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<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: 17yo M presents with palpitations. Patient reports 3-4 months of intermittent episodes of "heart beating/pounding out of my chest." 2 days ago during a soccer game had an episode, but this time had chest pressure and felt as if he were going to pass out (did not lose conciousness). Of note patient endorses abusing adderall, primarily to study (1-3 times per week). Before recent soccer game, took adderrall night before and morning of game. Denies shortness of breath, diaphoresis, fevers, chills, headache, fatigue, changes in sleep, changes in vision/hearing, abdominal paun, changes in bowel or urinary habits. PMHx: none Rx: uses friends adderrall FHx: mom with "thyroid disease," dad with recent heart attcak All: none Immunizations: up to date SHx: Freshmen in college. Endorses 3-4 drinks 3 nights / week (on weekends), denies tabacco, endorses trying marijuana. Sexually active with girlfriend x 1 year, uses condoms. Extract phrases from this text which may help understand the patient's medical condition.[/INST]dad with recent heart attcak, mom with "thyroid disease, chest pressure, intermittent episodes, episode, felt as if he were going to pass out, adderall, adderrall, adderrall, palpitations, heart beating/pounding, 3-4 months of, 17yo, M</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 Y/O M CAME TO THE CLINIC C/O HEART POUNDING. STARTED 2-3 MO AGO. IT STARTED SUDDENLY. DOES NOT RECALL ANY TRIGGERING EVENTS. IT COMES AND GOES, IT HAPPENED 5-6 TIMES SINCE IT STARTED. IT LASTS 3-4 MIN, AFTER THAN JUST GOES AWAY. HE HAS ALSO EXPERIENCING SOB, PRESSURE ON HER CHEST WHEN HE HAS THIS ATTACK. HE IS A COLLEGE STUDENT, EXPERIENCING SOME STRESS RECENTLY. DENIES COUGH, CHEST PAIN. ROS NEG EXCEPT AS ABOVE. PMH NONE. MEDS ATEROL, FOR HIS STUDIES, SHARING W HIS ROOMMATE. NKDA. PSH/ HOSP/ TRAVEL/ TRAUMA NONE. FH MOM HAS THYROID PROBLEMS. SH SEX ACTIVE W GIRLFRIEND, NO STDS, USING CONDOMS. SMOKE NONE. ETOH ONLY WEEKENDS. DRUG ONLY ONCE, 1 MO AGO.. Extract phrases from this text which may help understand the patient's medical condition.[/INST]MOM HAS THYROID PROBLEMS, PRESSURE ON HER CHEST, COMES AND GOES, HAPPENED 5-6 TIMES, SOB, HEART POUNDING, STARTED 2-3 MO AGO, 17 Y/O, M</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mr. Cleveland is a 17yo M who was consented by parents to be alone today and provide information. He has no notable PMH and presented today with palpitations that have been occurring sporadically for 2-3 months. He started college 7-8 months ago and described feelings of nervousness and anxiousness with starting school and exams. He endorses using his roommates prescription adderall to study for tests and this coincides with the palpitations at times. Nothing makes his palpitations worse or better when they occur. ROS is negative except for light headedness and SOB. He has not had any cold/heat intolerance, diarrhea, changes in voiding habits, or weight loss. Worried about being able to play basketball. Meds: Adderall from his roommate PMH: none PSH: none All: NKDA Family: mom: thyroid issues, father: heart attack social: no tob, occ EtOH, no illicits sex: with gf, use condoms diet: good exercise: basketball. Extract phrases from this text which may help understand the patient's medical condition.[/INST]father: heart attack, mom: thyroid issues, sporadically, light headedness, has not had any cold/heat intolerance, adderall, Adderall, SOB, palpitations, palpitations, palpitations, for 2-3 months, 17yo, M</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 yo M w/ no cardiac or arrhythmia PMH presents complaining of 3 months of episodic heart pounding. Pt reports sensation of heart racing and pounding out of chest about 5-6 times total over the past 3 months. THis last episode the patient experienced light headedness and had some shortness of breath. Pt is a college student and has recently began to "share" his roommates prescribed aderall approx 2 tabs/week over this time. Pt does not report any adverse effects of the aderall and reports it has helped him study. No changes in weight, dizziness, changes in appetite, fevers or chills. PMH none, PSH none, FHx Father MI, Mom thyroid problem. Meds none accept aderall (not prescribed) Social: college student in philosophy, 2-3 alcoholic drinks/week, does not smoke, tried marijuana once. Sexually active w/ 1 female partner uses condoms. ROS negative accept above.. Extract phrases from this text which may help understand the patient's medical condition.[/INST]Father MI, Mom thyroid problem, episodic, 5-6 times, light headedness, aderall, shortness of breath, heart pounding, heart racing, heart pounding, 3 months of, over the past 3 months, 17 yo, M</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: Dillon Cleveland is an otherwise healthy 17 year old male presenting due to rapid pounding heart rate for 2-3 months. He has never experienced these symptoms before. Comes on randomly, nothing makes it better. Lasts 3-4 minutes. Has happened 5-6 times over last 2-3 months. -Endorses light headedness, chest pressure the last time. -Intermittent tachycardia and pounding heart beat. -Denies throat pain, headache, dizziness, loss of conciousness, chest pain, nausea, vomiting, changes in bowel and urinary habits ROS: as per HPI PMH: no medical issues, no allergies, takes friend's adderall (dose unknown) SOC: No tobacco use, EtOH use 3-4 drinks per week, smoked "pot" once, full time student FAM: Mom-thyroid problem, Dad-MI last year. Extract phrases from this text which may help understand the patient's medical condition.[/INST]Dad-MI, Mom-thyroid problem, chest pressure, 5-6 times, light headedness, adderall, pounding heart, pounding heart, 2-3 months, 2-3 months, 17 year old, male</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 y/o M , Dillon Cleveland comes with c/o of palpitaions. Palpitaions are sudden onset ond have been occuring for the last 3-4 months. He has had 1-2 episodes of palpitaions every month. The last episode was accompanied by breathlessness and constricting pressure over chest which releived on its own. No aggravating or relieving factors. No h/o fever, pedal edema, cough, hemoptysis. no h/o of dyspnoea, orthopnoea. no h/o weight loss, tremors. PMH; not allergic to any medications. no known allergies. No similar episode in hte past. Psh; no history Family h/o; Mother has thyroid condition, father had acute MI last year. Social drinker . Sexaully active with girlfriend sincea a year. No h/o STD.. Extract phrases from this text which may help understand the patient's medical condition.[/INST]father had acute MI, Mother has thyroid condition, pressure over chest, 1-2 episodes, breathlessness, palpitaions, 3-4 months, 17 y/o, M</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 yo M college student comes to the clinic due to heart pounding. He states the he has had episodes of heart pounding for the last 3-4 months. Nothing makes it better or worse and it goes away on its own. he denies any chest pain but does report chest pressure during some of the episodes. He denies warmth or sweating, recent illness, abdominal pain or N/V, tingling in extremities, recent illness or trauma. He is new to college and has been taking aderol a few times a week. The last time he took aderol was 2 days ago, which was also the last time he had episode of palpitations. ROS: negative except for above PMH, PSH: none, medications: aderol self administered. knda, FH: Mother thyroid disease, father heart attach at 52 is okay now. SH: no changes in weight or appetite, he is on the meal plan and tries to be healthy, he plays intermural soccer and runs, no smoking, alcohol hx. Triend marijuanna, uses aderol. Stress college. Extract phrases from this text which may help understand the patient's medical condition.[/INST]father heart attach, Mother thyroid disease, chest pressure, episodes, episodes, aderol, aderol, aderol, heart pounding, heart pounding, palpitations, for the last 3-4 months, 17 yo, M</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: Patient is a 17 yo m with a c/o of palpitations. Palpitations began a few months ago. States that palpitations are sudden, unpredictable and feel like his heart is pounding fast/jumping out of his chest. Typically these episodes last 3-4 minutes and resolve on their own. His most recent episode was 2 days ago and lasted about 10 minutes. During this epsiode he felt lightheaded, Short of breath and had chest pressure located in the middle of his chest. Denies any sweating, changes in hair or bowel movements. ROS: Negative except as stated above PMH: None Meds: Takes his roommates Adderall to help study Allergies: NKDA PSHx: None FH: Mother has a thyroid problem, Father had a MI this past year at age 53 SH: denies to. Extract phrases from this text which may help understand the patient's medical condition.[/INST]Father MI, thyroid problem, Mother has a thyroid problem, chest pressure, episodes, lightheaded, Denies sweating, Adderall, Short of breath, palpitations, Palpitations, palpitations, heart is pounding, heart is fast, began a few months ago, 17 yo, m</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Pt is a 17 y/o M w/ episodic feeling of "heart pounding" and "jumping out of chest." cannot identify a pattern, and seem to come and go without clear trigger.. Also notes some chest pressure during episodes. Denies any tingling or numbness associated. At times during these events he feels like he will pass out although denies oss of ocnsciousness. The episodes last 3-4 minutes. He does not note any undue stressors. PMHx: None PSH: None FM: Mom has "thyroid disorder," dad had recent MI. Social history: Notes trying some of his roommates adderral. Denies other drug use. Alcohol use socially. College freshman studying marketing. Meds: None. Hospitaliaitons: None. Ros: Dizziness, lightheadedness during episodes. Denies tingling/numbness. Denies any feelings of dread or anxiety.. Extract phrases from this text which may help understand the patient's medical condition.[/INST]dad had recent MI, Mom has "thyroid disorder, chest pressure, come and go, lightheadedness, adderral, heart pounding, 17 y/o, M</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 y/o previously healthy male here with heart pounding. States a few months ago, he started having episodes of feeling like his heart is pound/jumping out of his chest. Denies any anxiety, sweating, shaking, or sense of impending doom during these episodes. States he also had shortness of breath with his last episode. Denies any temperature intolerance, jitteriness, chest pain, abdominal pain, GI symptoms, GU symptoms, or easy bruising/bleeding. States he drinks about 3-4 cups coffee/day and several energy drinks throughout the week. Denies any recent stressors in his life. ROS: negative except for above PMH, Surg hx, hospitalizations - none Meds: occasionally take roommate's adderall NKDA FH: mom has thyroid problems, dad had heart attack last year Social: started college 6-7 months ago, denies tobacco use, drinks 3-4 drinks/day on weekends (neg CAGE screening), tried MJ a few months ago. Sexually active with gf, no STD concerns. Extract phrases from this text which may help understand the patient's medical condition.[/INST]dad had heart attack, mom has thyroid problems, episodes, Denies any temperature intolerance, adderall, shortness of breath, drinks coffee, drinks energy drinks, heart pounding, heart is pound, few months ago, 17 y/o, male</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 yo M complains of heart pounding since 2-3 months. He had 5-6 episodes in the past 2-3 months. It is progressively worsening. No specific triggers noticed when these happen. No sweating/chest pain/N/B, SOB. The last episode was severe that he thought he would passout. Denies headaches/ blurry vision/cough/swelling of legs ROS- negative except as above PMH/Allergies/PSH- none Meds- takes adderall since college FH- Mother has thyroid issues, Father has heart problem SH-smoked pot once, nonsmoker, Etoh on weekends occasionally, college student, sexually active with girlfriend. Extract phrases from this text which may help understand the patient's medical condition.[/INST]Father heart problem, Mother thyroid issues, 5-6 episodes, episode, thought he would passout, adderall, heart pounding, since 2-3 months, in the past 2-3 months, 17 yo, M</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 yo m c/o palpitations for the last 3 months. Patient referred having 5- 6 episodes of palpitations in total that comes all of the sudden. He described the episodes as his heart is pounding and in the last episode had SOB and chest pressure. He is started college a few months ago and have no stressors except for recent MI of his father. Denies sweating, tingling, weakness, fear, changes in bowel habits or skin, anxiety. ROS: Negative excepts as above PMH: None Meds: Adderall from a friend's prescription since high school but have been taking it more now in college ( 2-4/ week) All: none PSH: none FH: Mother had thyroid disease, Father had MI at 50yo SH: He is a college student, does not smoke, drink 3-4 beers in the weekend, marihuana once, monogamous with girlfiend, no STI in the past, use condoms regularly. Excercise by playing basketball and running, eat a healthy diet. Drinks 3-4 cups of coffee/day, 2-4 energy drinks/week.. Extract phrases from this text which may help understand the patient's medical condition.[/INST]MI of his father, Father had MI, Mother had thyroid disease, chest pressure, episodes, episodes, Adderall, SOB, coffee, energy drinks, palpitations, palpitations, heart is pounding, for the last 3 months, 17 yo, m</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Patient is a 27 yy/o male with consent from his mother to talk to physician about complaints of pounding heart beat. The palpitations have been occuring for the past 3-4 months 1-2 times perweeek. When experiencing this episodes the symptoms last for 3-14 mionutes. There are no alleviating or precipitatiing factors. He also endorses 1 episode of non radiating midsternal pressure with associated shortness of breath. He does not notice an increase of symptoms with exertion or alcohol. He denies any nausea, pallor, or diaphoresis. He has no PMHx or SHx. He endorses family history of thyroid disease in the mother and MI in the father. He has no allergies and is taking no medications. He endorses occasional alcohol use but denies the use of cigarretes. He endorses use of marijuana once and uses his friends Adderral a few times a week to prepare for exams. He is sexually active with his girlfriend and uses condoms. He is a college Freshman.. Extract phrases from this text which may help understand the patient's medical condition.[/INST]MI in the father, family history of thyroid disease, midsternal pressure, uses Adderral, shortness of breath, pounding heart beat, palpitations, past 3-4 months, male</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Dillon Cleveland is a 17yo otherwise healthy M presenting with 5-6 episodes of palpitations within the duration of past 3 months. 2 days ago, the patient also experience a chest tightness during basketball and was relieved by rest. Basketball seemed to have made the chest tightness come on, but the palpitations have no associated trigger, and both are relieved by rest and resolves on its own. Patient endorses using Adderall taken from a friend's bottle a few times/wk or more depending on the college work. PMH: None PSH: None Meds: Adderall that is from a friend's bottle a few times a week; patient cannot recall the dosage or specific frequency Allergies: NKDA SH: Freshman in college as a 17yo majoring in Philosophy. Drinking on the weekends 3-4 beers. Denies use of marijuana and recreational drugs; denies smoking; has a girlfriend and are sexually active FH: Mother with "thyroid" and father with heart attack recently. Extract phrases from this text which may help understand the patient's medical condition.[/INST]father with heart attack recently, father with heart attack, Mother with "thyroid", chest tightness, chest tightness, using Adderall, palpitations, duration of past 3 months, 17yo, M</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Pt is a 17 y/o male presenting with heart pounding. For last 2-3 months has sensation of heart jumping out of chest not necessariy associated with anything including activity. During the last episode he was playing basketball and also had SOB and chest pressure. Occasionally will feel light headed too. Denies palpitations, leg swelling, diaphoresis, headaches, changes to vision, joint pain, diarrhea/constipation, nausea, vomiting, abd pain, skin/hair changes, heat/cold inotlerance. No LOC. No psychiatric hx or hx of ADHD FH: mom thryoid issues, dad MI in 50's. No hx of sudden death in childhood PMH: None Allergies/Meds: NKA, occasional aderol to help study and focus SH: 1st year in college, not too stressful, no smoking or illiict drugs, alcohol 3-4 x two days out of the week, once tried marijuana. Extract phrases from this text which may help understand the patient's medical condition.[/INST]dad MI, mom thryoid issues, chest pressure, light headed, Denies hair changes, Denies heat/cold inotlerance, aderol, SOB, heart pounding, 2-3 months, 17 y/o, male</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 YO M C/O HEART POUNDING X 4 MONTHS -ONSET DURING A SOCCER GAME, FELT AS IF HE WAS GOING TO LOSE CONSCIOUSNESS -EPISODES OCCUR 1-2 TIMES EVERY MONTH, DESCRIBES THE SENSATION OF PRESSURE IN HIS CHEST -COLLEGE FRESHMAN, OCCASIONALLY USES FRIEND'S PRESCRIPTION ADERALL TO HELP HIM STUDY -DENIES ANY WEIGHT OR APPETITE CHANGES, DENIES ANXIETY AND NAUSEA, VOMITING, DIARRHEA OR CONSTIPATION -DENIES FEVERS OR CHILLS ROS: NEGATIVE EXCEPT AS ABOVE PMH: NONE PSH: NONE ALLERGIES: NKDA MEDICATIONS: ADERALL (PRESCRIBED TO HIS FRIEND) TO HELP HIM STUDY FH: MOTHER HAS A THYROID PROBLEM, FATHER HAD AN MI AT 52 SH: COLLEGE FRESHMAN, PLAYS SOCCER, DENIES SMOKING, DRINKS ETOH ON THE WEEKENDS, SMOKES MARIJUANA OCCASIONALLY.. Extract phrases from this text which may help understand the patient's medical condition.[/INST]FATHER HAD AN MI, MOTHER HAS A THYROID PROBLEM, PRESSURE IN HIS CHEST, OCCUR 1-2 TIMES EVERY MONTH, USES ADERALL, ADERALL, HEART POUNDING, X 4 MONTHS, 17 YO, M</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: PMHx: 17 yo male with episodic heart palpitations. episodes started 2-3 months ago, all of a sudden and would last 3-4 minute and go away on their own . but last episode lasted 10 minutes and was accompanied by chest pressure like sensation and shortness of breath. denies warning sign, confusion, LOC, head trauma, vision changes, SENSITIVIty to ALLERGIES:none Meds: Addrell since high school. last pill was taken 2 days ago to focus on studies. PSHx:none FHx:mom has thyroid, dad had MI at age 52 and he is a smoker. SSHx: he started college 7 months ago. denies smoking and recreational drug use. takes addrell from friend. takes 3-4 beers on weekends.smoked pot once in hight school but never again . sexually active with gf and uses condoms always. never tested for any STIs.. Extract phrases from this text which may help understand the patient's medical condition.[/INST]dad had MI, mom has thyroid, chest pressure, episodic, episodes, episode, Addrell, addrell, shortness of breath, heart palpitations, started 2-3 months ago, 17 yo, male</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Patient is a 17yo m with no PMH, presented with complaint of heart palpitation. Palpitation going on for 3-4 months, 5-6 episodes, last 3-4 min (comes and goes, self resolves). Last episode 2 days ago, had pressure, SOB, and lightheadness, no LOC. Hx of hyperthyroidism with mother, and heart disease in father similar symptoms and hx of MI. HX of using prescription drugs not prescribed to him, Adderol, for studying. DRinks 3-4 drinks, 3 times a week. Denies tobacco use. Marijuana use a few weeks ago. Sexually active with GF, condom use. ROS: Denies fever, chills, weight change, nausea, vomiting, abdominal pain. NKDA.. Extract phrases from this text which may help understand the patient's medical condition.[/INST]father hx of MI, Hx of hyperthyroidism with mother, 5-6 episodes, lightheadness, Adderol, SOB, heart palpitation, for 3-4 months, 17yo, m</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: The mother has given verbal consent for a history, physical examination, and treatment. 17 yo M comes to the clinic c/o intermittent heart pounding which started a few months ago, he reaclls between 2-3 months ago. He has had no prev episodes, not precipitated by anything, not allev or aggrav by anything. 2 days ago while playing basket ball he presented w/lightheadedness, SOB and chest pressure. Denies LOC, falls, chest pain, numbness, tingling, changes in bowel habits and changes in urinary habits ROS: none except for the above PMH: none. Meds: non prescribed adderall, 1 pill a few times a week HOSP/TRAUMA/SURG: none FH: mother has thyroid condition, father had a heart attack Social: college student, lives w/room mate in dorm, drinks 3-4 beers on weekends, CAGE:0/4, denies tobacco, denies other rec drugs. Sexual: active w/gf, wears condom, monagomous, no stds. Extract phrases from this text which may help understand the patient's medical condition.[/INST]father had a heart attack, mother has thyroid condition, chest pressure, intermittent, lightheadedness, adderall, SOB, heart pounding, started a few months ago, 2-3 months ago, 17 yo, M</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 Yo M c/o intermittent feeling of heart racing/palpitations for past 2-3 months. He says the episodes happen randomly sometimes during rest/sometimes during strenous activity and he doesnt notice a pattern, the last episode he felt some chest pressure and SOB that resolved after the episode. He has never had a syncopal episode and does not feel anxiety/panic/ or a sense of doom during or before the episode. He drinks 3-4 cups of coffee today, intermittently uses redbull and takes his friend's adderall intermittently to help with school. He did notice that he took an adderal the morning before the last episode of palpitations. No reported weight loss/cold and heat intolerance Ros: - except what is mentioned PMH: - PSx: - Med/Alg: NKDA, intermittently uses friends adderal Fam: Mom has thyroid disease otherwise noncontributory Soc: Freshman in college, uses firends adderal intermittently, otherwise no tobacco/drug use sparse etoh. Extract phrases from this text which may help understand the patient's medical condition.[/INST]Mom has thyroid disease, chest pressure, intermittent, episodes, episode, No cold and heat intolerance, adderall, adderal, adderal, adderal, SOB, coffee, redbull, heart racing/palpitations, for past 2-3 months, 17 Yo, M</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: CC: "heart pounding episodes" HPI: 17 yo M presents with 2-3 mo history of heart pounding with a total of 5-6 episodes. The episodes last about 3-4 min usually but last episode was 10 min and assoiciated with some SOB as well as chest pressure/discomfort. Last episode was brought on when playing sports with friends. Pressure/pain does not radiate elsewhere and there have been no similar prior episodes. He would rate the chest pressure a 4/10 severity. Denies any sweating, heat/cold intolerance, changes in bowel movements, nausea/vomiting, fever chills, weight loss or gain. ROS: Negative except as above Allergies: none Medications: taking roommate's adderall pills occasionally PMH: none SH: Drinks 3-4 beers or mixed drinks on weekends, 3-4 cups of coffee per day and 1-2 energy drinks per week, no tobacco use, or regular drug use FH: Father had MI at 52, Mother has thyroid problems . Extract phrases from this text which may help understand the patient's medical condition.[/INST]Father had MI, Mother has thyroid problems, chest pressure, chest discomfort, 5-6 episodes, Denies heat intolerance, Denies cold intolerance, adderall, SOB, coffee, energy drinks, heart pounding, heart pounding, 2-3 mo, 17 yo, M</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17yo M with "heart pounding" for few months. Feels like heart is racing. Usually comes out of nowhere, happens when just sitting. Happens 1-2x/month. Last episode was during soccer game, felt chest pressure, light-headed, thought was going to pass out. Does not notice association with any activities, time of day, or activities. Additionally, drinks 3-4 cups of coffee/night and 3-4 energy drinks per week. Has had some increased anxiety since starting college recently, does not have trouble sleeping. Otherwise feels well, no additional symptoms. Has been able to play soccer. PMH: none Meds: uses friends adderal few x per week Allergies: none FH: father with MI at age 52 SH: does not smoke, drinks 3-4 alcoholic beverages/week, no illicit drugs. Extract phrases from this text which may help understand the patient's medical condition.[/INST]father with MI, chest pressure, Happens 1-2x/month, light-headed, adderal, drinks coffee, drinks energy drinks, heart pounding, heart is racing, for few months, 17yo, M</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17yo M presents with 2-3month history of "heart feeling like it is going to beat out of my chest". Feeling comes and goes, has happened a total of 5-6 times, lasts 3-4min per time, can occur at any time of day, and is not alleviated or exacerbated by anything. Never had palpitations in past. Also reports feeling of pressure in center of chest 2 days ago described as "someone sitting on me", lasting 10min as well as SOB during episode. Stressed with recently starting college, and taking roommate's adderall 2x/week. Denies diaphoresis, nausea, vomiting, skin or hair changes, weight changes, and appetite changes. ROS: negative except as above PMHx, allergies, surgeries: none Meds: adderall (see HPI) SH: EtOH: 3-4 on weekends (negative CAGEx4), marijuana once at party, denies tobacco, sexually active with girlfriend, uses condoms FH: mother with thyroid disease, father with MI last year. Extract phrases from this text which may help understand the patient's medical condition.[/INST]father MI, mother thyroid disease, pressure in chest, comes and goes, Denies hair changes, adderall, adderall, SOB, heart feeling like it is going to beat out of my chest, 2-3month history, 17yo, M</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: CC: 17 yo M c/o heart pounding HPI: Patient complains of episodes of heart punding, that happen once or twice monthly, that come and go, usually lasting 3-4 minutes, sudden. During the last episode he felt chest pressure, shortness of breath and felt like passing out, it happened during a fottball game. Between the episodes, he is assymptomatic. ROS: none PMH: none PSH: none med: takes alterol - medicine for enhancing concentration that his roomate gives him allergies: none FH: father had heart attack at age 52, mother has thyroid problem. Extract phrases from this text which may help understand the patient's medical condition.[/INST]father had heart attack, mother has thyroid problem, chest pressure, episodes, happen once or twice monthly, episodes, felt like passing out, shortness of breath, heart pounding, heart punding, 17 yo, M</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Pt is a 17yo previously healthy male who presents with heart pounding. Pt states first began having episodes of heart pounding 2-3 months ago, first time while sitting/watching TV. No associated pain, nausea or vomiting. Two days ago, did feel pressure on his chest with SOB. Episodes are sporadic, with no apparent trigger, and self-resolve within 2-3 min. Pt has not tried any medications. No syncopal episodes. No hx of travel. No hx of preceding illness/URI. He exercises and eats varied diet. No hx of congenital heart defects. ROS: as per HPI PMH, PSH: - Meds: - Fam Hx: Mom w/ thyroid issue. Dad had heart attack recently (due to poor diet). Sister healthy. No hx of heart issues or sudden cardiac death. Social: Studying philosophy, living on college campus. Sexually active in monogamous relationship w/ gf (uses condoms). Denies tobacco or drug use (tried marijauana once few mo ago). Drinks socially on weekends. Allergies: -. Extract phrases from this text which may help understand the patient's medical condition.[/INST]Dad had heart attack, Mom w/ thyroid issue, pressure on his chest, SOB, heart pounding, 17yo, male</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Dillon Cleveland is a 17yo male with a 3-4 month history of heart pounding. These palpitations come on suddenly and last four 3-4 minutes each. The most recent episode was accompanied by a pressure sensation in the chest and shortness of breath. The patient denies headache, chest pain, pallor, dizziness, diaphoresis, weight changes, heat/cold intolerance, hair loss. The patient drinks 3-4 cups of coffee per night and 1-2 energy drinks during the week to keep up with studying. He has also been taking his roommates prescribed Adderall, most recently twice in one day at which may have been associated with eps. Past Medical Hx: None Past surgical hx: None Medications: Adderall Social Hx: Patient is a freshman in college. He drinks 3-4 drinks over the weekend, denies smoking hx, endorses marijuana use in last month as well as a roommate's Adderall a few times a week. Family Hx: Thyroid disease - mother, Heart attack 1 year ago - father. Extract phrases from this text which may help understand the patient's medical condition.[/INST]Heart attack 1 year ago - father, Thyroid disease - mother, pressure sensation in the chest, denies heat/cold intolerance, denies hair loss, taking Adderall, Adderall, Adderall, shortness of breath, drinks coffee, drinks energy drinks, heart pounding, 3-4 month history, 17yo, male</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 y/o M complains of increased heart rate for the last 3 months. The sensation of increased heart rate has occured 5-6 times and the last episode has been the worst. Pt says the sensation goes away on its own and is not aware of what makes it worse. Pt notes episode at basketball game with exertion as well as notes an episode at rest. Pt admits to using college roomates prescription amphetimine to increase study performance on exams. Pt also admits to increased consumption of high caffine energy drinks. Additionally Pt denies any changes in weight, heat intolerance or any changes in mood sleep or urinary or bowel habits. ROS (-) except above PSH/PMH - nc MED- adderall ALL - NKDA SSH - no tobacco, tried marijuana once, drinks EtOH socially FH - father heart attack 52, mother thyroid problem. Extract phrases from this text which may help understand the patient's medical condition.[/INST]ather heart attack, mother thyroid problem, occured 5-6 times, denies heat intolerance, amphetimine, adderall, consumption caffine, increased heart rate, increased heart rate, last 3 months, for the last 3 months, 17 y/o, M</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: 17 YO M C/O PALPITATIPN X 2-3 MONTHS AGO. IT'S INTERMITTENT ( 5-6 EPISODES/2-3 MONTHS) , LAST ABOUT 1 MIN, AND IT'S NOT PROGRESSIVE. ALLEVIATED AND AGGRAVATED BY NOTHING. HE TOOK ADDERRAL 1 PILL/LAST WEEK DUE TO SUDYING FO FINAL EXAM. HE DENIES CHEST PAIN, SOB, SWEATING, COUGH, EDEMA IN LEGS, NAUSEA, VOMITING, FEVER, FATIGUE, NIGHT SWEAT, CHANGES IN SKIN/HAIR, CHANGES IN WEIGHT OR APPETITE. NO TRAUMA, RECENT INFECTION OR TRAVEL. HE USED POT 1 TIME LAST MONTH IN FRIEND'S PARTY. HIS MOOD AND SLEEP IS NL. HE IS NOT WORRY ABOUT FUTURE EPISODES. NO ANXIETY. ROS: NEG EXCEPT AS ABOVE. NKDA. MEDS: ADDERRAL. FH: MOTHER HAS THYROID DISEASE. FATHER HAD MI. SSH: SEXUALLY ACTIVE WITH GIRLFRIEND. USES CONDOMS. NO SMOKING. USED POT 1 TIME LAST MONTH. ETOH OCCASIONALLY. FULL TIME STUDENT, NO STRESS OR RECENT CHANGES IN LIFE.. Extract phrases from this text which may help understand the patient's medical condition.[/INST]FATHER HAD MI, MOTHER HAS THYROID DISEASE, INTERMITTENT, EPISODES, DENIES CHANGES IN HAIR, ADDERRAL, ADDERRAL, PALPITATIPN, X 2-3 MONTHS, 17 YO, M</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Patient is a 17 yo M presenting with 3-4 months of intermittent heart pounding and beating fast. Patient report that the symptoms have been getting worse. Episodes would last 3-4 minutes but the most recent episdoe 2 days ago during a soccer match lasted 10 minutes with associated chest tightness. Does not notice a pattern to the symptoms. Denies headache, vision changes, LOC, n/v, orthostatic hypotension, recent illness. Reports feeling behind with college and use of adderall to manage workload PMH: n/a PSH: n/a meds: adderall from a friend few times/week Allergies: n/a Family hx: mother with thyroid issue; father had heart attack at 52 years old last year; no hx of unexpected deaths in family; no hx of other heart problems in family social hx: denies tobacco use. Drinks 3-4 drinks/week. counceled on drinking and adderall use. tried marijuana in college. Extract phrases from this text which may help understand the patient's medical condition.[/INST]father heart attack, mother thyroid issue, chest tightness, intermittent, Episodes, adderall, adderall, adderall, heart pounding, heart beating fast, 3-4 months of, 17 yo, M</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17-year-old male presenting with heart palpitations for the past few months. He endorses that these episodes occur randomly are not associated with any particular activity. The episodes last 3-4 minutes and occur once-twice/month. He denies alleviating and provoking factors. His most recent episode occurred two days ago and he also experienced chest pressure that lasted for 10 minutes and a sensation that he was going to pass out when he was playing goalie in a soccer game, which resolved spontaneously. He denies headache, vision changes and weakness. He denies a family history of sudden cardiac death. ROS: negative except as noted above PMH: none PSH: none Meds: uses friend's adderoll before tests All: NKDA FHx: mother with hypothyroidism, father had an MI at 52 and is now fine/quit smoking SHx: freshman in college studying marketing, lives with roommate, no alcohol, other drug use, sexually active with girlfriend, uses condoms. Extract phrases from this text which may help understand the patient's medical condition.[/INST]father had an MI, mother with hypothyroidism, chest pressure, episodes occur randomly, uses adderoll, heart palpitations, past few months, 17-year-old, male</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 y.o. male presents with 2-3 month history of heart pounding. The heart pounding and chest pressure occurs for about 3-4 minutes and has happened 5-6 times since the first episode. Last episode was 2 days ago, he felt significant pressure in the chest, SOB, and light headedness. The episodes can occur while sitting down (most times) or while active. Pt denies any recent stressors, weight change, nausea/vomiting, diaphoresis. PMHx: No hospitalizations, chronic medical conditions, trauma or surgeries Meds: NKDA, no prescription meds, no OTCs or vitamins FHx: Heart attack in father, denies any family history of sudden death of syncope PSHx: 1st year college student. 3-4 beer on weekend socially, Sexually active with 1 partner(girlfriend), Denies smoking or tobacco history. Used marijuana 1x. Takes friends adderal 3-4x per week. Has been doing so fo1 year. Pt is active on his basketball team, this is not associated with his symptoms.. Extract phrases from this text which may help understand the patient's medical condition.[/INST]Heart attack in father, chest pressure, pressure in the chest, happened 5-6 times, light headedness, Takes adderal, SOB, heart pounding, heart pounding, 2-3 month history, 17 y.o., male</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: A 17 YO M COLLEGE STUDENT C/O HEART POUNDING X 2-3 MONTHS - INTERMITTENT, NOT PROGRESSIVE, NOTHING MAKES IT BETTER OR WORSE - ASSOCIATED WITH SOB X 2 DAYS - DENES CHEST PAIN, LOC, FATIGUE, ANXIOUS, SWEATING, NECK SWELLING, HEAT INTOLERANCE, RASH, LEG SWELLING, SLEEP DISTURBANCE, EXCESSIVE CAFFEINE INTAKE, HEADACHE AND CHANGES IN BOWEL MOVEMENT ROS: NEGATIVE EXCEPT ABOVE ALLERGY: NKDA MEDS: ADDREALL FOR STUDY PMH & PSH: NONE FH: MOTHER HAD THYROID DIEASE AND FATHER HAD HEART ATTACK SH: NO SMOKING, USED MARIJJANA 1 MONTH AGO, 2-4 DRINKS/WEKEND, SEXUALLY ACTIVE WITH GIRLFRIEND, NO STI, PERSISTENT CONDOM USED. Extract phrases from this text which may help understand the patient's medical condition.[/INST]FATHER HAD HEART ATTACK, MOTHER HAD THYROID DIEASE, INTERMITTENT, DENES HEAT INTOLERANCE, ADDREALL, SOB, HEART POUNDING, X 2-3 MONTHS, 17 YO, M</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mr. Cole is a 17 m with c/o heart pounding. He has had 5-6 episodes of his heart "jumping out of his chest". These episodes last 3-4 mintues normally, but the last one lasted 10 mintues. He also felt chest pressure, SOB, and lightheaded with the last episode. It has happened while exercising and while sitting around. Of note, this last episode occurred after he took some of his friends adderrall for a test. He has not had any pain, pounding elsewhere in the body, vision changes, appetite changes, weight loss, abdominal pain, or bowel movement changes. ROS: negative unless in HPI Meds: adderrall 2 per week, no allergies Med Hx: none Surg Hx: none Family Hx: MI at 52 for father, mother healthy Social Hx: at college, lives in dorms, feels safe. No tobacco use, drinks 3-4 beers per weekend. Smoked marijuana once. Sex with girlfriend, use condoms.. Extract phrases from this text which may help understand the patient's medical condition.[/INST]MI at 52 for father, chest pressure, 5-6 episodes, episodes, episode, lightheaded, adderrall, adderrall, SOB, heart pounding, heart "jumping out of his chest, 17, m</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: 17 yo m presents with episodic palpitation for the past 2 - 3 months. It is progressive worsening, 5-6 times over 3 months, lasting for 2-3 minutes, and with no exacerbating or alleviating factors. He reports SOB , lightheadedness and chest pressure with last episode. He denies any weight loss, tremors, hot intolerance, recent stress, numbness, tingling, diarrhea, wheezing, and cough. ROS: Negative except as above PMH: None Med: amphetamine PSH: None Allergy: NKDA FH: mother has hypothyroidism, father has MI SH: no smoking,used illicit drug once, sexually active with his girlfriend. Extract phrases from this text which may help understand the patient's medical condition.[/INST]father MI, mother hypothyroidism, chest pressure, episodic, lightheadedness, denies hot intolerance, amphetamine, SOB, palpitation, for the past 2 - 3 months, 17 yo, m</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: Dillon Cleveland is a 17 yo M with a 3-4 month history of heart pounding. He feels his heart beating quickly like it's coming out of his chest. These episodes occur 1-2x/month with no provoking factors or specific pattern and resolve on their own in 3-4 minutes. Last episode was 2 days ago during a soccer game and was associated with chest pressure, SOB, and lightheadness. He has never passed out or lost consciousness. He notes starting college recently was hectic but he was able to transition well. ROS: no weight changes, diarrhea, tremors, heat intolerance, anxiety PMH: negative Medications: takes his roommate's Addral a few times/wk Allergies: NKDA FHx: mom - thyroid problem, dad - heart attack last year Social: freshman in college, lives with his roommate; denies tobacco use, drinks occasionally, tried marijuna a few times, no other drug use, drinks 3-4 cups of coffee/day, sexually active with one F partner,uses condoms . Extract phrases from this text which may help understand the patient's medical condition.[/INST]dad - heart attack, mom - thyroid problem, chest pressure, lightheadness, no heat intolerance, Addral, SOB, drinks coffee, heart pounding, 3-4 month history, 17 yo, M</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 yr old m comes in with CC of "heart beating/pounding too fast". For the past month has been having random episodes of tachycardia that last 3-4 minutes at a time. Patient denies LOC, sweating, palpitations, tremors, chills, fever, numbness or tingling. He has never experienced this before. Pt is a freshmen in college and has been using adderall to keep up with his studies. Last use was 3 days ago, last episode of tachycardia was 2 days ago. States he feels light headed duing these episodes. Patient denies cold intolerance,weight loss, diarrhea, urinary changes, headaches and nausea. ROS: negative except above. Meds: occasionally takes adderall. NKDA PMH: none FH: mother has thyroid disease, Father had an MI 1 year ago Social: freshmen in college. does not use tobacco. drinks 3-4 beers on the weekend. No Illicits. Adderall. Exercise: runs a few miles a week, no relation to tachy.. Extract phrases from this text which may help understand the patient's medical condition.[/INST]Father had an MI, mother has thyroid disease, random episodes, light headed, denies cold intolerance, using adderall, takes adderall, Adderall, heart pounding, tachycardia, 17 yr old, m</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Dillon is a 17 yo M with no PMH c/o heart pounding. he has had 1-2 episodes a month for the last 3- 4 months and have been lasting longer. The episodes typically last 3-4 minutes and self resolve, there is no consistent percipitating factor. The last episode was 2 days ago during a soccer match where the patient felt SOB and lightheaded. He has not had any syncopal episodes, dizziness, N/V, Chest Pain, diarrhea, abdominal pain, headaches, sleep changes, sweating, sense of doom or vision changes. PMHX: none surgical: none Family: mom has thyroid issues, dad had MI med: occasionally uses friends adderal SHX: does not smoke, alcohol 3-4 drinks a weekend smokes marijuana occasionally exercise: plays soccer for school Caffeine- 3-4 cups of coffee a night, 1-2 red bulls/energy drinks a week sexual: sexually active with gf uses condoms. Extract phrases from this text which may help understand the patient's medical condition.[/INST]dad MI, mom has thyroid issues, episodes, episodes, episode, lightheaded, has not had sweating, adderal, SOB, Caffeine, coffee, energy drinks, red bulls, heart pounding, for the last 3- 4 months, 17 yo, M</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: CC: Heart pounding HPI: The patient is a 17-year-old male who presents with intermittent episodes of heart pounding. This has occurred 5-6 times over the last 2-3 months with each event lasting 3-4 minutes. There is nothing that brings them on and they resolve on their own. During the last event 2 days ago, he had associated chest pressure, SOB, and light-headedness. No diaphoresis or syncope during this event. ROS: Negative for headache, sore throat, chest pain, nausea, vomiting, constipation, diarrhea. PMH: Negative Rx: None All: NDKA Sx: None FMH: Father-recently had an MI. Mother-has thyroid problems Soc: Is a full-time student. Denies tobacco use. Drinks 3-4 beers on weekends (0/4 CAGE). Reports using his friend's Adderall a few times per week with his last use being 3 days ago. He also reports smoking marijuana a month ago.. Extract phrases from this text which may help understand the patient's medical condition.[/INST]Father-recently had an MI, Mother-has thyroid problems, chest pressure, intermittent episodes, occurred 5-6 times, light-headedness, Adderall, SOB, Heart pounding, heart pounding, over the last 2-3 months, 17-year-old, male</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mr. Cleveland is a 17yoM presenting with palpitations. Started 2-3months ago, getting worse, intermittent episodes with sudden onset and no triggers. Nothing makes better or worse. Episodes happen during exertion and rest, last 3-4min, self resolve. Most recent was 2 days ago, with SOB, chest pressure (at midline chest), and lightheadedness while playing basketball. States never had those symptoms before. Endorsed adderol use this morning prior to episode. Denies relation of palpatations to adderol usage. Denies other chest pain, SOB, cough, Headache, fatigue, fevers, weight change, appetite change, or body pains. PMX: none meds: none allergies: none surgeries: none family: father has heart issue and had MI at 52yo. Mom has thyroid issue. substances: never smoker, drinks 3-4x/week, adderol started 6-7 months ago, uses occassionally, most recently prior to episode stated above. Also marijuana used once. Social: goes to school.. Extract phrases from this text which may help understand the patient's medical condition.[/INST]father had MI, Mom has thyroid issue, chest pressure, intermittent episodes, lightheadedness, adderol, adderol, SOB, palpitations, 2-3months ago, 17yo, M</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: Mr. Cleveland is a 17yo M who presents with 2-3 months of heart pounding. Was sitting and watching TV when it first started. Sensation has been stable and unchanging since onset. Episodes last 3-4 minutes, self-resolve. Occurs randomly, no alleviating or aggravating factors. Had one episode 2 days ago during basketball game with midline chest pressure and lightheadedness. No loss of consciousness. He has a basketball game tomorrow and is worried the symptoms may return. ROS: No headache, vision changes, cold/heat sensitivity, abdominal pain, diarrhea, constipation, nausea, vomiting, urinary symptoms, weight changes, appetite changes, fever, chills PMH: None PSH: None Medications: Adderall 2-3 weekly Allergies: NKDA Fam Hx: Mom with thyroid disease, Dad Soc Hx: college student, sexually active with girlfriend, regular condom use, drinks 3-4 beers each weekend 0/4 CAGE, no tobacco or other drug use, tried marijuana once. Extract phrases from this text which may help understand the patient's medical condition.[/INST]Mom with thyroid disease, chest pressure, Occurs randomly, lightheadedness, No cold/heat sensitivity, Adderall, heart pounding, 2-3 months, 17yo, M</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI- 17 YO M WITH C/O HEART PALPITATIONS FOR 3 MONTHS WHICH WAS SUDDEN IN ONSET, INTERMITTENT AND PROGRESSIVE. HE HAD A SEVERE EPISODE 2 DAYS AGO WHERE HE HAD CHEST TIGHTNESS AND SOB. HE IS STRESSED OUT ABOUT COLLEGE AND IS TAKING ADY WHICH HIS FRIEND PROVOIDED TO HIM. HE ALSO CONSUMES 3 TO 4 CUPS OF COFFEE EACH DAY. DENIES FEVER, CHEST PAIN, SLEEP CHANGES COUGH, SKIN CHANGES, CHANGES IN WEIGHT OR APPETITE, TREMORS, SOB ON EXERTION, CHANGES IN URINARY OR BOWEL HABITS. PMH/PSH- NONE ALLERGIES- NKA MEDS- NONE FH- MOTHER HAS THYROID PROBLEMS AND FATHER HAD MI SH- DRINKS 3 TO 4 BEERS/WEEKEND, DENIES TOBACCO, SMOKED POT ONCE, PLAYS BASKETBALL AND DOES EXERCISE. SEXUAL- MONOGAMOUS AND USES CONDOMS.. Extract phrases from this text which may help understand the patient's medical condition.[/INST]FATHER MI, MOTHER THYROID PROBLEMS, CHEST TIGHTNESS, INTERMITTENT, EPISODE, SOB, CONSUMES COFFEE, COFFEE, HEART PALPITATIONS, FOR 3 MONTHS, 17 YO, M</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: 17 yo M presents with c/o heart pounding. Started 2 months ago and has experiences 5-6 episodes each lasting 3-4 minutes -Describes pain as substernal pressure and denies radiation of presure. -Most severr episode occurred 2 days ago. reported chest pounding and SOB -ROS: Denies LOC, observed seuizure like activity, change with position, relation to food. Denies bowle or bladder incontinence -PMH: none -Meds: Uses roomates Adderall a few times a week -All: NKDA -PSH: none -SHx: College student studying philosophy. Lives on campus. Drinks 3-4 beers on weekends. Tried marijuana 1x. Denies use of other ilicit drugs. Denies personal stressors. Sexually active with one female partner -FH: Dad- alive, MI @ 55 yo. Mom- alive, Hyperthyroid . Extract phrases from this text which may help understand the patient's medical condition.[/INST]Dad MI, Mom Hyperthyroid, substernal pressure, 5-6 episodes, Uses Adderall, SOB, heart pounding, chest pounding, Started 2 months ago, 17 yo, M</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17yo male. presents with paroxysmal episodes of "heart pounding". onset of symptoms 2-3 months ago. was sudden onset while watching television at home. has had 5-6 episodes in total. episodes last 2-3 minutes and are self-remitting. no identifiable triggers. last episode was 2 days ago. episode 2 days ago was accompanied by light-headedness, shortness of breath and central chest pressure. No recent illnesses. no sick contacts. no travel. no pets. no infective symptoms. no weight changes ROS: no syncopal events. no cough or wheeze. no haemoptysis no headaches or altered mentation. no diaphoresis MHx: nil Medications: nil prescribed, however takes his friend's adderall for studying. takes these a few times per week since highschool. nil known allergies. Social Hx: nonsmoker. drinks 3-4stds/weekend. smoked cannabis once a few months ago. denies other drug use. FHx: mother - thyroid issue. father - heart issue.. Extract phrases from this text which may help understand the patient's medical condition.[/INST]mother - thyroid issue, chest pressure, 5-6 episodes, light-headedness, takes adderall, shortness of breath, 2-3 months ago, 17yo, male</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 y.o male p/w 2-3 month history of intermittent episodes in which patient has the sensation his heart is 'pounding' and 'racing'. These episodes have occured 5-6 times over the interval and have lasted for ~3-4 minutes. The most recent episodes two days ago was also associated with SoB and occured several minutes into a game of basketball. Otherwise the patient does not attribute these episodes to any particular activity. Notably, the patient is a college freshman and reports taking street-adderal several times a week and has been doing so for the past two years. No other pertinent PMH, surgical, family, or social history. Pt denies LOC, HA, N/V, chest pain, and SOB only in the most recent episode. Paitient was counseled to avoid adderal and other stimulants, and to avoid strenuous physical activity until next clinic appointment.. Extract phrases from this text which may help understand the patient's medical condition.[/INST]intermittent episodes, 5-6 times, adderal, SoB, SOB, "heart is pounding", heart racing, 2-3 month, 17 y.o, male</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: CC: Heart Pounding HPI: Episodes of heart pounding that began a few months ago and last for 4-5mins at a time. The episodes occurr every couple weeks and have recently been accompanied by some mild lighheadeness. Patient states he needed to sit down on the last episode which happened while he was playing basketball. Patient denies chest pain but has been having some heaviness on his chest during the episodes. Denies any feelings of dread or panic, but has had some SOB. He has been recently trying adderall from his roommate every couple days, but there doesn't seem to be a relation to the drug use. He has never had syncope. PMH: none PSH: None Meds: Aderall allergies: none Social: Sexually active wears condom every time, no tobacco use, only drug use is the aderall and one time tried THC. Never Cocaine or PCP. He is full time student who just started ROS: No cough or congestion, no fatigue or diarrhea FM: Dad had MI at 52yr. Extract phrases from this text which may help understand the patient's medical condition.[/INST]Dad had MI, heaviness on his chest, Episodes, episodes, episodes, lighheadeness, adderall, Aderall, aderall, SOB, Heart Pounding, heart pounding, began a few months ago</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17yo M with cc palpitations for the past 2-3 months, palpitations have occurred 5-6 times in total, denies history of palpitations prior to this. pt reports lightheadedness, sob and chest pressure with last episode. episodes last about 3-4 min and resolve on their own. denies alleviating or aggrevating factors. denies N/V, diarrhea, constipation, weight changes, cold or heat intolerance or hair loss, denies changes with appetitie or sleep difficulty. denies allergies or medication use. ROS: negative except for above PMH: denies FH: mother-thyroid problem, father-MI at 52yo SH: denies tobacco use. tried cannabis once a few months ago. drinks socially on weekends with friends. is in his first year of college and becomes stressed with the workload. pt admits to taking adderrall from a friend to stay away. denies any drug use. pt drinks excessive amounts of coffee, red bulls and 5hr energy drinks in other to stay away.. Extract phrases from this text which may help understand the patient's medical condition.[/INST]father-MI, mother-thyroid problem, chest pressure, episode, episodes, lightheadedness, denies cold or heat intolerance, denies hair loss, adderrall, sob, coffee, red bulls, 5hr energy drinks, palpitations, palpitations, past 2-3 months, 17yo, M</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Dillon Cleveland is a 17 yo M who presents to the clinic for pounding heart. He states it seems to be unprovoked and has been happening for the last 2-3 months. He is has been in college for the last 7-8 months and is generally doing well with his mood and his grades. He did not one episode of heart pounding where he felt SOB and light headed while playing basketball. He denies any flushing, sweating, excessive worrying, recent illness, or allergies. He does not take any medications. No recreation drug other than 1 time with marijuana, he has taken non-prescribed adderall a couple times a week during exam times. Maximimun EtOH consumption is 3-4 beers or mixed drinks on the weekends only. Family history is positive for an MI in his father at age 52, and his mother has thyroid problems. He was never hospitalized or told he had heart problems in the past.. Extract phrases from this text which may help understand the patient's medical condition.[/INST]MI in his father, mother has thyroid problems, light headed, taken adderall, SOB, pounding heart, heart pounding, 2-3 months, 17 yo, M</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: Mr. Cleveland is a 17 yo m that presents with intermittent palpitations for the last 2-3 months. He notes that the last one was 2 days ago while playing basketball and after taking adderal. This episode was worse than those prior. They go away on their own with no alleviating or aggravating factors. Associated factors possibly include exercise and adderall use. He has had 5-6 episodes over the last 2 months. PMH: None. No surgeries Allergies: NKDA Medications: Adderal during test season ROS: Endorses SOB and lightheaded. Denies fever, chills, nausea, vomiting, chest pain, headache, dizziness, change in weight, or diaphoresis FH: Mother thyroid issue. Father MI Social Hx: Denies tobacco use. Social drinker 3-4 drinks on weekend. Experiment with marijuana once. Safe at home and in relationships. Student Sexual Hx: Sexually active monogamously and uses condoms. No STI Hx . Extract phrases from this text which may help understand the patient's medical condition.[/INST]Father MI, Mother thyroid issue, intermittent, episode, episodes, lightheaded, adderal, adderall, Adderal, SOB, palpitations, or the last 2-3 months, over the last 2 months, 17 yo, m</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Pt is a 17 year old male presenting with heart palpitations, he state it has been going on for the past 2-3 months and it comes and goes. nothing makes it better or worse. It has happened 5-6 times the past. nothing particualary triggers it. Pt is stressed with college that he started in the fall and has consumed redbull once a week coffee every once and a while. He also states he takes his friends adderal every once and while. last used was 2-3 days ago He has never had this happen to him in the past. he had shortness of breath about 2 days ago. Pt deneies headache, no vision change, no bowel issue, no temperature intolerance. PMHX: none medication: none exepect for friend adderal 2/3 days ago phx: na allergy: NA fHX: father heart issue mother: thyrid Shx: college student, does not smoke, drinks on weekends 2-3 beers, tried marijwana once but does not use it. Sexually active with one female partner and uses condoms consistently. Extract phrases from this text which may help understand the patient's medical condition.[/INST]comes and goes, happened 5-6 times, no temperature intolerance, adderal, adderal, shortness of breath, consumed redbull, coffee, heart palpitations, past 2-3 months, 17 year old, male</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mr. Cleveland is a 17 yo M presenting with epidosidic heart racing. This started 2-3 mos ago and he has had 5-6 episodes of tachycardia during this time. It doesn't seem to be related to exercise or public speaking. During the last episode he had SOB and felt lightheaded, but did not pass out. He also had chest pressure during this episode. Denies diaphoresis, headaches, vision changes, wt changes, fatigue, hair changes, heat or cold intolerance, changes in bowel or urinary habits, and chest and abdominal pain. No PMHx. Takes friend's adderal occassionally. No allergies. No surgeries. Dad had MI at 52; mom has thyroid disease. No tobacco or drug use. Occassionaly drinks on weekends. Sexually active with girlfriend and uses condoms.. Extract phrases from this text which may help understand the patient's medical condition.[/INST]Dad had MI, mom has thyroid disease, chest pressure, 5-6 episodes, felt lightheaded, Denies heat intolerance, Denies cold intolerance, adderal, SOB, heart racing, 2-3 mos ago, 17 yo, M</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: pt 17y/m c/o palpitation since 2-3 months, episodes come and go, last for 3-4 minutes, no precipitating or releiving factors. last episode happened while playing basketball, pt felt chest pressure, and felt like almost passed out. pt has no chest pain, nause or vomitting, no tremors, no heat or cold intolerance, no changes in bladder or bowel habits. no changes in diet or polydypsia pt had changed college 7-8 months back, and has trouble adjusting to it, no rashes. pt has been taking 3-4 cups of coffee every day and red bull 4-5 in a week. no mood changes, no anxiety or panic attack ROS - nothing significant except as above allergy - none medication - pt takes aderral multiple times, last 2 days ago. PMH - none PSH - none SH - no smoking, occasional marijuana 5month ago, sexually active with girlfriend, uses condom, no STI FH - father had problems with heart and mother has hyperthyroid . Extract phrases from this text which may help understand the patient's medical condition.[/INST]father had problems with heart, mother has hyperthyroid, chest pressure, episodes come and go, felt like almost passed out, no heat intolerance, no old intolerance, takes aderral, coffee every day, taking red bull, palpitation, since 2-3 months, 17y, m</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Dillon Cleveleand 17yoM with 2-3 months of intermittent episodes of cardiac palpitations. Episodes 3-4min and self resolve, happened 5-6x at rest and while active. Recently lightheadedness and SOB. Between these episodes denies any symptoms. ROS: Denies CP, dizziness, abdominal pain, dysuria, rash, edema, appetite change, weight change, change in BM. PMH: Denies. vaccines UTD PSH: Denies Meds: uses friends adderall 1-2x/week since starting college Fam hx: Mom with "thyroid problem;" Dad with "heart attack" last year Social: first year college student studying philosophy, 3-4 beers/week, denies tobacco use, used marijuana 1x last month. Sexually active only with girlfriend, denies STI testing. Healthy high fibe diet, runs and plays basketball 3-4x/week.. Extract phrases from this text which may help understand the patient's medical condition.[/INST]Dad with "heart attack, Mom with "thyroid problem, intermittent episodes, happened 5-6x, lightheadedness, uses adderall, SOB, cardiac palpitations, 2-3 months, 17yo, M</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 years old m presents with c/o heart pounding X 2-3 months. it starts suddenly and is getting worse since then no aggra/alleviating factors. he had 5-6 episodes in last 3 motnhs and each lasted for 3-4 mins. it is associated with sob. pt drinks 5-6 drinks of coffee and red bull and he also takes aderrol 2-3 times/week from past 7-8 months. denies any changes in the weight, tremors, heat intolerenace, fever, chest pain and cough. ros: neg exp above pmh/psh:na meds: adderrol X 7-8 months, last use : in last week. allergies/hosp:na travel/trauma:na fh: mother -thyroid ssh: denies smoking or illicit drug use, uses alcohol occassionally. Extract phrases from this text which may help understand the patient's medical condition.[/INST]mother -thyroid, episodes, denies heat intolerenace, aderrol, adderrol, sob, coffee, red bull, heart pounding, X 2-3 months, last 3 motnhs, 17 years old</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 yo M c/o heart racing - Episodes have been going on for the past 2-3 months - Episodes last for 3-4 minutes - Random with no precipating event. - Pt. denies sweating , vision changes, sleep changes. FHx: Mother had some thyroid issue, Father had some heart issue. SH: Student. Drinks 3-4 drinks on weekends, Used Pot once. Uses unprescribed Adderal as study aid which he aquires from friend. Allergies: NKDA. Extract phrases from this text which may help understand the patient's medical condition.[/INST]Mother had some thyroid issue, Episodes Random, Adderal, heart racing, past 2-3 months, 17 yo, M</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mr. Cleveland is a 17 yo otherwise healthy male that presents with 3 months of heart palpitations. He states that he has had 5-6 episodes in total and that they do not seem to be associated with anything, including stress or activity. He does however note that he has been taking his friend prescription aderall in order to help him study. He started this in high school but since starting college he has been taking them more often. He has not had any chest pain but he did have one instance of non-radaiting chest pressure that was accompanied with shortness of breath that lasted 15 mimutes 1 week. No fevers, headaches, weight changs, sweating, n/v, diarrhea, constipation, abdominal pain, urinary changes, skin changes, joint pains. No past medical history or surgical history. No meds beyond taking his friend's adderral. No smoking or illicit drugs. 3-4 beers on the weekend. Family hx: Father had MI last yar at 52 yo. Mom has thyroid disease. Extract phrases from this text which may help understand the patient's medical condition.[/INST]Father had MI, Mom has thyroid disease, chest pressure, 5-6 episodes, No sweating, aderall, adderral, shortness of breath, heart palpitations, 3 months, 17 yo, male</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI:17-year-old male, 2 months ago 6 episodies of heart pounding, the last whit shortness of breath, 4 to 6 minutes of duration , self imited, no sincope , no chest pain , no temperature problems ,no alliviating o , no worsering, no exercise asociation ,no gain or loss weight ROS: Negative except as above PMI:Neg,Meds:Neg;PSH:Neg;All:Neg;Hx:Neg FH: Mom Thyroid problem, Dad MI last year SH: Drinks: Weekend whit friends;Smoke: Neg;Drugs weed 1 episode;Sexually active 1 parner , uses condoms . Extract phrases from this text which may help understand the patient's medical condition.[/INST]Dad MI, Mom Thyroid problem, 6 episodies, no temperature problems, shortness of breath, heart pounding, 2 months ago, 17-year-old, male</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 yo previously healthy male who presents with a 2-3 month history of heart pounding. He says that he has had 5-6 episodes of this sensation where his heart feels like its beating faster and harder since his first episode. Each episode last about 3-4 minuts each and goes away with rest. He has not noticed anything that couses the episodes to occur and no relieving factors other than rest. His lat episode had associated feeling of pressure in his chest like someone was sitting on it and it lasted 10 minutes. No associated chest pain, shortness of breath, or changes to urinary or bowel habits, no changes to vision. Endorses regular use of adderall a few times week to help in study for which he has been taking for the last year. ROS Negative except as above Family history: Mom thyroid disease, Dad: Heart problem Social: Full time student. No Tobacco or recreational drugs. drinks 3-4 beers on weekends. Extract phrases from this text which may help understand the patient's medical condition.[/INST]Dad: Heart problem, Mom thyroid disease, pressure in his chest, 5-6 episodes, use of adderall, heart pounding, heart feels like its beating faster, 2-3 month history, 17 yo</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 yo M who presents with 3 months of episodic "heart beating out of my chest." He endorses 5-6 episodes over the last few months that last approx. 3 min and resolve spontaneously. THe last episode happened while he was playing basketball and he felt SOB and lightheaded. The pain doesn't radiate anywhere and hasn't progressed in severity. He is concerned given paternal FH positive for a recent heart attack. Patient also endorses taking 1-2 Adderrol pills per week to help with school work, which he is taking without prescription. Denies cough, wheezing, changing in vision, changes in hearing, skin/nail changes, tremor, or cold/heat intolerance. FH: Father- MI; Mother-"Thyroid problem" PMH: None PSH: None Medications: Per HPI Allergies: NKDA SH: ETOH-3-4 on weekends. Beer and/or mixed drinks. Tried Marijuana once. No illicit drug use or tobacco.. Extract phrases from this text which may help understand the patient's medical condition.[/INST]FH positive for a recent heart attack, Father- MI, Mother-"Thyroid problem, episodic, episodes, episode, lightheaded, Denies nail changes, Denies cold/heat intolerance, Adderrol, SOB, heart beating out of my chest, 3 months of, over the last few months, 17 yo, M</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mr. Cleveland is a 17yo male , to office with heart pounding for 3-4 months at epi region of chest. He states "it feels like my chest is going to jump out". He states it is getting worst and pain is at the center or chest. Non radiating. He states mom has thyroid issues and he is concerned. He had a previous episode that went away on its own. He denies vomit, nausea or abdominal pain. He cosumes roommates prescription Aldereol on several occasions. He states everyone is using it.Sleeps well. Pain comes and goes without notice. ROS: Neg, except as per HPI PHM:None PSH:None Allergies:None Meds:None FH: Mom has thyroid issues , dad has cardiac issues Sh; Coolege student lives swith roommate, He consume 3-4 beers on weekend, Has previously used marijuana and presciption Alderol. Extract phrases from this text which may help understand the patient's medical condition.[/INST]dad has cardiac issues, mom has thyroid issues, Mom has thyroid issues, Aldereol, Alderol, heart pounding, feels like my chest is going to jump out, for 3-4 months, 17yo, male</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: CC: worried heart racing will interfere with sports HPI: Mr. Cleveland is a 17 yo male with complain of heart pounding. He states his heart has been racing for the past 2-3 months, each episode last 3-4 minuts, he has had 5-6 episodes and there is no pain associated. Sometimes it is associated with exercise and sometimes laying down. Has had SOB. It goes away on its own and is random. 4/10 bothersome in life. No change in weight, no cold or heat intolerance, no sweating or chest pain. Of note, he has been using friends prescription aderrall. PMH: No chronic illnesses, no prescription medications of his own, NKDA, no hx of hospitalizations FH: mom has thryoid problem, dad had MI last year SH: no tobacco use, drinks occassionally on weekends, tried marijuana once a few months ago. Goes to college, lives in dorms iwth roommate, no travel outside of US, sex. active w/ GF uses condoms. ROS: negative except as noted per HPI.. Extract phrases from this text which may help understand the patient's medical condition.[/INST]dad MI, mom thryoid problem, episode, episodes, no cold or heat intolerance, aderrall, SOB, heart racing, heart pounding, heart has been racing, past 2-3 months, 17 yo, male</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 yo male with 2-3 months of intermittent heart racing/pounding episodes. No recent anxiety or stress about college and no recent changes in activities. Episodes come out of the blue with no warning, heart pounds for 3-4 min then resolves. Recent episode associated with chest pressure, light headedness and shortness of breath. No diaphoresis. Uses roommates adderall a few times a week for concentration at school. No tremors, skin changes, or weight changes. PMH: none PSH: none Meds: roommate's adderall, few times per week. No other meds. Allergies: NKDA Family: dad with recent heart attack, mom with thyroid disorder Social: freshman in college, lives in dorms, no cigarette smoking. Has smoked pot in the past. Drinks alcohol on weekends, 3-4 beers, no driving under influence. Sexually active with girlfriend of 1 year, uses condoms but wants to switch to OCPs, states they are monogamous.. Extract phrases from this text which may help understand the patient's medical condition.[/INST]dad with recent heart attack, mom with thyroid disorder, chest pressure, intermittent, episodes, Episodes, episode, light headedness, adderall, adderall, shortness of breath, heart racing, heart pounding, heart pounds, 2-3 months of, 17 yo, male</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: CC: 17 yo M c/o heart pounding. The pt reports episodic heart pounding over the last 2 months. They occur randomly and last 3-4 minutes. There have been 5-6 in that time. There are no alleviating or aggrevating factors. No previous episodes. The last episode he experienced pressure in his chest and SOB. He reports taking adderoll (w/o a prescription)3-4x wk since in college. ROS: Negative except as above. Allergies: NKDA. Meds: adderoll PMH: None. PSH: None. Prenatal hx: None. Birth Hx: NSVD SH: College student lives dormatory. Sexually active with girlfriend, uses condoms. Tried "pot once", no other rec drugs. No tobacco hx. EtOH 3-4 beers xwk. FH: Mother thyroid "problem". Father MI 1 yr ago.. Extract phrases from this text which may help understand the patient's medical condition.[/INST]Father MI, Mother thyroid "problem, pressure in his chest, episodic, episode, adderoll, adderoll, SOB, heart pounding, heart pounding, over the last 2 months, 17 yo, M</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 YO M in student heatlh clinic c/o sudden onset heart pounding x few mo. No precipitating factor, describes heart jumping out of the chest, worsening, intermittent, last 3-4 mins, 1-2 episode in a mo. no allev/aggrav. A/w chest pressure, and SOB, 3-4 cup of coffee a day, 1-2 energy drink a week. No previous episode in the past. Denies fear of having other episode, cough, dizziness, tiredness, tremor, change in skin/hair, change in weight/appetite, change in sleep, weakness/tingling/numbness, change in BM/urine. Ros neg except as above PMH none, Meds takes aderal from his roomate, NKDA PSH/hosp/travel/trauma none FH father heart disease, mother has thyroid disease SH student, lives w roommate, denies smoking, occ ETOH, tried pot 1 time in a party, healthy diet, plays soccer and walk few miles, sexually active w GF, 1 partner in the past 6 mo. sometimes use condoms w her. He preffer the pill and no condom use, no STDs in the past. Extract phrases from this text which may help understand the patient's medical condition.[/INST]mother has thyroid disease, chest pressure, intermittent, 1-2 episode in a mo, takes aderal, SOB, 3-4 cup of coffee a day, 1-2 energy drink a week, heart pounding, heart jumping, x few mo, 17 YO, M</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mr. Dillon is a 17yo mM otherwise healthy presenting with 3-4 month history of intermiitent, palpiations, tachycardia; regular adderol use from roomate; 2 days ago while playing soccer, experienced chest pressure, SOB, resolved on its own. Denies chest paion, diaphoresis, changes in bowel habits. PMH: non, NKA SH: P is a freshman in colleg, plays soccer and runs regularly. Drinks 2-3 beers on the weekends, tried marijuana, denies smoking. Healthy diet. FH: father- MI at 5yo, Mother- thyroid issues. Extract phrases from this text which may help understand the patient's medical condition.[/INST]father- MI, Mother- thyroid issues, chest pressure, intermiitent, adderol, SOB, palpiations, tachycardia, 3-4 month history, 17yo, M</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: CC : 17 yo M presenting for "heart pounding." HPI: Going on 3-4 months. Has 1-2 episodes a month. Last episode was a week ago while playing soccer, he stated he also felt chest throbbing in center of chest and light headedness which is different from previous episodes. There is nothign that he associates with onset of these episodes. Lasts 3-4 minutes originally and last one lasted 10 minutes. Endorses shortness of breath with episodes. Denies diaphoresis, dizzinses, changes in vision, changes in hearing, radiation of pain, loss of sensation, weakness, anxiety. Endorses using roommates adderall prescription. PMH: none; PSH: none; meds: vitamins; allergies: none FH: father - MI (no known heart disorder); mother: thyroid problem SH: student, doign marketing, active playing soccer and running, denies tobacco use, etoh 3-4 on weekend (CAGE 0/4), adderall use, sexually active with girlfriend uses condoms . Extract phrases from this text which may help understand the patient's medical condition.[/INST]father - MI, mother: thyroid problem, chest throbbing, 1-2 episodes a month, light headedness, adderall, adderall use, shortness of breath, heart pounding, 3-4 months, 17 yo, M</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 yo male presents for 3-4 months of intermittent palpitations. He first noticed when he was just sitting. They happend 1-2x/month and last for 3-4 minutes. Nothing makes it better and it goes away on its own. Nothing seems to make it worse. No associated chest pain, but did note substernal chest presure associated with SOB 2 days ago. Denies fevers, chills, diaphoresis, sleeping problems, tremor, diarrhea, or constipation. He has a normal mood but admits to some stress starting college 5-6 months ago. Now feels well-adjusted. Majoring in marketing. Denies PMHx and PSHx and allergies FHx: Father with MI at age 52, mother with thyroid problem Denies tobacco use, alcohol 3-4 drinks on weekend Drugs: Tried pot a few months ago Meds: Roommate shares Rx Adderall a few times a week before exams (started about a year ago) . Extract phrases from this text which may help understand the patient's medical condition.[/INST]Father with MI, mother with thyroid problem, substernal chest presure, intermittent, 1-2x/month, Adderall, SOB, palpitations, 3-4 months, 17 yo, male</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 YO M Pt c/o racing heart x 2-3 months. Random onset, lasting 3-4 mins. No chest pain or SOB, No dizziness, or LOC. No aggrevating/alleviating factors. He mentions 2 days ago he had an epsiode of palpitations while playing basketball which was accompanied by SOB, lightheadedness, and pressure in the center of his chest. This lasted for 10 mins and went away on its own once he sat down. He did not fall or hit his head. He denies any changes in his bowel habits, appetite, weight or skin. No fever, chills, or visual changes. Pt admits to taking his roomates Adderal since high school. He has been taking 1 pill a few times a week. PMH/PSH: none Medications: as mentioned above SH: Lives with roomate, is a fulltime student. Denies smokin, Drinks ETOH on the weekends. Occasionally uses Marijuana. FH: Father had possible MI last year and has "Heart issues", Mother has "Thyroid Issues". Extract phrases from this text which may help understand the patient's medical condition.[/INST]Father had possible MI, Mother has "Thyroid Issues, pressure in the center of his chest, epsiode, lightheadedness, Adderal, SOB, racing heart, palpitations, x 2-3 months, 17 YO, M</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Dillon cleaveland is a 17 yo M presenting for heart pounding. He noticed this 2-3 mo ago. He has had 5-6 episodes of this over that timeframe. No kown triggers, nothing stops them. He gets lightheaded during them. He feels like his heart is bearting really fast " beating out of my chest". They last for 3-4 minutes. Yesterday was the worst of these episdoes. it lasted for 10 minutes, and in additon to the pounding, he has pressure in the middle of his chest that didn't radiate, he was also SOB that that time. Those symtpoms resolved after the pounding went away. He does endorse a historyof taking his friend's adderall prescription but hx does not coincide with symtpoms. No headache, vision changes, diarrhea, fever, chills, or temperature issues. PMH: none- born at term, immunizations complete, growth curve normal med: adderall allergiesl none FH: mom-thyroid problem, dad, heart attack-52 SH: no smoking, alcohol 3-4drinks, drug- MJ. Extract phrases from this text which may help understand the patient's medical condition.[/INST]dad, heart attack, mom-thyroid problem, pressure in the middle of his chest, episodes, episdoes, lightheaded, No temperature issues, adderall, adderall, SOB, heart pounding, heart is bearting really fast, beating out of my chest, noticed this 2-3 mo ago, 17 yo, M</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Patient is a 17 year old male no PMH complaining of rapid heart beating in his chest. He has felt this for many months, 1-2 times per week, 3-4 minutes per episode. He is unsure of what brings them on or stops them. The most recent episode occurred 2 days ago while playing soccer and was associated with pressure in the center of his chest, non-radiating, as well as lightheadedness, after which he sat down and it stopped in ten minutes. In the past year, he has used his roommate's adderall frequently. He drinks 3-4 cups of coffee per night and 1-2 energy drinks per week. Denies recent heat intolerance, sweating, anxiety, weight loss. Meds: None Allergies: None PMH: None FH: Mom has "thyroid problems", dad had a heart attack at age 52 and is still alive. SH: Uses roommate's adderall frequently. 3-4 beers per weekend day, CAGE 0/4. Marijuana once months ago. Currently freshman in college.. Extract phrases from this text which may help understand the patient's medical condition.[/INST]dad had a heart attack, Mom has "thyroid problems, pressure in the center of his chest, 1-2 times per week, lightheadedness, Denies heat intolerance, adderall, Uses adderall, drinks coffee, drinks energy drinks, rapid heart beating, many months, 17 year old, male</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Dillon Cleveland is a 17 year old male presenting with a chief complaint of "heart pounding." He has had 6 episodes over the last 2-3 months, all lasting about 3-4 minutes and then self-resolving. The episodes occur at rest and with exercise, although the last one during a basketball game was associated with a dull chest pressure, shortness of breath, and presyncope. He denies any radiation of the pressure. He denies any aggravating or alleviating factors. PMH/PSH: none FH: Father had an MI at 52; Mother has "thyroid issue"; No known history of hypertrophic cardiomyopathy or atrial fibrillation, or other "heart rhythm" disorders SH: Slightly more stressed; tried marijuana once but no other recreational drugs; alcohol 3-4 drinks on the weekend; no tobacco products. Plays basketball ROS: no nausea or vomiting, weight changes, dairrhea, constipation, hair loss. Extract phrases from this text which may help understand the patient's medical condition.[/INST]Father had an MI, Mother has "thyroid issue, chest pressure, episodes, episodes, presyncope, no hair loss, shortness of breath, heart pounding, over the last 2-3 months, 17 year old, male</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mr. Dillon Cleveland is a 17 year old male who presents for heart pounding. - Started occuring 3 months ago, with 3-4 minute episodes of heart racing and pounding. - Nothing seems to specifically bring on the episodes, relieving factors include resting in a sitting position for a few minutes - He denies sweating, nervousness, anxiousness, heat intolerance - Of note, he was playing in a basketball game recently and acutely felt lightheaded like he was going to pass out. He required rest to resolve this issues. Past medical history and surgical history and allergies to medications was all negative Family history: Mother: thyroid problem; Father: Myocardial infarction at 51 years old Medications: Adderal 2-3 times a week (not prescribed to patient), coffee and caffeine 3-4 times a week Social: Patient is a college student studying philosophy, drinks 3-4 beers on the weekend, 0-4 CAGE questions, does not smoke, and rare marijuana. Extract phrases from this text which may help understand the patient's medical condition.[/INST]Father: Myocardial infarction, Mother: thyroid problem, lightheaded, denies heat intolerance, Adderal, coffee, caffeine, heart pounding, heart racing, heart pounding, Started 3 months ago, 17 year old, male</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: This is a 17 year old male presenting with palpitations. Began 2-3 months ago, described as "heart pounding". States symptoms occur randomly and may happen at rest or with activity, lasts about 15 minutes at a time -One episode recently included shortness of breath while playing basketball, patient had difficulty catching his breath which resolved on its ownHe denies any syncope but complains of some dizziness during a recent episode during. Has not taken anything for his symptoms, nothing makes them better or worse, symptoms usually resolve "on their own" -denies any weight loss, fatigue, changes in bowel habits -He states he has been taking adderall from his friends perscription for several years a few times a week, denies any other drug use PMH: -No medical problems, no surgery -Takes adderall from friend 2-3x per week Family Hx: -Thyroid disease in mother -CAD in father Social - drinks occasionally on weekends, no drug . Extract phrases from this text which may help understand the patient's medical condition.[/INST]CAD in father, Thyroid disease in mother, occur randomly, episode, dizziness, adderall, adderall, shortness of breath, difficulty catching his breath, palpitations, heart pounding, Began 2-3 months ago, 17 year old, male</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Case of a 17 yo male that comes due to chest palpitations since 3 months ago. He states he has had around 6 episodes total. They come completely at random with no particular inciting event and end rather quickly. Patient refers no improving or worsening factors. He does refer they have been progressing, with the last episode (about 2 days ago) having additional features of chest pressure, SOB, and lightheadedness. He denies: nausea, vomiting, fever, bowel or urinary pattern changes, abdominal pain, chest pain, hair loss, feelings of anxiety, tremors, or sweating. PMHx: unremarkable All.: NKDA PSHx: none FMHx: mother has a thyroid disease. Father suffer an MI at age 52. Social Hx: He is a full time college student. He drinks 3 - 4 weeks a week. Denies smoking. Admits drug use only once (marijuana) with no similar complaints. He refers a healthy and active lifestyle. Currently sexually active and uses condoms. No STDs. Extract phrases from this text which may help understand the patient's medical condition.[/INST]Father suffer an MI, mother has a thyroid disease, chest pressure, 6 episodes, lightheadedness, SOB, chest palpitations, since 3 months, 17 yo, male</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 YO M C/O RACING OF HEART FOR 3 MONTHS, EPISODIC, LAST EPISODE 2 DAYS BACK WHEN PLAYING BASKET BALL ASSOCIATED WITH SOB, LIGHTHEADEDNESS. HE ALSO REPORT TAKING CAFFENATED DRINKS (4-5 DRINKS PER DAY), AND ADDERAL( LAST INTAKE WAS 2 DAYS BACK). HE HAS NO HISTORY OF PASSING OUT, OR HAS NOT NOTICED ANY SKIP BEATS. DENIES CHEST PAIN, N/V, SKIN CHANGES, TEMPERATURRE INTORELANCE, CHANGE IN BOWEL OR BLADDER HABIT, NO CHANGE IN SLEEP ROS: NEGATIVE EXCEPT ABOVE FH: FATHER HAD HEART ATTACK ALLERGIES/PSH/PMH: NONE MEDS: ADERRAL SH: NO SMOKE, DRINK IN WEEKEND 3-4 BEER, SEXUALLY ACTIVE WITH GIRLFRIEND, NO OTHER DRUGS BESIDE ADDERRAL. Extract phrases from this text which may help understand the patient's medical condition.[/INST]FATHER HAD HEART ATTACK, EPISODIC, LIGHTHEADEDNESS, DENIES TEMPERATURRE INTORELANCE, ADDERAL, ADERRAL, SOB, CAFFENATED DRINKS, RACING OF HEART, FOR 3 MONTHS, 17 YO, M</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 yo pat. presents with heart pounding and racing. Symptoms began 2-3 months ago and have occured 5-6 times during this period. Two days ago the patient had an episode that was also accompanied by chest pressure and dyspnea. No cough, fever, N/V, angina, abdominal pain, changes in bowel or urinary habits. No rashes or edema. Pat. uses roommates Aderol 2-3 times/wk as a study aid. ROS: neg. except as above. PMH/PSH/Hospitalisations: none Meds: Roommate's aderol 1-2x/wk NKDA EtOH 3-4 beers/weekend, no tobacco, Drugs: marijuana once, no reg. consume FH: Mother thyroid problem, Father had a MI one year ago. No travel or sick contacts SH: student, lives in dorms Excercise: basketball adn running 3-4x/wk Sexual hx: active with girlfriend, condoms, 1 partner/past year, no prior STI, last screening negative.. Extract phrases from this text which may help understand the patient's medical condition.[/INST]Father MI, Mother thyroid problem, chest pressure, occured 5-6 times, Aderol, dyspnea, heart pounding, heart racing, Symptoms began 2-3 months ago, began 2-3 months ago, 17 yo</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 y/o M in student clinic c/o heart pounding x 2-3 months. Started suddenly, the palpitations are wosening, occurs 5-6 times in last 2-3 months. Last episode was 2 days ago precipitated by taking Adderall to concentrate. A/w stress in school, pressure like discomfort in chest, 5-6/10 in intensity, non radiating. The palpitations resolve spontaneously. Denies LOC, dizziness, fainting, cough, colds, association of discomfort to inspiration/exertion, hot/cold intolearance. ROS Negative except as above PMH/PSH/Hosp/Trauma None, Meds Adderrall since high school, currently takes it 2x/week, Last intake 2 days ago in AM; NKA FH Mom had thyroid problems, Dad had heart attack at age 52 SH college student, has good grades but has been stressed in school, no smoking, drinks 3-4 beers/weekend, took Potts once months ago, sexaully active with girlfriend only, no STDs, uses protection regularly . Extract phrases from this text which may help understand the patient's medical condition.[/INST]Dad had heart attack, Mom had thyroid problems, pressure like discomfort in chest, 5-6 times, Denies hot/cold intolearance, Adderall, Adderrall, heart pounding, palpitations, palpitations, x 2-3 months, in last 2-3 months, 17 y/o, M</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Pt is a 17 yo M who presents with heart pounding and racing x3-4 months. He reports these events occur about 1-2/month and last for about 3-4 minutes before resolving spontaneously. His most recent episode occured 2 days ago, and he had associated chest pressure and SOB and notes that he felt he may pass out. Of note, he had taken a dose of his friends' adderal the night prior and the morning of the episode. He is unsure of any other preceding events that have caused prior episodes. He denies any recent fevers, chills, fatigue, weight loss, heat intolerance, cough, or changes in bowel habits. ROS: Neg other than HPI PMH: None PSH: None Allergies: None Meds: Adderall a few times a week. Borrows from friend. SH: Freshman student in college. Lifetime non-smoker. Drinks 3-4 beers at parties on weekends. Tried marijuana in past but no recent recreational drug use. FH: Mother - "thyroid problem" (pt unsure). Father - MI at age 52. Extract phrases from this text which may help understand the patient's medical condition.[/INST]Father - MI, Mother - "thyroid problem, chest pressure, occur about 1-2/month, adderal, Adderall, SOB, heart pounding, 3-4 months, 17 yo, M</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 year old male presenting with heart pounding and racing. This has happened 5-6 times over the past 2-3 months. Endorses some stress from college. Reports taking his friend's Addirall to help him study and 2-3 cups of coffee per day. The most recent episode was 2 days ago, when he also had substernal chest pain and felt lightheaded. ROS: denies cold/heat intolerance, constipation/diarrhea, energy changes, headache during episodes, weight change, sleep problems. PMH: none PSH: none meds: Taking his friend's Addirall a few times a week to help with studying. Willing to schedule f/u appointment to discuss this further. FH: mom with thyroid problem, father with herat attack one year ago (smoker) SH: college student. Alcohol 3-4 beers per night on the weekend. Tried marijuana 1x. Denies other drug use. Sexually active with girlfriend, always use condoms. Feels safe in relationships.. Extract phrases from this text which may help understand the patient's medical condition.[/INST]father with herat attack, mom with thyroid problem, chest pain, happened 5-6 times, episode, lightheaded, denies cold/heat intolerance, Addirall, Addirall, coffee, heart pounding, heart racing, over the past 2-3 months, 17 year old, male</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 yo male presents with 3 months of heart palpitations. He states that they occur without association to any activity or time of day. Each event is associated with sob and last about 3-4 minutes. nothing makes it better or worse. 2 days ago he had a severe episode that lasted 10 minutes and was accompanied by chest pressure and lightheadedness while playing basketball. He mentions that he started college 8 months ago and has started taking his roommates adderal 2xweek to aid in studying for the last 7 months. denies any diarrhea, weightloss, appetite changes, or diaphoresis. ros: neg except for hpi pmhx: none pshx: none fhx: mother with "thyroid problem" and father with MI at 57yo medications: adderal (no prescription) social hx: started college no declared major yet, lives with roommate in doorms, drinks 3-4 beers or mixed drinks on weekends, no smoking, sexually active with girlfriend of one year. uses condoms. no stds.. Extract phrases from this text which may help understand the patient's medical condition.[/INST]father with MI, mother with "thyroid problem, chest pressure, lightheadedness, adderal, adderal, sob, heart palpitations, 3 months, 17 yo</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: 17yo,m,c/o palpitations,started suddenly,intermittent,5-6times in a week,nothing makes it better or worse.He drinks a few cups of coffee in a week,he also has dyspnea in his last episode of palpitations.He denies fever/urinary problems/changes in his appetite/weight changes/bowel changes/skin changes/chest pain/loss of consciousness/tremors/sweating/eye problem/temperature intolerance.Mood is good, no stress recently ROS: Neg apart from the above symptoms PMh : No similar symptoms,No other medical problems,Allergy: NKDA,NKA Meds: Adderall for exam, 1 pill a week Hospitalization : no ill contact/surgery/trauma FH: father has heart problem,mother has thyroid problem SH : No smoking/EtOH/rec drugs - used Pop, last 2 mos ago at a party, work : college student, Sexually active with girlfriend, uses condomas. Extract phrases from this text which may help understand the patient's medical condition.[/INST]father has heart problem, mother has thyroid problem, intermittent, denies temperature intolerance, Adderall, dyspnea, drinks coffee, palpitations, palpitations, 17yo, m</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 y.o. M presents with a few months history of episodes of palpatations and dyspnea. the episodes have been getting worse. the worst episode occured 2 days ago during which he felt presyncopal, he was also short of breath and had pressure in his chest. He denies any Loss of consciousness, headache, dizziness, tremor, heat intolerance, bowel or urinary symptoms. ROS: negative except as above PMH: none PSH: none FH: mother has a Thyroid problem, father had an MI SH: nonsmoker, drinks on the weekends, has tried marijuana, sexually active with his girlfriend and uses condoms. Sometimes uses adderall which he gets from him friend. Meds: none Allergies: NKDA . Extract phrases from this text which may help understand the patient's medical condition.[/INST]father had an MI, mother has a Thyroid problem, pressure in his chest, episodes, episodes, episode, presyncopal, denies heat intolerance, adderall, short of breath, palpatations, few months history, 17 y.o, M</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI Pt is a 17 yo M presenting with 2 months of intermittant palpitations. Reports 5-6 episodes of palpitations that last 3-4 minutes and resolve spontaneously. Reports most recent episode was at a basketball game where he had chest pressure, dyspnea, and lightheadedness. Normaly, these episodes have no palpitations, chest pain, shortness of breath, loss of conciousness, syncope. symptoms have never happened before. Denies any chest pain, or abdominal pain. No known precipitant. ROS -neg unless above Med/surg hist - none Med- took a couple pills of roommates adderall allergies -none SocialH-no tobacco, 3/4 drinks of alcohol a week, tried marijuana once, lives with roomate in college. Sexhist-1 partner, wheres condoms, never tested for STDs, denies hist of STD symptoms. fam hist- Dad had heart attack at 52, mom has hypothyriod. Extract phrases from this text which may help understand the patient's medical condition.[/INST]Dad had heart attack, chest pressure, intermittant palpitations, 5-6 episodes, lightheadedness, mom has hypothyriod, adderall, dyspnea, palpitations, 2 months, 17 yo, M</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 yo M c/o heart pounding. Reported 5-6 episodes heart pounding in 2-3 months, last 3-4 mins each episode, but last episode lasted almost 10 mins, associated chest tightness, mild SOB during baskerball game. Denies dizziness, intolerance to heat, diaphoresis, hand tremor, change of bowel movements. No severe change in life but in new semester in college. PMH:none PSH?hospitalization:none Meds: Adderral, and ponds once NKDA FH: father had heart disease, mother had diarrhea related disease SH: No smoking, social drinker, Adderal use and last dose 2 days ago. Sexually active with GF only, with condom and pills protection.. Extract phrases from this text which may help understand the patient's medical condition.[/INST]father had heart disease, chest tightness, 5-6 episodes, Denies intolerance to heat, Adderral, Adderal use, SOB, heart pounding, heart pounding, 2-3 months, 17 yo, M</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 yr Old M comes to clinic with c/o Heart Pounding, which started 2-3 Months. Symptoms comes and goes and last 3-4 min. Pt had 5-6 episodes so far and goes away on its on. Also feeling chest pressure which is in center x 2 days and difficulty in breathing x 2 days. Denies headache, diaphoresis, loss of consciouness, flushing, diarrhea, constipation, hair and skin chages. Diet and Appetite is normal. Pt is on Health plan for diet and eats fruits, veggies and protein meal. ROS negative except above PMH None Meds Takes addrall from room mate, NKDA PSH none Hospital none No trauma FH Mother had thyroid condition, Father has heart problem SH student, No smoking, ETOH occasional, Recreational drugs Pot one time SEX H Active with GF, Use condom and NO STD.. Extract phrases from this text which may help understand the patient's medical condition.[/INST]Mother had thyroid condition, chest pressure, Symptoms comes and goes, 5-6 episodes, Denies hair chages, Takes addrall, Heart Pounding, started 2-3 Months, 17 yr Old, M</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: CC" "My heart has been pounding" HPI: Mr. Cleveland is a 17 year old male with no PMH who presents for the sensation of his heart pounding. For the past 3-4months he has had episodes of feeling as if his heart is racing. They happen sporadically and self resolve within 3-4 minutes. There is no recognizable trigger, including stress or exertion. The most recent epsidoe happened while playing soccer and was assciated with a midsternal pressure type pain that was non-radiating. They are not associated with dizziness or sweating. He has not had any recent unexplained weight loss. PMH: none Meds: none persribed Family hx: mom has thyroid issues, dad had a heart attack at 52 SH: 3-4 beers on weekend, non smoker, does take roommates adderall (took some the night before and morning of the last episode that had associated chest pain). Extract phrases from this text which may help understand the patient's medical condition.[/INST]dad had a heart attack, mom has thyroid issues, midsternal pressure, happen sporadically, adderall, My heart has been pounding, heart pounding, heart is racing, past 3-4months, 17 year old, male</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mr. Cleveland is 17 year old Male who came to student health clinic for complaints of chest pounding that has been going on for about 5 or 6 months and states that he feels the episodes are getting worse. He states that the episodes seem to be random but when further questioned he admits to taking his roommates adderall on occasion. He admits that the last episode occurred on the same day that he took some adderall. He denies palpitations but endoreses some chest pressure and SOB. ROS: all other ROS negative unless stated above. PMHx: none Medication: none SurgHx: none FamHx: father MI at age 52, mother has a thyroid disorder SocialHx: patient drinkds 3-4 mixed drinks or beer on weekends, smoke marijuana once at a party, endorses occassional non perscription aderall use Allergies: none. Extract phrases from this text which may help understand the patient's medical condition.[/INST]father MI, mother has a thyroid disorder, chest pressure, episodes random, adderall, took adderall, SOB, chest pounding, 5 or 6 months, 17 year old, Male</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mr Cleveland is a 17 yo male c/o heart punding. It happened yesterday, started suddenly, lasted for 3-4 minutes and went away by itself. It has been about 3 months he has been having such episodes, for a total of 5-6. In this last episode he also felt dizzy, short of breath and had some chest pressure. He finds that the last episode might have been linked to aderol intake. Denies loss of consciousness, any nausea or vomit. Denies any sweating. ROS: as per HPI. PMH: none. PSH: none. NKA. Meds: he has been taking aderol before tests to improve his performance. No hospitalizations, injuries or surgeries. Immunizations up to date. FH: mother has thyroid problems, father had a MI recently. SH: college student, denies any smoke, occasional drinking on the weekends, has tried pot once. Sexually active with his girlfriend, regular condom use.. Extract phrases from this text which may help understand the patient's medical condition.[/INST]father MI, mother thyroid problems, chest pressure, episodes, Denies any sweating, aderol, short of breath, heart punding, 3 months been having, 17 yo, male</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Dillon Cleveland is a 70 yo male with no pertinent pmh who is presenting with 2-3 mo of irregular heartbeat/ pounding in his chest. It has happened 5-6 times over the past 2-3 months. Doesn't radiate. Feels like heart is going to jump out of his chest. 6/10 in severity. Unsure if anything makes it better or worse. No sugeries, hospitalizations, trauma. Up to date on immunizations. No sick contacts. Student at UH undeclared major; states transition to college was stressful and takes lots of tests at school (has coping measures and good support system). Alcohol on weekends (3-4 beers/ mixed drinks). No tobacco. Tried marijuana in past. Denies recreational drugs (ex. cocaine). No RX medications; uses friends adderall 2-3 times a week. No allergies. Takes protein supplements; no pre-workout. Eats healthy. Mom hx of thyroid (unsure hyper or hypo). Dad hx MI at 52. ROS otherwise negative (denies SOB, fever, chills, nausea, vomitting).. Extract phrases from this text which may help understand the patient's medical condition.[/INST]Dad hx MI, Mom hx of thyroid, 5-6 times, adderall, irregular heartbeat, pounding in his chest, heart is going to jump out of his chest, 2-3 mo, 2-3 months, male</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: 17 YO M CAME WITH SUDDEN ONSET OF EPISODIC PALPITATIONS FOR THE PAST 2 MONTHS. HE HAS HAD 5-6 EPISODES WITHOUT AGGRAVATING OR RELIEVING FACTORS. LAST EPISODE WAS ASSOCIATED WITH CHEST PRESSURE, AND SOB. HE DENIES SWEATING, COUGH, FEVER. HE DRINKS 3-4 CUPS OF COFFEE/DAY AND 2 ENERGY DRINKS/WEEK. HE RECENTLY JOINED A NEW COLLEGE AND HAS SOME STRESS IN HIS COLLEGE IN ADJUSTING TO NEW ENVIRONMENT. HE IS MILDY WORRIED ABOUT HAVING NEXT EPISODE. HE DENIES SKIN/HAIR CHANGES, TEMPERATURE INTOLERANCE, CHEST PAIN. NORMAL MOOD, SLEEP, WEIGHT, BLADDER AND BOWEL HABITS. ROS: AS PER HPI. PMH/PSH/ALLERGIES: NONE MEDS: NONE FH: FATHER HAS HEART PROBLEM, MOTHER HAS THYROID PROBLEM SH: USES ADERRAL TWICE A WEEK/7 MONTHS; NO SMOKING; OCCASIONAL ETOH INTAKE; SEXUALLY ACTIVE WITH GIRLFRIEND; USES CONDOMS. Extract phrases from this text which may help understand the patient's medical condition.[/INST]FATHER HAS HEART PROBLEM, MOTHER HAS THYROID PROBLEM, CHEST PRESSURE, EPISODIC, EPISODES, DENIES TEMPERATURE INTOLERANCE, DENIES SKIN/HAIR CHANGES, ADERRAL, SOB, COFFEE, ENERGY DRINKS, PALPITATIONS, FOR THE PAST 2 MONTHS, 17 YO, M</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mr. Dillon Cleveland is a 17 y/o boy with no significant pmh presenting with 5-6 episodes of palpitations over the last few months. Most recently this occurred a few days ago while he was playing basketball. At that time it was associated wtih lightheadedness, shortness of breath, and chest pressure. Previously also had palpitations when resting quietly. This would last 3-4 minutes and subside spontaneously. IT was not associated wtih any activities or time of day. Of note, pt takes friends' adderall prescription 3x/week for extra focus while studying. baseline he denies difficulty concentrating. ROS: denies chest pain, cough, abdominal pain, N/V/D/bloody/black stools/dysuria, and all otherwise negative PMH: none, takes no medications other than friends' adderall non-prescribed, no allergies SOC: studies philosophy in school, drinks up to 3-4 drinks/week, sexually active weith girlfriend, uses condoms. Extract phrases from this text which may help understand the patient's medical condition.[/INST]chest pressure, 5-6 episodes, lightheadedness, takes adderall, shortness of breath, palpitations, palpitations, over the last few months, 17 y/o, boy</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Dillon Cleveland is a 17 year old male with no significant past medical history who presents for evaluation of episodic palpitations, chest pressure, and light headedness. He reports that these issues started after he started taking adderall given to him by a friend to help with studying at college. He also drinks energy drinks from time to time. He reports that his mood is good and college has been fine but a little hectic. He has not noted any particular triggers. Denies recent weight changes or changes to hair and skin. No prior surgeries or hospitalizations. Meds: Adderall from a friend. Denies others. Allergies: NKA FmHx: Father- MI at 52 Mother; Thyroid issue SHx: College student for 1 year. Living on campus. School is "hectic" High risk: Denies smoking. Drinks 3-4 drinks per weekend. Tried marajuana once. Denies other drugs.. Extract phrases from this text which may help understand the patient's medical condition.[/INST]Father- MI, Mother; Thyroid issue, chest pressure, episodic, light headedness, Denies changes to hair, adderall, Adderall, energy drinks, palpitations, 17 year old, male</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 yo male with no PMH presents with 3-4 months of palpitations -episodes occur randomly, no associated with activity, associated with shortness of breath and pre-syncope -no sweating, feeling of impending doom, anxiety with episodes, no diarrhea -takes adderall a few times that is prescribed to friend, however has been taking this for a year now -no history of thyroid problems PMH: none Meds: adderall (not prescribed) FamHx: Mom- "thyroid problem"; dad- heart attack at 52 Social: lives with roomate; 3-4 alcoholic beverages/week, no durgs, sexually active w girlfriend and uses condoms. Extract phrases from this text which may help understand the patient's medical condition.[/INST]dad- heart attack, Mom- "thyroid problem, episodes, adderall, adderall, shortness of breath, palpitations, 3-4 months of, 17 yo, male</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: MR clevland is a 17 year old male ho presetn wth episodes of his heart pounding and racing, they hve happended 5-6 times in the past 3 months, nothing seems to set the episodes off or make them go away, he felt short of breath in one episode while he was playing basketball, there is no pain. there are no asosiated syptoms such as headaches, lightheadenss, consistant shortness of breath, feelings of impending doom, fear, PMHx- no medical diagnosis, healthy Meds- admits to taking friends prescription adderal for study usage, no othe meds Allegeries- nka Surg hx- none Fam hx- mom has some thyoid disorder he is unsure of, father had heart attack last year Social- doesnt smoke, drinks with friends on weekends 3-4 beers, uses a Designated Driver, tried pot once but hasnt since then, no IVD use. Extract phrases from this text which may help understand the patient's medical condition.[/INST]father heart attack, mom thyoid disorder, episodes, 5-6 times in the past 3 months, adderal, short of breath, heart pounding, heart racing, past 3 months, 17 year old, male</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: History: The patient is a 17-year-old male presenting with chief concern that his heart is pounding. His episodes started 3-4 months ago without any identifiable stressor, occuring intermittently 1-2 times per month at rest or while exercising. They go away on their own afer 3-4 minutes and are associated with a pressure sensation in the center of the chest. His most recent episode occured 2 days before presentation during a soccer game, lasted for 10 minutes, and was associated with shortness of breath + lightheadedness. No , unexpected weight loss, chest pain. ROS: Negative except HPI PMH: N/A PSHx: N/A Allergies: N/A Medication: Takes friend's adderal a few times per week FH: mother with "thyroid" condition; father (52) with heart attack SH: Student. Drinks 3-4 drinks per week (CAGE = 0 for all questions); no tobacco use; tried marijuana once not using. Vaginal intercourse w/ monogamous female; uses condoms; no hx STIs. Extract phrases from this text which may help understand the patient's medical condition.[/INST]father with heart attack, mother with "thyroid" condition, pressure in chest, occuring intermittently, 1-2 times per month, lightheadedness, Takes adderal, shortness of breath, heart is pounding, 3-4 months ago, 17-year-old, male</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 yo male with no significant PMH presenting with 3-4 months of episodes where his "heart is pounding and going to jump out of my chest." The episodes each last 3-4 minutes, and he has had 1-2 espisodes per month. he has not noticed a pattern or trigger. they resolve on their own, nothing makes them better or worse. the last time it occured, also had chest pressure and felt that he couldn't catch his breath (during a soccer game) and felt that he was going to pass out, though didn't. has not experienced lightheadedness, dizziness, LOc, otherwise. Reports taking his roommate's adderall "a few times per week" for the past year. Also drinks 3-4 cups of coffee per night, plus 1-2 energy drinks a few times per week also. No PMH. no PSH, NKDA, no recent travel, no recent illness. No other meds. no smoking, drinks 3-4 drinks alcohol on weekends, sexually active with one partner, no recent STD testing. Dad had MI age 52. Mom has thyroid dz. Extract phrases from this text which may help understand the patient's medical condition.[/INST]Dad had MI, Mom has thyroid dz, chest pressure, episodes, episodes, 1-2 espisodes per month, felt that he was going to pass out, adderall, "couldnt catch his breath", coffee, energy drinks, heart is pounding and going to jump out of my chest, 3-4 months of, 17 yo, male</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 yo M who presents with episodes of heart palpitations. He has had 2-3 episodes per month for the past 2 months. Most recent episode was yesterday. Episodes last 3-4 minutes, and he reports no known triggers, can occur at rest or with exercise. Patient denies chest pain, dyspnea, sweating, dizziness, or LOC. Denies fevers, diarrhea, constipation. Patient reports using friend's Adderall 2-3 times weekly to help him focus. Last use was yesterday. Drinks 3-4 beers on weekends. Tried marijuana use, denies other drug use. Nothing known to alleviate or exacerbate symptoms. PMH: none Meds: none Allergies: none SH: ETOH and substance use above, lives in dorm at school, sexually active with girlfriend only FH: mother has thyroid condition, father had MI 1 year ago. Extract phrases from this text which may help understand the patient's medical condition.[/INST]father MI, mother thyroid condition, 2-3 episodes per month, Adderall, heart palpitations, past 2 months, 17 yo, M</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 yo CC palpitation -Started 3 months ago, , has experienced 5-7 episodes wich last 3-4 minutes, sudden onsent, no precipitations factor, no alleviating or aggravating factor -Do not has any visual disturbances, sweating. has has episodes during rest and exertion. has been progressively worsened. -Last episode associated SOB no chet pain -No changes in bowel movement, no heat intolerance, no skipped meals, no fever. No mood changes, no weigth loss -Good relationship with friends, good school grades. -ROS: Negative except above PMH: None AllergiesNKDA-NKA Meds: Nones FH: Mother hx of thyroid disease, Father IM at 52 SH: College student, live with roomates, no tobacco, drinks socially, One use of marijuana and stopped. Sexually active 1partner last yr, +Condoms. Exercises regualrly Healthy diet. Extract phrases from this text which may help understand the patient's medical condition.[/INST]Mother hx of thyroid disease, 5-7 episodes, no heat intolerance, SOB, palpitation, Started 3 months ago, 17 yo</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: dillon cleveland is a 17yo male with no PMH that comes in with palpitations. the last time he felt them, about 2 days ago, he also felt short of breath and some chest pressure, and like he was going to "pass out". he denies sweating, loss of consciousness, he says these palpitations happen a couple times a month and have been going on for a few months. he does not associate any pattern with when the palpitations happen. the only medication he takes is adderall a few times a week that he gets from his roommate. his family history consists of his mother with a thyroid problem and his father who had a heart attack at age 52. he does not smoke, drinks 3-4 beers on the weekends, and used marijuana once.. Extract phrases from this text which may help understand the patient's medical condition.[/INST]father heart attack, mother hyroid problem, chest pressure, felt ike he was going to "pass out", denies sweating, adderall, short of breath, palpitations, going on for a few months, 17yo, male</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mr. Cleveland is a 17 yo male who presents with a chief complaint of heart pounding. Patient has experienced this sensation for the past 2-3 months, 5-6 times total, roughly 2x/month. The last episode was 2 days ago while playing basketball. Patient describes heart racing, pressure, shortness of breath, and light headedness. Episodes have occured variably, some while exercising, some while resting. He reports the use of a friend's adderall roughly 2x/week for the past 7 months to help with concenctration. He also endorses drinking 3-4 cups of coffee/day and energy drinks as well. Patient is a freshman in collee, sexually active with his long term girlfriend, uses condoms, but denies use of tobacco products and ilicit drugs. He reports drinking 3-4 alcholoic drinks on weekends. Family hx is positive for thyroid dx in his mother and a MI in his father. He has no significiant medical/surgical hx. No allergies or weight/appetite changes.. Extract phrases from this text which may help understand the patient's medical condition.[/INST]MI father, thyroid dx mother, pressure, 5-6 times, Episodes, light headedness, adderall, shortness of breath, drinking coffee, drinking energy drinks, heart pounding, heart racing, for the past 2-3 months, 17 yo, male</s>

<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: CC: Dillon Cleveland is a 17 year old male with a 2-3 month history of chest palpitations Dillon has had chest palpitations for the last two to three months. He has not found anything that has made them worse or given him relief at this time. The palpitations usually self resolve. Dillon had a particularly bad episode during a basketball game yesterday with strong shortness of breath. Dillon has had no changes in weight, sweating, nausea vomiting or diarhea at this time. Particularly chest fluttering in particular due to the fact his father had a heart attack last year. Dillon is taking two adderal per week since starting school. NKDA.Patient takes no medications other than the two adderal from his roommate per week, Patient is a college student living in the dorms. Drinking 3-4 drinks per week. Remote use of marijuana, no tobbacco, advised to not play basketball for now, Mother thyroid issues.Father MI. Sexually active w/gf,use. Extract phrases from this text which may help understand the patient's medical condition.[/INST]Father MI, father had a heart attack, Mother thyroid issues, adderal, shortness of breath, chest palpitations, chest palpitations, 2-3 month, 17 year old, male</s>