CHIEF COMPLAINT: Known sinus of Valsalva aneurysm for surgical repair. Same day
admit

PRESENT ILLNESS: 78 yoM known sinus of valsalva aneurysm from previous
admission([**2187-4-8**]) for scheduled surgical repair

MEDICAL HISTORY: h/o prostate cancer s/p XRT
Epidermal inclusion cysts
Right inguinal hernia s/p repair in [**2183**]
Emphysema, negative smoking history
Osteoporosis

MEDICATION ON ADMISSION: Colace 100mg [**Hospital1 **]
Metoprolol 25mg [**Hospital1 **]
Flomax 0.4mg QD
MVI 1 tab QD

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: Preop
T 98  HR71  BP 120/60  RR  18  Sat 97%RA
Gen NAD
Psych A&Ox3 MAE folows commands non focal exam
CV RRR 3/6 SEM
Pulm CTAB
Abdm  Soft NABS
Ext Warm well perfused no edema

FAMILY HISTORY: Father deceased at 71 from MI
Mother died suddenly
Brother deceased at 70 from MI

SOCIAL HISTORY: The patient lives alone in a 1 story apartment. He is
independent with his own ADLs. He drinks on occasion on the
weekends but denies any smoking history. His father and brother
were heavy smokers.
Thoracic aneurysm without mention of rupture,Aortic valve disorders,Chronic airway obstruction, not elsewhere classified,Atrial fibrillation,Iatrogenic pneumothorax,Osteoporosis, unspecified,Personal history of malignant neoplasm of prostate,Personal history of irradiation, presenting hazards to health,Ostium secundum type atrial septal defect
Thoracic aortic aneurysm,Aortic valve disorder,Chr airway obstruct NEC,Atrial fibrillation,Iatrogenic pneumothorax,Osteoporosis NOS,Hx-prostatic malignancy,Hx of irradiation,Secundum atrial sept def
Admission Date:  [**2187-5-1**]              Discharge Date:   [**2187-5-8**]

Date of Birth:  [**2108-10-11**]             Sex:   M

Service: CARDIOTHORACIC

Allergies:
Patient recorded as having No Known Allergies to Drugs

Attending:[**First Name3 (LF) 1283**]
Chief Complaint:
Known sinus of Valsalva aneurysm for surgical repair. Same day
admit

Major Surgical or Invasive Procedure:
AVR
Sinus of Valsalva Aneurysm repair

History of Present Illness:
78 yoM known sinus of valsalva aneurysm from previous
admission([**2187-4-8**]) for scheduled surgical repair

Past Medical History:
h/o prostate cancer s/p XRT
Epidermal inclusion cysts
Right inguinal hernia s/p repair in [**2183**]
Emphysema, negative smoking history
Osteoporosis

Social History:
The patient lives alone in a 1 story apartment. He is
independent with his own ADLs. He drinks on occasion on the
weekends but denies any smoking history. His father and brother
were heavy smokers.


Family History:
Father deceased at 71 from MI
Mother died suddenly
Brother deceased at 70 from MI

Physical Exam:
Preop
T 98  HR71  BP 120/60  RR  18  Sat 97%RA
Gen NAD
Psych A&Ox3 MAE folows commands non focal exam
CV RRR 3/6 SEM
Pulm CTAB
Abdm  Soft NABS
Ext Warm well perfused no edema

Discharge
T 98.5  HR 84 SR  BP 122/62  RR 20   O2 sat 98% 3LNP
Gen NAD
Psych A&Ox3 MAE non focal exam
Pulm CTA
CV RRR, sternum stable, Wound clean and dry no erythema or
drainage
Abdm soft NT/ND/NABS
Ext Warm, well perfused, no C/C/E

Pertinent Results:
[**2187-5-1**] 04:55PM   UREA N-19 CREAT-0.8 CHLORIDE-116* TOTAL
CO2-24
[**2187-5-1**] 04:55PM   WBC-12.9* RBC-3.25* HGB-10.5* HCT-30.0*
MCV-93 MCH-32.3* MCHC-34.9 RDW-15.3
[**2187-5-1**] 04:55PM   PLT COUNT-151
[**2187-5-8**] 06:10AM BLOOD WBC-7.9 RBC-3.40* Hgb-11.0* Hct-31.8*
MCV-94 MCH-32.2* MCHC-34.4 RDW-15.2 Plt Ct-228#
[**2187-5-8**] 06:10AM BLOOD UreaN-21* Creat-0.9 K-4.5

Brief Hospital Course:
Pt admitted directly to operating room where he underwent
AVR(#23pericardial) and repair of aneurysm of the sinus of
valsalva w/dacron patch. Seee OR report for full details.
Pt was transferred from OR to Cardiac surgery recovery unit. The
patient was somewhat hypoxic in the immediate postop period and
remained intubated and sedated throughout the day of surgery. On
POD1 a TEE was done, it showed good LV and valvular function
w/no signs of tamponade. Interventional pulmonary was also
consulted. Additionally the patient had an episode of atrial
fibrilllation for which he was started on Amiodarone and
Metoprolol, following which he converted to SR.
Following the echo the sedation was discontinued and over the
next day the patient was weaned from the ventilator and
successfully extubated on POD2.
On POD3 the patient was transferred to the cardiac surgery floor
for continued postop recovery. He had an uneventful recovery
once on the floors and on POD 7 it was decided that he was ready
for discharge to rehabilitation

Medications on Admission:
Colace 100mg [**Hospital1 **]
Metoprolol 25mg [**Hospital1 **]
Flomax 0.4mg QD
MVI 1 tab QD

Discharge Medications:
1. Furosemide 20 mg Tablet Sig: One (1) Tablet PO once a day for
2 weeks. Tablet(s)
2. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2
times a day).
3. Aspirin 81 mg Tablet, Delayed Release (E.C.) Sig: One (1)
Tablet, Delayed Release (E.C.) PO DAILY (Daily).
4. Magnesium Hydroxide 400 mg/5 mL Suspension Sig: Thirty (30)
ML PO HS (at bedtime) as needed for constipation.
5. Tamsulosin 0.4 mg Capsule, Sust. Release 24HR Sig: One (1)
Capsule, Sust. Release 24HR PO HS (at bedtime).
6. Potassium Chloride 10 mEq Capsule, Sustained Release Sig: Two
(2) Capsule, Sustained Release PO once a day for 2 weeks.
7. Metoprolol Tartrate 50 mg Tablet Sig: One (1) Tablet PO BID
(2 times a day).
8. Amiodarone 200 mg Tablet Sig: Two (2) Tablet PO BID (2 times
a day): 400mg [**Hospital1 **] x 1wk then 400mg QD x1wk
then 200mg QD.
9. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO
every 4-6 hours as needed for pain.


Discharge Disposition:
Extended Care

Facility:
[**Location (un) 582**] of [**Location (un) 583**]

Discharge Diagnosis:
sinus of valsalva aneurysm repair
aortic regurgitation s/p AVR
COPD
prostate CA


Discharge Condition:
good


Discharge Instructions:
may shower, no bathing or swimming for 1 month
take all medications as preescribed
no lifting > 10# for 10 weeks
call for any fever redness or drainage from wounds
no creams, lotions or powders to any incisions


[**Last Name (NamePattern4) 2138**]p Instructions:
with Dr. [**Last Name (STitle) 2204**] in [**2-16**] weeks
with Dr. [**Last Name (STitle) **] in [**2-16**] weeks
with Dr. [**Last Name (Prefixes) **] in 4 weeks



Completed by:[**2187-5-8**]
{'Thoracic aneurysm without mention of rupture,Aortic valve disorders,Chronic airway obstruction, not elsewhere classified,Atrial fibrillation,Iatrogenic pneumothorax,Osteoporosis, unspecified,Personal history of malignant neoplasm of prostate,Personal history of irradiation, presenting hazards to health,Ostium secundum type atrial septal defect'}


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: Known sinus of Valsalva aneurysm for surgical repair. Same day
admit

PRESENT ILLNESS: 78 yoM known sinus of valsalva aneurysm from previous
admission([**2187-4-8**]) for scheduled surgical repair

MEDICAL HISTORY: h/o prostate cancer s/p XRT
Epidermal inclusion cysts
Right inguinal hernia s/p repair in [**2183**]
Emphysema, negative smoking history
Osteoporosis

MEDICATION ON ADMISSION: Colace 100mg [**Hospital1 **]
Metoprolol 25mg [**Hospital1 **]
Flomax 0.4mg QD
MVI 1 tab QD

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: Preop
T 98  HR71  BP 120/60  RR  18  Sat 97%RA
Gen NAD
Psych A&Ox3 MAE folows commands non focal exam
CV RRR 3/6 SEM
Pulm CTAB
Abdm  Soft NABS
Ext Warm well perfused no edema

FAMILY HISTORY: Father deceased at 71 from MI
Mother died suddenly
Brother deceased at 70 from MI

SOCIAL HISTORY: The patient lives alone in a 1 story apartment. He is
independent with his own ADLs. He drinks on occasion on the
weekends but denies any smoking history. His father and brother
were heavy smokers. 

### Response:
{'Thoracic aneurysm without mention of rupture,Aortic valve disorders,Chronic airway obstruction, not elsewhere classified,Atrial fibrillation,Iatrogenic pneumothorax,Osteoporosis, unspecified,Personal history of malignant neoplasm of prostate,Personal history of irradiation, presenting hazards to health,Ostium secundum type atrial septal defect'}
