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: no known allergies / adverse drug reactions attending: chief complaint: left sided weakness, aphasia major surgical or invasive procedure: tpa history of present illness: 62 yo f with hx htn and hld was at work this afternoon and reported to not be speaking much around 2 pm onward. at 4 pm she developed global aphasia and right hemiplegia and ems was called. no further information was available at time code stroke was called. past medical history: - htn - hld - cad s/p cabg/avr - dilated cardiomyopathy - systolic chf with ef 20% social history: pt reports that she used to live alone but since her recent cardiac surgery her daughter has moved in with her. resides in . has a history of etoh abuse and cocaine use. has been decreasing her alcohol consumption since her daugther moved in. family history: no early cad or scd per patient. physical exam: inital admission exam: 1a. level of consciousness: 0 1b. loc question: 2 1c. loc commands: 2 2. best gaze: 2 3. visual fields: 2 4. facial palsy: 1 5a. motor arm, left: 0 5b. motor arm, right: 4 6a. motor leg, left: 0 6b. motor leg, right: 4 7. limb ataxia: n/a 8. sensory: 1 9. language: 3 10. dysarthria: n/a 11. extinction and neglect: 1 vs; bp 151/108 p 110 rr 20 gen; awake, nad heent; nc/at cv; tachycardic, regular rate pulm; cta anteriorly abd; soft, nt, nd extr; no edema neuro; awake with eyes open but does not follow any commands and does not verbalize. fixed left gaze deviation, unable to overcome. does not blink to threat on the right. right facial droop. moves lue and lle spontaneously. 0/5 strength in rue and rle. grimaces to noxious stimuli in rue but no movement. upgoing toe on right, mute on left. pertinent results: tox screens 10:00pm urine bnzodzpn-neg barbitrt-neg opiates-neg cocaine-pos amphetmn-neg mthdone-neg 04:55pm asa-neg ethanol-neg acetmnphn-neg bnzodzpn-neg barbitrt-neg tricyclic-neg 05:38am blood alt-30 ast-33 ck(cpk)-71 alkphos-96 totbili-1.2 05:38am blood %hba1c-5.1 eag-100 05:38am blood triglyc-65 hdl-52 chol/hd-2.5 ldlcalc-67 06:15am blood pt-16.8* inr(pt)-1.5* ct perfusion: there is a matched perfusion abnormality with reduced flow and increased mean transit time involving the left inferior division mca territory consistent with established infarction. impression: area of increased mean transit time with reduced flow in the left inferior division of mca with a vessel cutoff suggesting a reversible infarct. no evidence of intracranial hemorrhage. mr head w/o contrast study date of 10:59 am 1. moderately large evolving acute infarct in the left posterior mca territory, and additional small evolving acute infarcts in the left aca territory and medial left temporal lobe. embolic etiology should be considered. echo the left atrium is elongated. the right atrium is moderately dilated. no atrial septal defect or patent foramen ovale is seen by 2d, color doppler or saline contrast with maneuvers. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity size is top normal/borderline dilated. overall left ventricular systolic function is severely depressed (lvef= 15-20%) with septal akinesis/dyskinesis, apical akinesis and mid inferior/inferolateral akinesis and hypokinesis elsewhere. the basal to mid anterolateral segments contract best. no left ventricular thrombus was identified. the right ventricular cavity is mildly dilated with normal free wall contractility. the aortic valve leaflets (3) are mildly thickened. there is no aortic valve stenosis. trace aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. a mitral valve annuloplasty ring is present. moderate to severe (3+) mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. moderate to severe tricuspid regurgitation is seen. there is at least moderate pulmonary artery systolic hypertension. there is no pericardial effusion. there is atherosclerotic plaque in the aortic arch (in limited brief hospital course: neuro: r mca stroke 62 yo f with hx htn and hld was at work when she developed global aphasia and right hemiplegia. her nihss was 22 and exam was notable for global aphasia, fixed left gaze deviation, and right hemiplegia. there were no early infarct signs on ct head, cta showed l m2 cutoff, and ct perfusion imaging showed smaller infarct than what would expect given deficits. after discussion with stroke fellow and attending, iv tpa was administered at 0.9 mg/kg with 10% bolus over one minute at 17:43 followed by remainder as drip for one hour. at 19:05, she was awake, alert but unable to vocalize. she followed some simple one step command but inconsistently. conjugate eye deviation to left but can look over to the right on volition. decreased blink to visual threat on right. r-facial droop. dense right sided hp with hemisensory loss. the patient was admitted to the neuro icu for post-tpa monitoring. bp was allowed to autoregulate with goal sbp 120-185 (home antihypertensives were held). the following morning, the neuro exam was significantly improved. she was alert and oriented x 3, with intact naming, repetition and comprehension. she had extreme difficulty controlling her r arm and leg, and it seemed to be moving on its own (severe flinging movements, such that the r wrist was restrained). we wondering if this was an alien limb syndrome, however her sensation was significantly impaired, in particular her position sense, so this could also explain her difficulty. the following day, the flinging and uncontrolled movements had stopped. she was able to reach and grab objects with the r hand, though it remained clumsy due to poor sensory input. mri showed moderately large evolving acute infarct in the left posterior mca territory, and additional small evolving acute infarcts in the left aca territory and medial left temporal lobe. the etiology is most likely cardioembolic, given her history of dilated cardiomyopathy. she was started on coumadin without a bridge. her fasting lipid panel was: chol 132, hdl 52, ldl 67, tg 65. language: pt was seen by the speech team. summary and recommendations are as follows: ms. presents with at least mild auditory comprehension, moderate verbal expression deficits, and moderate comprehension deficits on today's brief, informal aphasia evaluation. speech and voice appear wnl and pragmatics, insight, problem solving, and attention were functional for structured tasks. she is meeting acute needs in this setting with verbal communication, though relies on her listener for some inference to her specific thoughts. she will benefit from further dx/tx of aphasia in a rehab setting upon d/c. specific goals should include improved auditory comprehension of complex information, reduced frequency of paraphasias and word finding, and functional tasks to promote indepedence in the community. prognosis for improvement in communication is good given her age, previous level of functioning, family supports, and motivation. her current personal goal is to determine whether or not she'll be able to return to work at the gap, as she's concerned her physical and communication deficits will make this too challenging. cards: her cardiac history was discussed with her outpatient cardiologist, dr. at hospital. she had mvr in and has dilated cm (non-ischemic) with ef 25%. repeat tte during this hospitalizaton showed ef 15-20%. she had no evidence of failure. blood pressures were low on minimal medications (100-125) and so she was kept on only 25mg tid metoprolol and 5mg of lisinopril. she was started on coumadin and baby aspirin. she has an appointment with her cardiologist scheduled for . id: uti patient had foul smelling urine and ua was grossly positive. she was treated with bactrim for 3 days. substance abuse: urine tox was positive for cocaine. this may have been a factor in causing her stroke. it may contribute to her cardiomyopathy. the patient also has a history of etoh abuse, though current quantity is unclear. she did not exhibit any signs or symptoms of etoh withdrawal. social work as consulted and the patient was given resources for support. medications on admission: metoprolol xr 100mg daily lisinopril 20mg daily discharge medications: 1. acetaminophen 325 mg tablet sig: two (2) tablet po q6h (every 6 hours) as needed for pain/fever. 2. metoprolol tartrate 25 mg tablet sig: one (1) tablet po tid (3 times a day). 3. warfarin 2.5 mg tablet sig: two (2) tablet po once daily at 4 pm. 4. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 5. lisinopril 5 mg tablet sig: one (1) tablet po once a day. discharge disposition: extended care facility: - discharge diagnosis: right mca stroke s/p tpa hypertension hypertension cad s/p cabg/avr dilated cardiomyopathy systolic chf with ef 20% discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - requires assistance or aid (walker or cane). neuro: clumsy right hand/difficulty with motor planning, minimal weakness of the right side. right parietal drift. language is fluent but has frequent paraphasic errors. discharge instructions: you were admitted to evaluation of a stroke. it was felt that your stroke was related to your poor heart function. because of this, you were started on a blood thinning medication, coumadin. you will need to work closely with your doctors to monitor this medication and the correct dose, as too much or too little may place you at risk for stroke or bleeding. you were found to have cocaine in your system, which may have contributed to your stroke. you need to stop cocaine. followup instructions: cardiology/pcp: . at 1:30 , seton building , phone: ( (in replacement of previously scheduled appointment). department: neurology when: friday at 2:30 pm with: , md building: sc clinical ctr campus: east best parking: garage procedure: injection or infusion of thrombolytic agent diagnoses: urinary tract infection, site not specified congestive heart failure, unspecified unspecified essential hypertension coronary atherosclerosis of unspecified type of vessel, native or graft aortocoronary bypass status systolic heart failure, unspecified heart valve replaced by other means cerebral artery occlusion, unspecified with cerebral infarction hemiplegia, unspecified, affecting unspecified side 

Answer: The patient is high likely exposed to