CHIEF COMPLAINT: transfer from rehab for management of CHF, abdominal pain

PRESENT ILLNESS: The patient is an 82 year-old woman with a h/o CHF, CAD s/p MI
('[**32**]), Type 2 DM, and bilateral blindness who had a recent
admission to an OSH for dizziness with a fall and tibial fx, and
was then transferred to rehab. On [**3-9**], she was readmitted with
post-prandial abdominal pain, dyspnea with an O2sat of 76% on
RA, fevers to 104.0 and elevated WBC count. She was diagnosed
with worsening CHF (BNP has steadily risen since [**3-9**] and was
1100 at last measurement) and urosepsis. U/A and urine cultures
were negative, though Cipro had already been started at the time
that cultures were drawn. The etiology of her post-prandial
abdominal pain is still unclear, though CT scan shows extensive
calcification of the aorta and mesenteric vessels, and the
patient has newly diagnosed PAF and mesenteric ischemia from
emboli is also a possibility.  Pt transferred to CCU team on
HD#1 for better management of CHF.

MEDICAL HISTORY: CHF
paroxysmal A-fib with RVR
CAD s/p MI '[**32**]
GERD
HTN
h/o GIB
venous stasis
s/p inguinal hernia repair '[**34**]
s/p TAH '[**25**]
s/p CCY '[**16**]
DM2
bilateral blindness
IBS
s/p tibial fx

MEDICATION ON ADMISSION: Amiodarone 200 mg qd
Atenolol 50 mg qd
Ciprofloxacin 400 mg IV q12h
Lanoxin 0.125 mg qd
Donnatal 5 mg a.c.
Furosemide 40 mg IV qd
Gabapentin 300 mg PO qd
RISS
Protonix 40 mg IV qd
Lisinopril 20 mg PO qd
Flagyl 500 mg IV q8h
Lomotil 1-2 tablets q6h prn diarrhea
Morphine sulfate 1 mg SC q1h prn pain
Zofran 4 mg IV q6h prn nausea
Zocor 20 mg qhs
Allergies: ? allergy to Levaquin

ALLERGIES: Levaquin

PHYSICAL EXAM: Vitals: T 96.4 HR 71 BP 121/50 RR 22 O2 sat 100% on 100%NRB
General: lying in bed, moaning, using accessory muscles to
breathe
HEENT: anicteric, elevated JVD to carotid angle
CV: irregularly irregular, no m/r/g
Chest: diffuse crackles and wheezes bilaterally
Abd: soft, mildly tender to palpation in RUQ, ND, +BS
Ext: warm, no edema
Neuro: moaning, difficult to communicate with
Skin: decubitus ulcer on back, sacrum

FAMILY HISTORY: non-contributory

SOCIAL HISTORY: lives w/ daughter who works @ [**Hospital1 18**] as PA, denies smoking, EtOH
Diastolic heart failure, unspecified,Acute kidney failure, unspecified,Atrial fibrillation,Pressure ulcer, lower back,Coronary atherosclerosis of native coronary artery,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Unspecified essential hypertension
Diastolc hrt failure NOS,Acute kidney failure NOS,Atrial fibrillation,Pressure ulcer, low back,Crnry athrscl natve vssl,DMII wo cmp nt st uncntr,Hypertension NOS
Admission Date:  [**2158-3-25**]              Discharge Date:   [**2158-3-27**]


Service: MEDICINE

Allergies:
Levaquin

Attending:[**First Name3 (LF) 898**]
Chief Complaint:
transfer from rehab for management of CHF, abdominal pain


Major Surgical or Invasive Procedure:
none

History of Present Illness:
The patient is an 82 year-old woman with a h/o CHF, CAD s/p MI
('[**32**]), Type 2 DM, and bilateral blindness who had a recent
admission to an OSH for dizziness with a fall and tibial fx, and
was then transferred to rehab. On [**3-9**], she was readmitted with
post-prandial abdominal pain, dyspnea with an O2sat of 76% on
RA, fevers to 104.0 and elevated WBC count. She was diagnosed
with worsening CHF (BNP has steadily risen since [**3-9**] and was
1100 at last measurement) and urosepsis. U/A and urine cultures
were negative, though Cipro had already been started at the time
that cultures were drawn. The etiology of her post-prandial
abdominal pain is still unclear, though CT scan shows extensive
calcification of the aorta and mesenteric vessels, and the
patient has newly diagnosed PAF and mesenteric ischemia from
emboli is also a possibility.  Pt transferred to CCU team on
HD#1 for better management of CHF.

Past Medical History:
CHF
paroxysmal A-fib with RVR
CAD s/p MI '[**32**]
GERD
HTN
h/o GIB
venous stasis
s/p inguinal hernia repair '[**34**]
s/p TAH '[**25**]
s/p CCY '[**16**]
DM2
bilateral blindness
IBS
s/p tibial fx

Social History:
lives w/ daughter who works @ [**Hospital1 18**] as PA, denies smoking, EtOH


Family History:
non-contributory

Physical Exam:
Vitals: T 96.4 HR 71 BP 121/50 RR 22 O2 sat 100% on 100%NRB
General: lying in bed, moaning, using accessory muscles to
breathe
HEENT: anicteric, elevated JVD to carotid angle
CV: irregularly irregular, no m/r/g
Chest: diffuse crackles and wheezes bilaterally
Abd: soft, mildly tender to palpation in RUQ, ND, +BS
Ext: warm, no edema
Neuro: moaning, difficult to communicate with
Skin: decubitus ulcer on back, sacrum

Pertinent Results:
CXR: findings consistent with CHF, moderately sized R pleural
effusion, can not rule out PNA

EKG: atrial fibrillation, rate 71, nl axis, ST elevations in
V1-V3, aVR and downgoing ST segments in I, II, V5, and V6 which
were present on prior EKGs.

[**2158-3-26**] 05:00AM BLOOD CK(CPK)-72
[**2158-3-26**] 05:00AM BLOOD CK-MB-NotDone cTropnT-0.10*
[**2158-3-26**] 12:33PM BLOOD Lactate-2.3*
[**2158-3-26**] 12:33AM BLOOD Type-ART pO2-84* pCO2-56* pH-7.37
calHCO3-34* Base XS-4

Brief Hospital Course:
Ms. [**Known lastname **] is a 82 y/o woman with MMP, most notably CHF,
ARF, and question of pneumonia/UTI.  Her blood gas on admission
was 7.37/56/95 on 100% NRB, and continued to worsen despite
being on BIPAP and Natrecor.  Her lactate rose to 3.3 and her
urine output remained nearly zero.  Her primary medical team
communicated with her daughter throughout her hospital stay, and
respected her wishes to not intubate or resusitate given her
unfortunate prognosis.  Ms. [**Known lastname **] died the morning after
admission from respiratory failure due to CHF in the setting of
renal failure.


Medications on Admission:
Amiodarone 200 mg qd
Atenolol 50 mg qd
Ciprofloxacin 400 mg IV q12h
Lanoxin 0.125 mg qd
Donnatal 5 mg a.c.
Furosemide 40 mg IV qd
Gabapentin 300 mg PO qd
RISS
Protonix 40 mg IV qd
Lisinopril 20 mg PO qd
Flagyl 500 mg IV q8h
Lomotil 1-2 tablets q6h prn diarrhea
Morphine sulfate 1 mg SC q1h prn pain
Zofran 4 mg IV q6h prn nausea
Zocor 20 mg qhs
Allergies: ? allergy to Levaquin

Discharge Disposition:
Expired

Discharge Diagnosis:
Deceased

Discharge Condition:
Deceased
{'Diastolic heart failure, unspecified,Acute kidney failure, unspecified,Atrial fibrillation,Pressure ulcer, lower back,Coronary atherosclerosis of native coronary artery,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Unspecified essential hypertension'}


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: transfer from rehab for management of CHF, abdominal pain

PRESENT ILLNESS: The patient is an 82 year-old woman with a h/o CHF, CAD s/p MI
('[**32**]), Type 2 DM, and bilateral blindness who had a recent
admission to an OSH for dizziness with a fall and tibial fx, and
was then transferred to rehab. On [**3-9**], she was readmitted with
post-prandial abdominal pain, dyspnea with an O2sat of 76% on
RA, fevers to 104.0 and elevated WBC count. She was diagnosed
with worsening CHF (BNP has steadily risen since [**3-9**] and was
1100 at last measurement) and urosepsis. U/A and urine cultures
were negative, though Cipro had already been started at the time
that cultures were drawn. The etiology of her post-prandial
abdominal pain is still unclear, though CT scan shows extensive
calcification of the aorta and mesenteric vessels, and the
patient has newly diagnosed PAF and mesenteric ischemia from
emboli is also a possibility.  Pt transferred to CCU team on
HD#1 for better management of CHF.

MEDICAL HISTORY: CHF
paroxysmal A-fib with RVR
CAD s/p MI '[**32**]
GERD
HTN
h/o GIB
venous stasis
s/p inguinal hernia repair '[**34**]
s/p TAH '[**25**]
s/p CCY '[**16**]
DM2
bilateral blindness
IBS
s/p tibial fx

MEDICATION ON ADMISSION: Amiodarone 200 mg qd
Atenolol 50 mg qd
Ciprofloxacin 400 mg IV q12h
Lanoxin 0.125 mg qd
Donnatal 5 mg a.c.
Furosemide 40 mg IV qd
Gabapentin 300 mg PO qd
RISS
Protonix 40 mg IV qd
Lisinopril 20 mg PO qd
Flagyl 500 mg IV q8h
Lomotil 1-2 tablets q6h prn diarrhea
Morphine sulfate 1 mg SC q1h prn pain
Zofran 4 mg IV q6h prn nausea
Zocor 20 mg qhs
Allergies: ? allergy to Levaquin

ALLERGIES: Levaquin

PHYSICAL EXAM: Vitals: T 96.4 HR 71 BP 121/50 RR 22 O2 sat 100% on 100%NRB
General: lying in bed, moaning, using accessory muscles to
breathe
HEENT: anicteric, elevated JVD to carotid angle
CV: irregularly irregular, no m/r/g
Chest: diffuse crackles and wheezes bilaterally
Abd: soft, mildly tender to palpation in RUQ, ND, +BS
Ext: warm, no edema
Neuro: moaning, difficult to communicate with
Skin: decubitus ulcer on back, sacrum

FAMILY HISTORY: non-contributory

SOCIAL HISTORY: lives w/ daughter who works @ [**Hospital1 18**] as PA, denies smoking, EtOH 

### Response:
{'Diastolic heart failure, unspecified,Acute kidney failure, unspecified,Atrial fibrillation,Pressure ulcer, lower back,Coronary atherosclerosis of native coronary artery,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Unspecified essential hypertension'}
