CHIEF COMPLAINT: 

PRESENT ILLNESS: The patient is a 65-year-old
female with diabetes and hypertension who developed chest
pain with associated jaw pain and bilateral arm pain at
approximately 2:00 a.m. on the morning of admission.  This
was also associated with diaphoresis and the patient called
9-1-1 and was taken to [**Hospital3 7362**] where she was noted to
have inferior ST elevations.  The patient was given
nitroglycerin, aspirin, heparin drip, Integrelin drip,
Lopressor IV and morphine with continued pain and was,
therefore, transferred to [**Hospital1 18**] for cardiac catheterization.
By arrival at [**Hospital1 18**], the ST elevations had resolved.  At
cardiac catheterization, the patient was noted to have an RCA
lesion with ulcerated plaque which was angiojetted and
stented times two.  The patient became bradycardiac and was
briefly paced and required Atropine with improvement.  The
patient had also developed runs of NSVT and, therefore, given
her arrhythmia, she was admitted to the CCU for postcardiac
catheterization care.

MEDICAL HISTORY: 1.  Type 2 diabetes well controlled on Prandin, most recent
hemoglobin A1C of 6.7 in [**2154-10-23**].
2.  Hypertension.
3.  Hypercholesterolemia.
4.  Breast cancer, status post lumpectomy five years prior,
status post XRT and currently on Tamoxifen for the past two
years.

MEDICATION ON ADMISSION: 

ALLERGIES: Codeine, causes hives.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: The patient smokes eight cigarettes per day.
She has one drink per day.  She lives with her husband and is
independent for all activities of daily living.
Acute myocardial infarction of other inferior wall, initial episode of care,Paroxysmal ventricular tachycardia,Urinary tract infection, site not specified,Coronary atherosclerosis of native coronary artery,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Unspecified essential hypertension,Personal history of malignant neoplasm of breast,Pure hypercholesterolemia
AMI inferior wall, init,Parox ventric tachycard,Urin tract infection NOS,Crnry athrscl natve vssl,DMII wo cmp nt st uncntr,Hypertension NOS,Hx of breast malignancy,Pure hypercholesterolem
Admission Date:  [**2155-4-30**]     Discharge Date:  [**2155-5-3**]

Date of Birth:   [**2089-6-17**]     Sex:  F

Service:  CCU

HISTORY OF THE PRESENT ILLNESS:  The patient is a 65-year-old
female with diabetes and hypertension who developed chest
pain with associated jaw pain and bilateral arm pain at
approximately 2:00 a.m. on the morning of admission.  This
was also associated with diaphoresis and the patient called
9-1-1 and was taken to [**Hospital3 7362**] where she was noted to
have inferior ST elevations.  The patient was given
nitroglycerin, aspirin, heparin drip, Integrelin drip,
Lopressor IV and morphine with continued pain and was,
therefore, transferred to [**Hospital1 18**] for cardiac catheterization.
By arrival at [**Hospital1 18**], the ST elevations had resolved.  At
cardiac catheterization, the patient was noted to have an RCA
lesion with ulcerated plaque which was angiojetted and
stented times two.  The patient became bradycardiac and was
briefly paced and required Atropine with improvement.  The
patient had also developed runs of NSVT and, therefore, given
her arrhythmia, she was admitted to the CCU for postcardiac
catheterization care.

PAST MEDICAL HISTORY:
1.  Type 2 diabetes well controlled on Prandin, most recent
hemoglobin A1C of 6.7 in [**2154-10-23**].
2.  Hypertension.
3.  Hypercholesterolemia.
4.  Breast cancer, status post lumpectomy five years prior,
status post XRT and currently on Tamoxifen for the past two
years.

ADMISSION MEDICATIONS:
1.  Mavik 5 q.d.
2.  Lescol 1 q.d.
3.  Prandin 2 q.d.
4.  Tamoxifen 20 q.d.

ALLERGIES:  Codeine, causes hives.

SOCIAL HISTORY:  The patient smokes eight cigarettes per day.
She has one drink per day.  She lives with her husband and is
independent for all activities of daily living.

PHYSICAL EXAMINATION ON ADMISSION:  Vital signs:  Temperature
98.2, heart rate 80, blood pressure 137/70, respirations 14,
saturating 100% on 2 liters nasal cannula.  The patient is 5'
3" tall, weighs 65 kilograms.  HEENT:  The pupils were equal.
The oropharynx was clear.  Lungs:  Clear to auscultation
bilaterally.  Cardiac:  Regular rate and rhythm.  No murmurs.
Abdomen:  Soft, nontender, nondistended with good bowel
sounds.  She was Guaiac negative at the outside hospital.
Extremities:  No edema.

CATHETERIZATION DATA:  Wedge pressure of 20, cardiac index of
2.13, LAD lesion with an 80% midstenosis, D2 70%, RCA with
99% stenosis with thrombus for which she had two cypher
stents placed successfully.

LABORATORY/RADIOLOGIC DATA:  EKG after cardiac
catheterization revealed normal sinus rhythm, normal axis,
normal intervals, ST elevations in II, III, and aVF resolved.
She did have T wave flattening and inversions inferiorly.

The laboratory values on admission revealed a white count of
11.3, crit 41, platelets 344,000, INR 0.8, PT 26.  Chem-7 was
essentially within normal limits.  ABG revealed 7.32, 42,
136.

HOSPITAL COURSE:  1.  CORONARY ARTERY DISEASE:  After cardiac
catheterization, the patient was continued on an aspirin,
Plavix, started on a beta blocker and a statin.  In addition
to this, she was started on an ACE inhibitor as her blood
pressure tolerated.  The patient's cardiac enzymes were
cycled and were trending down at the time of discharge.  The
patient's RCA lesion was successfully stented; however, she
has an 80% LAD lesion which remains.  The plan is to have
this lesion stented in the upcoming month.  She will
follow-up with Dr. [**Last Name (STitle) **] further.

2.  CARDIAC PUMP:  The patient had an echocardiogram post
myocardial infarction which showed an ejection fraction of
40-45% and also showed inferior and inferolateral akinesis
and 1+ MR.  The patient had no evidence of heart failure on
this admission and can be further monitored as an outpatient.

3.  CARDIAC RHYTHM:  The patient had episodes of NSVT and
frequent PVCs post cardiac catheterization.  This was likely
due to reperfusion in the setting of her myocardial
infarction.  The patient was given a beta blocker to further
rate control her which in addition to time significantly
helped.  The patient is not having episodes of NSVT at the
time of discharge.

4.  DIABETES MELLITUS:  The patient was maintained on a
regular insulin sliding scale during this admission and at
the time of discharge was transitioned back to her home dose
of Prandin.

5.  INFECTIOUS DISEASE:  The patient had a question of a UTI
at the outside hospital and had a positive U/A here.  She was
started on Levofloxacin for a total of seven days.

6.  BREAST CANCER:  The patient was continued on her
Tamoxifen.

CONDITION ON DISCHARGE:  Stable.

DISCHARGE STATUS:  To home.

DISCHARGE DIAGNOSIS:
1.  Inferior myocardial infarction with ST elevations.
2.  Urinary tract infection.

DISCHARGE MEDICATIONS:
1.  Aspirin 325 q.d.
2.  Plavix 75 q.d.
3.  Atorvostatin 80 q.d.
4.  Tamoxifen 20 q.d.
5.  Trandolapril 2 mg q.d.
6.  Metoprolol XL 100 q.d.
7.  Prandin 2 q.d.
8.  Levofloxacin 500 q.d. for four additional days.

FOLLOW-UP:  The patient will follow-up with her primary care
physician, [**Last Name (NamePattern4) **]. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 172**], within one week following
discharge.  In addition to this, the patient will follow-up
with Dr. [**Last Name (STitle) **] of Cardiology on [**2155-5-23**] and will have
a repeat cardiac catheterization scheduled for her remaining
LAD lesion.




                          [**First Name8 (NamePattern2) **] [**First Name8 (NamePattern2) **] [**Name8 (MD) **], M.D.  [**MD Number(1) 7169**]

Dictated By:[**Name8 (MD) 12502**]

MEDQUIST36

D:  [**2155-5-5**]  02:22
T:  [**2155-5-7**]  14:46
JOB#:  [**Job Number 14367**]
{'Acute myocardial infarction of other inferior wall, initial episode of care,Paroxysmal ventricular tachycardia,Urinary tract infection, site not specified,Coronary atherosclerosis of native coronary artery,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Unspecified essential hypertension,Personal history of malignant neoplasm of breast,Pure hypercholesterolemia'}


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: The patient is a 65-year-old
female with diabetes and hypertension who developed chest
pain with associated jaw pain and bilateral arm pain at
approximately 2:00 a.m. on the morning of admission.  This
was also associated with diaphoresis and the patient called
9-1-1 and was taken to [**Hospital3 7362**] where she was noted to
have inferior ST elevations.  The patient was given
nitroglycerin, aspirin, heparin drip, Integrelin drip,
Lopressor IV and morphine with continued pain and was,
therefore, transferred to [**Hospital1 18**] for cardiac catheterization.
By arrival at [**Hospital1 18**], the ST elevations had resolved.  At
cardiac catheterization, the patient was noted to have an RCA
lesion with ulcerated plaque which was angiojetted and
stented times two.  The patient became bradycardiac and was
briefly paced and required Atropine with improvement.  The
patient had also developed runs of NSVT and, therefore, given
her arrhythmia, she was admitted to the CCU for postcardiac
catheterization care.

MEDICAL HISTORY: 1.  Type 2 diabetes well controlled on Prandin, most recent
hemoglobin A1C of 6.7 in [**2154-10-23**].
2.  Hypertension.
3.  Hypercholesterolemia.
4.  Breast cancer, status post lumpectomy five years prior,
status post XRT and currently on Tamoxifen for the past two
years.

MEDICATION ON ADMISSION: 

ALLERGIES: Codeine, causes hives.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: The patient smokes eight cigarettes per day.
She has one drink per day.  She lives with her husband and is
independent for all activities of daily living. 

### Response:
{'Acute myocardial infarction of other inferior wall, initial episode of care,Paroxysmal ventricular tachycardia,Urinary tract infection, site not specified,Coronary atherosclerosis of native coronary artery,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Unspecified essential hypertension,Personal history of malignant neoplasm of breast,Pure hypercholesterolemia'}
