
for a positive urinary tract infection, and since then she
has had no fevers.  The patient reportedly had received 125
mg of Solu-Medrol two days prior to admission for an asthma
exacerbation.  The patient's Perm-A-Cath (through which she
was receiving gamma globulin) was discontinued under local
anesthetic on Friday - three days prior to admission.  She
complained of no pain since that time.

The patient had an echocardiogram in [**Month (only) 958**] of this year with
an ejection fraction of 65 percent and a right atrial mass of
2 cm x 2 cm.

PAST MEDICAL HISTORY:  The patient has a significant history
of asthma, chronic obstructive pulmonary disease,
hypertension, morbid obesity, degenerative disc disease,
systemic lupus erythematosus, sleep apnea, hypoglycemia, skin
cancer, renal calculi, steroid-induced myopathy of the spine,
and rheumatoid arthritis.

PAST SURGICAL HISTORY:  The patient is status post
laparoscopic cholecystectomy, bilateral temporal artery
biopsy, and right subclavian Port-A-Cath placement.

ALLERGIES:  She is allergic to BETADINE, ERYTHROMYCIN, SULFA,
AMOXICILLIN, AUGMENTIN, CIPROFLOXACIN, VASOTEC, BIAXIN,
TETRACYCLINE, XOLAIR, OXYCONTIN, ETODOLAC, PSEUDOEPHEDRINE,
and GUAIFENESIN.

MEDICATIONS AT HOME:
1. Albuterol nebulizer twice per day.
2. Atacand 8 mg by mouth once per day.
3. Celexa 10 mg by mouth once per day.
4. Pulmicort nebulizers three times per day.
5. Zantac 150 mg by mouth twice per day.
6. Singulair 10 mg by mouth once per day.
7. Gamma globulin infusion 84 grams every three weeks.
8. Ambien 2.5 mg by mouth as needed.
9. Nasonex 2 squirts as needed.
10.      Verapamil 280 mg by mouth once per day.
11.      Topamax 50 mg by mouth once per day.
12.      Uniphyl 400 mg by mouth twice per day.
13.      Weekly intramuscular allergy injections.
14.      Ceftin 500 mg by mouth twice per day (for the past
   two weeks).


FAMILY HISTORY:  Mother is alive at the age of 67.  Father
died at the age of 51 - killed in a motor vehicle accident.

SOCIAL HISTORY:  The patient denies smoking or the use of
alcohol.  The patient is disabled and lives with her husband.
The denies the use of cocaine or marijuana.

PHYSICAL EXAMINATION ON PRESENTATION:  The patient's
temperature was 99.3, her pulse was 86, her blood pressure
was 138/78, respiratory rate was 18, and she was saturating
96 percent on room air.  The patient was generally obese,
alert, and oriented.  The patient had no obvious lesions on
the skin.  The patient's pupils equal, round and reactive to
light.  The extraocular movements were intact.  The sclerae
were anicteric.  The eyes were not injected.  There were no
bruits heard.  There was no jugular venous distention on the
neck.  There was no lymphadenopathy.  The patient's lungs
were clear to auscultation bilaterally.  The patient had a
well-healed right Port-A-Cath site.  Cardiovascular
examination revealed first heart sounds and second heart
sounds heard.  A regular rate and rhythm.  There were no
murmurs.  The patient's abdomen was obese and healed.  The
extremities were warm and well perfused.  There was no
clubbing, cyanosis, or edema.  The patient's neurologic
examination was grossly intact.  The patient had good 2 plus
dorsalis pedis pulses bilaterally and 1 plus posterior tibial
pulses bilaterally.

SUMMARY OF HOSPITAL COURSE:  The patient was admitted to the
hospital and underwent a repeat urinalysis and complete blood
count.

The patient was admitted to the Cardiac Surgery Service and
an evaluation for low-grade fever prior to her surgery.  The
patient had a repeat urinalysis and straight catheter
urinalysis recommended by Infectious Disease.  We obtained a
consultation from them, who felt that the patient did not
have a urinary tract infection and that there was no need for
her to continue antibiotic coverage.  Thus, from that
standpoint, was able to go to the operating room.  The repeat
urinalysis was negative with the straight catheterization.
The patient's white blood cell count was 13.5 preoperatively;
however, the patient had Solu-Medrol three days prior.  Thus,
this was not a concern.  Infectious Disease recommended that
the patient may go to the operating room without antibiotics.

The patient underwent a right atrial removal.  On
postoperative day one, the patient was extubated.  She
remained neurologically intact and remained in a sinus rhythm
with good pressure without any clips.  The patient was
saturating 97 percent on 2 liters.  She was able to take
clears without any difficulties.  She had a low-grade
temperature of 100.1, but this temperature defervesced.  The
patient's creatinine was 0.6.  Otherwise, she was doing well.
The patient's chest tubes were removed due to low chest tube
output, and she was advanced to a cardiac diet.

On postoperative day two, the patient was doing well.  The
patient was on the floor.  She was afebrile with stable vital
signs.  The patient was put on Toradol for pain management.
There were no major issues.

On postoperative day three, the patient remained afebrile
with stable vital signs.  The patient was put back on her
home medication and was given Dilaudid and Motrin for pain
management and was discharged home.

MEDICATIONS ON DISCHARGE:
1. Verapamil 280 mg by mouth once per day.
2. Celexa 10 mg by mouth once per day.
3. Zantac 150 mg by mouth twice per day.
4. Theophylline 400 mg by mouth twice per day.
5. Atacand 8 mg by mouth once per day.
6. Pulmicort nebulizer three times per day.
7. Colace 100 mg by mouth twice per day.
8. Dilaudid 2 mg to 4 mg by mouth once per day.
9. Motrin 600 mg by mouth three times per day (for three
   days).
10.      Tylenol as needed.
11.      Albuterol as needed.


DISCHARGE FOLLOWUP:  The patient was instructed to follow up
with Dr. [**First Name (STitle) **] [**Last Name (Prefixes) **] in four weeks.

The patient was instructed to follow up with Dr. [**First Name (STitle) **] in
one to two weeks.

DISCHARGE STATUS:  Discharged home with Visiting Nurses
Association.

CONDITION ON DISCHARGE:  Good.



                        [**Doctor Last Name **] [**Last Name (Prefixes) **], M.D. [**MD Number(1) 1288**]

Dictated By:[**Doctor Last Name 6052**]
MEDQUIST36
D:  [**2127-7-19**] 12:21:58
T:  [**2127-7-19**] 14:06:55
Job#:  [**Job Number **]
{'Benign neoplasm of heart,Chronic airway obstruction, not elsewhere classified,Systemic lupus erythematosus,Unspecified essential hypertension,Morbid obesity,Osteoarthrosis, unspecified whether generalized or localized, site unspecified,Rheumatoid arthritis,Toxic myopathy,Adrenal cortical steroids causing adverse effects in therapeutic use'}


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: Atrial mass.

PRESENT ILLNESS: The patient is a 37-year old
female with a right atrial mass that was found on
echocardiogram.  The patient was hospitalized in [**Month (only) 958**] of
this year for an asthma exacerbation.  The patient underwent
an echocardiogram to follow up for a high-dose steroid use.
The echocardiogram revealed a right atrial mass.  The patient
had reported six to seven weeks of a low-grade fever with a
temperature of 99 to 100.  The patient was placed on Ceftin
for a positive urinary tract infection, and since then she
has had no fevers.  The patient reportedly had received 125
mg of Solu-Medrol two days prior to admission for an asthma
exacerbation.  The patient's Perm-A-Cath (through which she
was receiving gamma globulin) was discontinued under local
anesthetic on Friday - three days prior to admission.  She
complained of no pain since that time.

MEDICAL HISTORY: The patient has a significant history
of asthma, chronic obstructive pulmonary disease,
hypertension, morbid obesity, degenerative disc disease,
systemic lupus erythematosus, sleep apnea, hypoglycemia, skin
cancer, renal calculi, steroid-induced myopathy of the spine,
and rheumatoid arthritis.

MEDICATION ON ADMISSION: 

ALLERGIES: She is allergic to BETADINE, ERYTHROMYCIN, SULFA,
AMOXICILLIN, AUGMENTIN, CIPROFLOXACIN, VASOTEC, BIAXIN,
TETRACYCLINE, XOLAIR, OXYCONTIN, ETODOLAC, PSEUDOEPHEDRINE,
and GUAIFENESIN.

PHYSICAL EXAM: 

FAMILY HISTORY: Mother is alive at the age of 67.  Father
died at the age of 51 - killed in a motor vehicle accident.

SOCIAL HISTORY: The patient denies smoking or the use of
alcohol.  The patient is disabled and lives with her husband.
The denies the use of cocaine or marijuana. 

### Response:
{'Benign neoplasm of heart,Chronic airway obstruction, not elsewhere classified,Systemic lupus erythematosus,Unspecified essential hypertension,Morbid obesity,Osteoarthrosis, unspecified whether generalized or localized, site unspecified,Rheumatoid arthritis,Toxic myopathy,Adrenal cortical steroids causing adverse effects in therapeutic use'}
