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T1 Age 2 13 63-year-old T2 Sex 14 19 woman T3 History 25 49 no known cardiac history T4 Sign_symptom 83 90 dyspnea E1 Sign_symptom:T4 T5 Therapeutic_procedure 101 111 intubation E2 Therapeutic_procedure:T5 T6 Therapeutic_procedure 116 135 ventilatory support E3 Therapeutic_procedure:T6 T7 Nonbiological_location 136 151 out of hospital R1 MODIFY Arg1:T7 Arg2:E3 T8 Detailed_description 67 79 sudden onset R2 MODIFY Arg1:T8 Arg2:E1 T9 Clinical_event 50 59 presented E4 Clinical_event:T9 T10 Sign_symptom 192 202 discomfort E5 Sign_symptom:T10 A1 POLARITY E5 NEG T11 Biological_structure 186 191 chest R3 MODIFY Arg1:T11 Arg2:E5 T12 Sign_symptom 204 216 palpitations E6 Sign_symptom:T12 A2 POLARITY E6 NEG T13 Sign_symptom 218 225 syncope E7 Sign_symptom:T13 A3 POLARITY E7 NEG T14 Disease_disorder 229 238 infection E8 Disease_disorder:T14 A4 POLARITY E8 NEG T15 Sign_symptom 256 264 afebrile E9 Sign_symptom:T15 T16 Sign_symptom 269 281 normotensive E10 Sign_symptom:T16 T17 Sign_symptom 296 307 tachycardia E11 Sign_symptom:T17 T18 Detailed_description 290 295 sinus R4 MODIFY Arg1:T18 Arg2:E11 T19 Lab_value 311 324 140 beats/min R5 MODIFY Arg1:T19 Arg2:E11 T20 Diagnostic_procedure 330 359 cardiorespiratory examination E12 Diagnostic_procedure:T20 T21 Diagnostic_procedure 391 414 jugular venous pressure E13 Diagnostic_procedure:T21 T23 Biological_structure 422 438 angle of the jaw R7 MODIFY Arg1:T23 Arg2:E13 T24 Sign_symptom 453 470 third heart sound E14 Sign_symptom:T24 T25 Detailed_description 442 452 left-sided R8 MODIFY Arg1:T25 Arg2:E14 T26 Sign_symptom 485 493 crackles E15 Sign_symptom:T26 T27 Detailed_description 475 484 bibasilar R9 MODIFY Arg1:T27 Arg2:E15 T28 Biological_structure 497 506 both lung R10 MODIFY Arg1:T28 Arg2:E15 T29 Diagnostic_procedure 519 544 complete blood cell count E16 Diagnostic_procedure:T29 T30 Diagnostic_procedure 546 558 electrolytes E17 Diagnostic_procedure:T30 T31 Diagnostic_procedure 563 581 cardiac biomarkers E18 Diagnostic_procedure:T31 T33 Diagnostic_procedure 620 637 electrocardiogram E19 Diagnostic_procedure:T33 T34 Sign_symptom 647 660 ST depression E20 Sign_symptom:T34 T35 Diagnostic_procedure 664 678 leads V2 to V6 E21 Diagnostic_procedure:T35 R14 SUB_PROCEDURE Arg1:E21 Arg2:E19 R15 MODIFY Arg1:E20 Arg2:E21 T36 Disease_disorder 694 716 anterolateral ischemia E22 Disease_disorder:T36 T37 Diagnostic_procedure 737 747 radiograph E23 Diagnostic_procedure:T37 T38 Biological_structure 731 736 chest R16 MODIFY Arg1:T38 Arg2:E23 T39 Sign_symptom 771 790 vascular congestion E24 Sign_symptom:T39 T40 Biological_structure 761 770 pulmonary R17 MODIFY Arg1:T40 Arg2:E24 T41 Disease_disorder 822 837 pulmonary edema E25 Disease_disorder:T41 T42 Diagnostic_procedure 853 882 echocardiographic examination E26 Diagnostic_procedure:T42 T43 Diagnostic_procedure 899 917 cardiac dimensions E27 Diagnostic_procedure:T43 T45 Diagnostic_procedure 926 937 wall motion E28 Diagnostic_procedure:T45 T47 Disease_disorder 947 968 diastolic dysfunction E29 Disease_disorder:T47 T48 Severity 942 946 mild R20 MODIFY Arg1:T48 Arg2:E29 T49 Diagnostic_procedure 977 1028 early diastolic to late diastolic transmitral ratio E30 Diagnostic_procedure:T49 T51 Diagnostic_procedure 1055 1072 deceleration time E31 Diagnostic_procedure:T51 R22 SUB_PROCEDURE Arg1:E27 Arg2:E26 R23 SUB_PROCEDURE Arg1:E28 Arg2:E26 R24 SUB_PROCEDURE Arg1:E30 Arg2:E26 T52 Lab_value 1074 1080 250 ms R25 MODIFY Arg1:T52 Arg2:E31 R27 SUB_PROCEDURE Arg1:E31 Arg2:E26 T54 Biological_structure 1136 1164 lateral mitral valve annulus T55 Diagnostic_procedure 1096 1128 early diastolic annular velocity E32 Diagnostic_procedure:T55 R29 MODIFY Arg1:T54 Arg2:E32 R30 SUB_PROCEDURE Arg1:E32 Arg2:E26 T57 Sign_symptom 1187 1195 diuresis E33 Sign_symptom:T57 T58 Therapeutic_procedure 1218 1237 ventilatory support E34 Therapeutic_procedure:T58 T59 Therapeutic_procedure 1187 1195 diuresis E35 Therapeutic_procedure:T59 #1 AnnotatorNotes E35 Intentional, likely through medication (diuretics) T60 Lab_value 1176 1186 aggressive R31 MODIFY Arg1:T60 Arg2:E35 T61 Lab_value 1210 1217 minimal R32 MODIFY Arg1:T61 Arg2:E34 T62 Therapeutic_procedure 1255 1264 extubated E36 Therapeutic_procedure:T62 T63 Date 1265 1282 one day following E37 Date:T63 T64 Time 1309 1319 Within 1 h E38 Time:T64 T65 Disease_disorder 1367 1382 pulmonary edema E39 Disease_disorder:T65 T66 Detailed_description 1357 1366 recurrent R33 MODIFY Arg1:T66 Arg2:E39 T67 Diagnostic_procedure 1398 1414 radiographically E40 Diagnostic_procedure:T67 T68 Therapeutic_procedure 1426 1448 mechanical ventilation E41 Therapeutic_procedure:T68 T69 Diagnostic_procedure 1450 1473 Cardiac catheterization E42 Diagnostic_procedure:T69 T70 Lab_value 1501 1507 normal T71 Biological_structure 1508 1525 coronary arteries R34 MODIFY Arg1:T71 Arg2:T70 R35 MODIFY Arg1:T70 Arg2:E42 T72 Date 1527 1535 On day 4 E43 Date:T72 T73 Clinical_event 1562 1571 admission E44 Clinical_event:T73 T74 Nonbiological_location 1543 1561 coronary care unit R36 MODIFY Arg1:T74 Arg2:E44 T75 Therapeutic_procedure 1612 1622 extubation E45 Therapeutic_procedure:T75 A5 POLARITY E45 NEG T77 Diagnostic_procedure 1626 1646 computed tomographic E46 Diagnostic_procedure:T77 T78 Disease_disorder 1688 1694 goiter E47 Disease_disorder:T78 T79 Detailed_description 1675 1687 multinodular T80 Area 1663 1674 4 cm × 9 cm R38 MODIFY Arg1:T79 Arg2:E47 R39 MODIFY Arg1:T80 Arg2:E47 T81 Biological_structure 1714 1725 mediastinum R40 MODIFY Arg1:T81 Arg2:E47 T82 Sign_symptom 1760 1768 stenosis E48 Sign_symptom:T82 T83 Biological_structure 1751 1759 tracheal R41 MODIFY Arg1:T83 Arg2:E48 R42 CAUSE Arg1:E47 Arg2:E48 T84 Disease_disorder 1801 1805 NPPE E49 Disease_disorder:T84 #2 AnnotatorNotes E49 Negative pressure pulmonary edema T85 Disease_disorder 1831 1837 goiter E50 Disease_disorder:T85 T86 Severity 1822 1830 enlarged R43 MODIFY Arg1:T86 Arg2:E50 R44 CAUSE Arg1:E50 Arg2:E49 T87 Therapeutic_procedure 1861 1882 surgical intervention E51 Therapeutic_procedure:T87 T88 Therapeutic_procedure 1889 1902 thyroidectomy E52 Therapeutic_procedure:T88 R45 SUB_PROCEDURE Arg1:E52 Arg2:E51 T89 Diagnostic_procedure 1919 1931 bronchoscopy E53 Diagnostic_procedure:T89 T90 Detailed_description 1904 1918 Intraoperative R46 MODIFY Arg1:T90 Arg2:E53 T91 Lab_value 1962 1978 greater than 50% T92 Sign_symptom 1950 1958 stenosis E54 Sign_symptom:T92 T93 Biological_structure 1941 1949 tracheal R47 MODIFY Arg1:T93 Arg2:E54 R48 MODIFY Arg1:T91 Arg2:E54 T94 Diagnostic_procedure 1984 2004 postoperative course E55 Diagnostic_procedure:T94 T96 Date 2028 2050 three months following E56 Date:T96 T97 Clinical_event 2051 2060 discharge E57 Clinical_event:T97 T98 Outcome 2074 2082 returned E58 Outcome:T98 T99 Detailed_description 2090 2113 previous activity level R50 MODIFY Arg1:T99 Arg2:E58 T100 Sign_symptom 2133 2140 dyspnea E59 Sign_symptom:T100 A6 POLARITY E59 NEG R51 AFTER Arg1:E4 Arg2:E1 * OVERLAP E1 E2 E3 R52 AFTER Arg1:E3 Arg2:E5 * OVERLAP E5 E6 E7 E8 R53 BEFORE Arg1:E8 Arg2:E9 * OVERLAP E9 E10 E11 E12 E13 E14 E15 E16 E17 E18 E19 E20 E22 E23 E24 E25 E26 E29 A7 POLARITY E22 UNCERTAIN R54 BEFORE Arg1:E29 Arg2:E35 * OVERLAP E35 E33 E34 R55 BEFORE Arg1:E34 Arg2:E36 * OVERLAP E36 E37 R56 BEFORE Arg1:E37 Arg2:E38 T101 Coreference 1323 1333 extubation E60 Coreference:T101 R57 IDENTICAL Arg1:E60 Arg2:E36 * OVERLAP E38 E60 E39 E40 E41 R58 BEFORE Arg1:E41 Arg2:E42 R59 BEFORE Arg1:E42 Arg2:E43 * OVERLAP E43 E44 E45 E46 E47 E48 E49 E50 R60 BEFORE Arg1:E50 Arg2:E51 * OVERLAP E51 E53 E54 R61 BEFORE Arg1:E54 Arg2:E55 R62 BEFORE Arg1:E55 Arg2:E56 R63 AFTER Arg1:E56 Arg2:E57 R64 BEFORE Arg1:E57 Arg2:E58 * OVERLAP E58 E59 T56 Lab_value 1088 1095 reduced E61 Lab_value:T56 R18 MODIFY Arg1:E61 Arg2:E32 T53 Lab_value 1045 1054 prolonged E62 Lab_value:T53 R19 MODIFY Arg1:E62 Arg2:E31 T50 Lab_value 1032 1043 less than 1 E63 Lab_value:T50 R21 MODIFY Arg1:E63 Arg2:E30 T46 Lab_value 919 925 normal E64 Lab_value:T46 R26 MODIFY Arg1:E64 Arg2:E28 T44 Lab_value 892 898 normal E65 Lab_value:T44 R28 MODIFY Arg1:E65 Arg2:E27 T76 Clinical_event 1585 1591 failed E66 Clinical_event:T76 R37 MODIFY Arg1:E66 Arg2:E45 T22 Lab_value 382 390 elevated E67 Lab_value:T22 R6 MODIFY Arg1:E67 Arg2:E13 T32 Lab_value 587 607 within normal limits E68 Lab_value:T32 R11 MODIFY Arg1:E68 Arg2:E18 R12 MODIFY Arg1:E68 Arg2:E17 R13 MODIFY Arg1:E68 Arg2:E16 T95 Lab_value 2009 2022 uncomplicated E69 Lab_value:T95 R49 MODIFY Arg1:E69 Arg2:E55