$re = '/\b(?!lv\b)\w+\b(?=(?:\s+lv)?\s+d(?:[iy]a|i)stolic d[yi]sfunction)/mi';
$str = '*AVR(1380),redo AVR (1396)due to AV prosthesis malfunction -Normal LV size with preserved systolic function(GEF= 50-55%)severe hypertrophy in apical segments maximom thickness=1.6cm with sparing of posterior wall, echo feature is mostly compatible with apical HCM-Mild LV diastolic dysfunction(Grade I)-Normal RV size with mild systolic dysfunction -Mild biatrial enlargemen (LAVI=40cc/m2 ,RAVI=33cc/m2)-Normal MVLs ; No MS;Mild to moderate MR-Mechanical prosthesis AV with good hemodynamic study (MG=6mmHg ,PG=11mmHg , AVACCT=63)No paravalvular leakage ;dilated ascending aorta=3.9cm ,(No visible dissection flap in ascending) -Normal PVLs ;No PS;Mild PI;Mean PAP=22mmHg-Normal TVLs ;No TS;Mild TR-Top Normal PAP-Normal IVC size and collapse-No pericardial effusion-IAS redundant
-HOCM type III with significant resting LVOT obstruction(PPG=100 mmHg)-Normal LV size with good systolic function(EF=60%)-Mild diastolic dysfunction(grade I)-Normal RV size and systolic function-Severe SAM with moderate eccentric MR(ROA=0.25 cm2)-Mild TR-';
preg_match_all($re, $str, $matches, PREG_SET_ORDER, 0);
// Print the entire match result
var_dump($matches);
Please keep in mind that these code samples are automatically generated and are not guaranteed to work. If you find any syntax errors, feel free to submit a bug report. For a full regex reference for PHP, please visit: http://php.net/manual/en/ref.pcre.php