Consider the following medical report that includes the patient's historical health records. Use it to predict the disease that the patient is high likely exposed to. 

 Medical Report: allergies: morphine / ace inhibitors attending: chief complaint: shortness of breath/ came to hospital for le weakness major surgical or invasive procedure: emg history of present illness: mrs. is a 77 year old female with a history of coronary artery disease s/p cabg, congestive heart failure (ef 30%), and copd who initially presented to an osh with a three week history of progressive lower extremity weakness and falls at home. she denies specific trauma on presentation. she also complained of an involuntary 30 lb weight loss over a period of 3 months. she has chronic dyspnea on exertion thought to be secondary to her severe cad and congestive heart failure but she had not had a worsening of these symptoms prior to presentation. she was transferred to this hospital for neurology consultation for possible syndrome. . she was admitted to the neurology service on . she initially underwent non-contrast ct scan of the abdomen and pelvis which showed no clear etiology of her weakness of weight loss. she underwent emg which showed no electrophysiologic evidence for a generalized polyneuropathy (including a demyelinating radiculopolyneuropathy) or for a lumbosacral polyradiculopathy on the right. on she underwent non-contrast ct c-spine which showed multilevel degenerative changes as well as a ct of the abdomen with contrast which showed no active malignancy. she received iv hydration prior to her ct scan. since her ct scan she has had a worsening of her creatinine from 1.1 on admission to 1.4 on and 2.0 on . she received iv hydration at 70 cc/hr for her acute renal failure. overnight on she was noted to have worsening dyspnea. she underwent cxr which showed hyperinflation but no evidence of pneumonia or volume overload. . the micu consult service was called on at approximately 6pm for worsening respiratory distress. on arrival the patient was audibly wheezing and was using accessory muscles of respiration. while previously satting well on room air she was noted to be 85% on ra and was placed on a non-rebreather. prior to arrival she had received 10 mg iv lasix with no effect (previously on torsemide 20 mg daily). abg showed acute respiratory acidosis 7.26/56/124 on a non-rebreather. repeat cxr was concerning for mild worsening of pulmonary edema. she did not have improvement after nebulizer therapy. she was transferred to the micu for respiratory distress. . micu course: on arrival to the micu she was placed on bipap out of concern for pulmonary edema. she was somnolent and not responsive to questions. she was continuing to use accessory muscles of respiration. nitro gtt was given for a few hours. despite minimal urine output from furosemide, patient's respiratory status rapidly improved. her acute renal failure was thought to be from contrast loads. in the morning after micu transfer, patient started to autodiurese. past medical history: coronary artery disease s/p cabg and s/o inferior myocardial infarction cardiac catheterization in with significant disease not amenable to intervention systolic heart failure (ef 30%) atrial fibrillation on coumadin sinus bradycardia s/p pacemaker placement hypertension hyperlipidemia type ii diabetes history of tias peripheral vascular disease gout copd stage ii chronic kidney disease (creatinine 1.2) social history: lives alone in a housing complex in in a single floor apartment w/ an elevator in the building. she pays her own bills. smoked up until 2 years ago w/ recent relapses. no alcohol or drug use. family history: heart disease and cancer. she is 1 of 12 children but only 4 of them are living. physical exam: vitals: t: 95 bp: 123/50 hr: 70 rr: 22 o2: 94% on 1l nc general: elderly woman in nad heent: sclera anicteric, mm moist, oropharynx clear neck: jvp elevated at 12 cm cardiac: regular rate and rhythm, s1 + s2, no murmura, rubs, gallops chest: khyphotic lungs: diffuse inspiratory and expiratory wheezes, crackles throughout r side, halfway up on left side, hyperinflation gi: soft, non-tender, non-distended, +bs ext: cool, pulses dopplerable, no clubbing, cyanosis or edema neurologic: cn ii-xii intact motor: symm u and le : symm cereb: fnf intact, gait assessment deferred ms: a+ox3, speech fluent, tp linear pertinent results: 06:20am blood wbc-5.1 rbc-3.92* hgb-12.1 hct-36.0 mcv-92 mch-30.9 mchc-33.7 rdw-15.3 plt ct-266 03:10pm blood neuts-52.6 lymphs-40.0 monos-6.6 eos-0.4 baso-0.4 06:20am blood glucose-89 urean-43* creat-1.7* na-138 k-3.9 cl-102 hco3-23 angap-17 07:58pm blood ck-mb-4 ctropnt-0.04* probnp-* 04:54am blood ck-mb-5 ctropnt-0.05* probnp-* 12:15pm blood ck-mb-4 ctropnt-0.06* 09:20am blood caltibc-293 ferritn-103 trf-225 03:10pm blood %hb . 12:38 pm csf;spinal fluid source: lp tube#3. **final report ** gram stain (final ): no polymorphonuclear leukocytes seen. no microorganisms seen. this is a concentrated smear made by cytospin method, please refer to hematology for a quantitative white blood cell count.. fluid culture (final ): no growth. a1c-7.9* . conclusions the left atrium is elongated. the estimated right atrial pressure is 0-5 mmhg. left ventricular wall thicknesses and cavity size are normal. there is severe global left ventricular hypokinesis (lvef = 20 %). the basal anterior wall contracts best, but is also hypokinetic. no masses or thrombi are seen in the left ventricle. the estimated cardiac index is low (2.1l/min/m2). tissue doppler imaging suggests an increased left ventricular filling pressure (pcwp>18mmhg). right ventricular chamber size is normal with mild global free wall hypokinesis. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. there is no aortic valve stenosis. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. mild to moderate (+) mitral regurgitation is seen. there is mild pulmonary artery systolic hypertension. there is a trivial/physiologic pericardial effusion. impression: normal left ventricular cavity size with severe global hypokinesis and mild right ventricular free wall hypokinesis c/w diffuse process (toxin, metabolic, etc., cannot exclude multivessel cad). mild pulmonary artery systolic hypertension. mild-moderate mitral regurgitation. . . radiology report ct abdomen w/contrast study date of 8:36 pm . impression: 1. severe atherosclerotic stenosis at the origins of the celiac axis and sma with post-stenotic dilatation. these findings raise the possibility of intestinal angina, particularly given the patient's history of weight loss. there is no ct evidence of acute ischemia. 2. enlargement of the adrenal glands bilaterally without focal nodules, likely adrenal hyperplasia. 3. a 3.3 cm right adnexal cyst, which is abnormal in this postmenopausal patient. pelvic ultrasound is recommended for further characterization. 4. two peripherally enhancing hepatic lesions consistent with hemangiomas. 5. patent aorto-bifem graft. 6. 3 and 4 mm pulmonary nodules at the lung bases. the patient is scheduled to have a dedicated chest ct shortly, at which time the remainder of the chest can be evaluated. brief hospital course: ms 77-year-old woman with a history of coronary artery disease s/p cabg, congestive heart failure (ef 30%), and copd who initially presented to an osh with a three week history of progressive lower extremity weakness and falls at home, who was admitted to the neurology service initially. . # acute chf exacerbation: the pt developed respiratory failure in the setting of receiving iv hydration (prior to contrast administration). cardiac enzymes were unremarkable. the pt was initially diuresed with iv lasix, and was then changed to her home torsemide regimen when her renal failure began to improve. . # progressive lower extremity weakness: the pt had a head ct, ct c-spine, and emg which were largely unremarkable, and did not show evidence of syndrome. malignancy workup included ct torso with contrast which was unrevealing. on transfer to the floor following the chf exacerbation the pt's strength in her lower extremities was . the pt worked with physical therapy, and was discharged with plans for home pt. on discharge the pt was able to walk comfortably with a walker. . # acute renal failure: the pt's creatinine rose to 2.6 from baseline of 1.1 following administration of iv contrast. the pt's creatinine improved over the rest of admission. the renal failure was likely contrast-induced nephropathy in the setting of two dye loads. urine eosinophils were negative. . # coronary artery disease s/p cabg: reportedly the pt was known to have persistent lesions not amenable to intervention and as an outpatitient was on nitrates and ranolazine for persistent dyspnea on exertion and angina. the pt's home isosorbide mononitrate, simvastatin, metoprolol, and aspirin 325 were continued, and the pt's cardiac enzymes trended down during this admission. the pt was noted to have an ace inhibitor intolerance. . # atrial fibrillation: the pt has a pacemaker and on discharge coumadin was restarted. . # diabetes mellitus: the pt's home glyburide was changed to glipizide due to the patient's decreased creatinine clearance in the setting of contrast-induced nephropathy. medications on admission: spironolactone 25mg po daily metoprolol 50 po bid potassium 20 meq daily ranexa (ranolazine) 1 g daily omeprazole 20 mg simvastatin 40 mg daily torsemide 20 mg po daily isorbide mononitrate 30 daily glyburide 2.5 mg colchicine 0.6 daily coumadin 2 mg qd discharge medications: 1. simvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 2. spironolactone 25 mg tablet sig: one (1) tablet po daily (daily). 3. isosorbide mononitrate 30 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po daily (daily). 4. colchicine 0.6 mg tablet sig: one (1) tablet po daily (daily). 5. potassium chloride 20 meq tab sust.rel. particle/crystal sig: one (1) tab sust.rel. particle/crystal po daily (daily) for 24 weeks. 6. torsemide 20 mg tablet sig: one (1) tablet po once a day. 7. ranolazine 500 mg tablet sustained release 12 hr sig: two (2) tablet sustained release 12 hr po qday () as needed for cad. 8. warfarin 2 mg tablet sig: one (1) tablet po daily (daily): please do not restart your warfarin until you have your inr checked and dr. office calls you to tell you to restart your warfarin. 9. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po twice a day. 10. outpatient lab work check inr on 11. glipizide 2.5 mg tab,sust rel osmotic push 24hr sig: one (1) tab,sust rel osmotic push 24hr po bid (2 times a day). disp:*60 tab,sust rel osmotic push 24hr(s)* refills:*2* 12. toprol xl 50 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po once a day. disp:*30 tablet sustained release 24 hr(s)* refills:*2* discharge disposition: home with service facility: discharge diagnosis: acute on chronic congestive heart failure diabetes hypertension gout discharge condition: stable discharge instructions: ms. : you were admitted with leg weakness, you had a muscle test to look at the nerve function in your muscles and this was normal. you had a number of radiology studies to look for anatomical causes of your weakness and there was no evidence of any dangerous abnormality. during this hospitalization you developed respiratory distress, which was probably caused by the fluids you were given for hydration prior to a radiology study. you were treated with diuretic medicines to allow you to get rid of the fluid in your lungs and you improved. you worked with physical therapy and your leg weakness resolved. . most of your home medications remain the same. please continue to take your home medications as directed. some changes have been made to your home medications: metoprolol has been changed to toprol xl. your warfarin has been stopped. please do not restart your warfarin until you have your inr checked and dr. office calls you to tell you to restart your warfarin. your glyburide has been stopped. you have been started on glipizide. . if you develop any chest pain, shortness of breath, wheezing or any other distressing symptom, please return to the emergency room. followup instructions: appointment #1 md: dr. specialty: cardiology date and time: wednesday at 2:30 pm location: medical center 2 dr. , ma phone number: ( . appointment #2 md: dr. specialty: internal medicine date and time: wednesday at 3:15 pm location: medical center 2 dr. , ma phone number: ( procedure: spinal tap incision of lung diagnoses: acidosis congestive heart failure, unspecified diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute kidney failure, unspecified chronic airway obstruction, not elsewhere classified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified gout, unspecified atrial fibrillation coronary atherosclerosis of unspecified type of vessel, native or graft aortocoronary bypass status acute respiratory failure cardiac pacemaker in situ acute on chronic systolic heart failure chronic kidney disease, stage ii (mild) muscle weakness (generalized) 

Answer: The patient is high likely exposed to