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: patient recorded as having no known allergies to drugs attending: chief complaint: shortness of breath, transferred for cath major surgical or invasive procedure: cardiac catheterization bronchoscopy history of present illness: the patient is a 72 year old female with a history of hypertension, hyperlipidemia, and copd who presents from an outside hospital with increased sob and new anterolateral st elevations, transferred for cardiac catheterization. she was admitted to 3-4 weeks ago for an asthma exacerbation and at that time was started on 2l home o2. she has continued to feel sob since then. she reports that she has been on prednisone for the past 3 months, is currently on 30 mg daily, and reports that her symptoms worsen when she goes down to 20 mg daily. she denies any chest pain, neck/arm pain, weakness, n/v, diaphoresis, fever/chills, cough, or decrease in exercise tolerance. she felt like there was mucus in her chest, but could not produce any. since she was so short of breath, she went to hospital. . at the osh, she was admitted for copd exacerbation and romi. cxr showed right lung base subsegmental atelecatasis. she was started on moxifloxin 400 mg daily, mucinex 1200 mg , albuterol nebs, symbicort, spiriva, and solumedrol 60 iv q6hr. she had "drainage" with posterior nasal suction to help remove her secretions, but did not tolerate that well. during the hospital course, and ekg showed st elevation in leads i, avl, and v2-v6, and there was concern for a previous anterior septal wall mi. ces: trop i 0.58->0.29, ck 24->20, ckmb ->5.9. she remained chest pain free. cardiology was consulted (dr. , and determined that the patient was having an acute anterior wall mi. she was started on asa 325->81 daily, plavix 75 daily, and transferred to . her hr was 110 prior to transfer, treated with lopressor 5 mg iv x2 with improvement to the 80s-90s. . at , vitals pre-cath showed bp 104/52, hr 86, rr 32, sao2 89% on 2l. cardiac catheterization showed mild non-obstructive cad (lad with 30% proximal stenosis, lcx 40% after om1)and possible takotsubos. after the procedure her sbp ranged 88-90s with occasional decrease to 78. she was given a total of 1 l ns divided into boluses. a bedside echo was completed. . she currently is chest pain free, and her sob has improved. she is fatigued. . on review of systems, she denies any prior history of stroke, tia, deep venous thrombosis, pulmonary embolism, bleeding at the time of surgery, myalgias, joint pains, cough, hemoptysis, black stools or red stools. she denies recent fevers, chills or rigors. she denies exertional buttock or calf pain. all of the other review of systems were negative. *** cardiac review of systems is notable for absence of chest pain, paroxysmal nocturnal dyspnea, orthopnea, ankle edema, syncope or presyncope. she has occasional dyspnea on exertion and palpitations. past medical history: cardiac risk factors: (-) diabetes (+) dyslipidemia (+) hypertension (baseline bp 140/70) . cardiac history: cabg, pci, pacemaker/icd - none. . other past history: 1. copd/asthmatic bronchitis, asthma developed 10 yrs ago after she stopped smoking, has been on 2 l o2 on a prn basis for the past 3 weeks, has been on prednisone maintenance for the last 3 months and is currently on 30 mg/day. pulmonologist is dr. at . has had 3 hospitalizations for asthma, never been intubated. 2. previous tobacco use social history: social history is significant for the absence of current tobacco use. she previously smoked 1 ppd for 35 years, quit 10 yrs ago. there is no history of alcohol abuse. she is a retired nurse. she lives in an apartment within her relative's house. at baseline she is independent in her adls and iadls, and is very active. family history: there is no family history of premature coronary artery disease or sudden death. her mother and sister have disease and her father died of multiple myeloma. physical exam: physical examination: vs - bp 83/45, hr 85, rr 16, sao2 91% on 2l gen: wdwn elderly female in nad. oriented x3. mood, affect appropriate. heent: ncat. sclera anicteric. eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. no xanthalesma. mucous membranes slightly dry. no submandibular, anterior cervical, or supraclavicular lymphadenopathy. area of ecchymosis (3 cm x 2 cm) on upper chest. neck: supple with no jvd cv: pmi located in 5th intercostal space, midclavicular line. very quiet heart sounds, rr, normal s1, s2. no m/r/g. no thrills, lifts. no s3 or s4. chest: no chest wall deformities, scoliosis or kyphosis. resp were unlabored, no accessory muscle use. poor inspiratory effort. ctab, no crackles, wheezes or rhonchi. abd: soft, ntnd. no hsm or tenderness. ext: no lower extremity edema. r groin cath site without evidence of hematoma. skin: no stasis dermatitis, ulcers, scars, or xanthomas. . pulses: right: carotid 2+ radial 2+ dp 2+ pt 2+ left: carotid 2+ radial 2+ dp 2+ pt 2+ pertinent results: labs from osh: trop i 0.58->0.29, ck 24->20, ckmb ->5.9, bun 52, cr 1.4, plt 519, wbc 24.2, hct 41.8 abg on 3l o2: 7.44/27/61 brief hospital course: 72f h/o copd, htn, s/p acute mi coronary vasospasm (no takotsubo given no ballooning on cath), s/p cath with fluid resuscitation, transferred to micu in acute hypoxic respiratory distress, found to have pneumonia and lll collapse. 1) hypoxic respiratory distress copd, collapsed ll: copd with end-stage lung disease, collapsed ll, and initially chf, with also pna. s/p bronchoscopy with extensive suctioning for mucous plug and lll collapse, stable on supplemental o2. improved on zosyn therapy and s/p bronch. volume overload: bnp initially elevated s/p cath, the pt autodiuresing for a goal even i/os. for her copd she was placed on a steroid taper to 15mg daily. plan to taper every two weeks as outlined in the discharge orders. for her pneumonia she received a one week course of vanc and zosyn. she continues to have an oxygen requirement and benefits from pulmonary rehab. while on prednisone she will receive pcp prophylaxis bactrim ds 1 tab mwf. on the day of discharge she was saturating 98% on 2l nc. she will benefit from pulmonary rehab and will need to see a pulmonologist as an outpatient. she was scheduled with follow up prior to discharge. 2)labile bps: fluctuated between hypo and hypertension, with historical baselines of sbp 140s. initial concern for cardiogenic origin of patient's respiratory distress. bedside echo in the setting of acute hypotension post cath did not indicate rv strain. likely poor forward flow due to diastolic failure. bps becoming more normotensive at the end of her hospitalization. she was started on metoprolo 12.5mg tid which was then increased to qid, titrated to blood pressure and hr. 3) acute mi coronary vasospams: cath showed only mild non obstructive disease, but hypokinesis evident on echo, indicating likely coronary vasospasm, although not takotsubo as no ballooning on echo. she remained on aspirin and statin and metoprolol at discharge. 4) supraventricular tachycardia: ?avnrt v ?mat, controlled with metoprolol although she continues to have occasional bursts of non sustained svt. 5)thrombocytopenia - most likely acute illness, time course not c/w hit however will d/c heparin sq and start pneumoboots in case. 6)chronic diastolic heart failure: currently euvolemic. she was discharged on metoprolol q6 hours. her outpatient medications including lisinopril, hydrochlorothiazide and verapamil were held during her admission as metoprolol was titrated up for rate control. lisinopril should be restarted once blood pressure will tolerate. she will follow up with dr. as an outpatient. 7) anemia: stable, however significantly lower than baseline on admission, likely significant acute/infectious illness . no evidence of acute bleed, no transfusion requirement. 8) hyperlipidemia: atorvastatin 80mg daily. 9) communication , daughter 10)code status- full medications on admission: current medications: verapamil 180 mg daily lisinopril 10 mg daily hydrochlorothiazide 25 mg daily zocor daily flovent inh foradil inh combivent prn duoneb prednisone 30 mg daily finished azithromycin 1 wk ago generally takes doxycycline the first 2 weeks of each month . medications on transfer: -aspirin 81 mg x4 (), 81mg daily () -plavix 75mg daily () -verapamil 60 mg po q6 vs. 180 mg daily -lisinopril 10 mg po daily -lopressor 5mg iv x2 today, hr down to 80s -zocor 20 mg po qhs -mucinex 1200 mg po bid -solumedrol 60 mg iv q6hr -symbicort 160/4.5, 2 pills -spiriva 1 inh daily -albuterol nebs q4hr prn -nitropaste 1 inch to chest wall prn angina -lovenox 50 mg sc bid -moxifloxin 400 mg po daily -protonix 40 mg daily 1/2 ns at 60cc/hour hctz was discontinued as patient was hyponatremic to 133 . allergies: nkda discharge medications: 1. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 2. guaifenesin 600 mg tablet sustained release sig: two (2) tablet sustained release po bid (). 3. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 4. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 5. fluticasone 110 mcg/actuation aerosol sig: two (2) puff inhalation (2 times a day). 6. calcium carbonate 500 mg tablet, chewable sig: one (1) tablet, chewable po bid (2 times a day). 7. insulin lispro 100 unit/ml solution sig: sliding scale subcutaneous asdir (as directed): while on steroids. 8. famotidine 20 mg tablet sig: one (1) tablet po q24h (every 24 hours). 9. atorvastatin 40 mg tablet sig: two (2) tablet po daily (daily). 10. trimethoprim-sulfamethoxazole 160-800 mg tablet sig: one (1) tablet po mwf (monday-wednesday-friday): while on steroids. 11. cholecalciferol (vitamin d3) 400 unit tablet sig: one (1) tablet po bid (2 times a day). 12. alendronate 70 mg tablet sig: one (1) tablet po qtues (every tuesday). 13. prednisone 5 mg tablet sig: three (3) tablet po daily (daily): taper as indicated. 14. ipratropium bromide 0.02 % solution sig: one (1) nebulizer inhalation q6h (every 6 hours). 15. levalbuterol hcl 0.63 mg/3 ml solution for nebulization sig: one (1) nebulizer inhalation q6h (every 6 hours). 16. metoprolol tartrate 25 mg tablet sig: 0.5 tablet po q6h (every 6 hours): may be changed to toprol xl once blood pressures stabilized; hold for sbp <100 or hr < 90. 17. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 18. acetaminophen 325 mg tablet sig: 1-2 tablets po every hours as needed for pain. 19. vitamin d 400 unit tablet sig: one (1) tablet po twice a day. discharge disposition: extended care facility: discharge diagnosis: coronary artery vasospasm pneumonia and left lung collapse hypertension tachycardia chronic obstructive pulmonary disease discharge condition: stable. discharge instructions: you were admitted with a suspected heart attack but no coronary artery vessel disease was noted on your cardiac catheterization. your heart strain was thought to be secondary to coronary artery vasospasm. you also had a fast heart rhythm which was stabilized with fluids and medications. you also had collapse of your left lung likely from mucous plugging from a pneumonia. you received a one week course of intravenous antibiotics as well as prednisone for your underlying lung disease. your prednisone will need to be slowly decreased and discontinued once you are improved. you have required supplemental oxygen and may need to continue with oxygen for your comfort for the time being. . you will need to follow-up with a cardiologist and a pulmonologist. . please take all of your medications as prescribed and adhere to all medical appointments. . if you develop any concerning symptoms such as persistent fever, cough, shortness of breath. followup instructions: pulmonology: you have an appointment on at 2:30 with dr. . you will have pulmonary function tests prior to this appointment. this appointment is on the of the building. the phone number is . . cardiology: please call and schedule an appointment to follow up with dr. after you leave rehab. . pcp: should call your primary care physician and schedule an appointment to be seen within 1-2 weeks of discharge from rehab. procedure: venous catheterization, not elsewhere classified coronary arteriography using two catheters left heart cardiac catheterization other bronchoscopy arterial catheterization diagnoses: pneumonia, organism unspecified thrombocytopenia, unspecified anemia, unspecified pure hypercholesterolemia congestive heart failure, unspecified unspecified essential hypertension acute kidney failure, unspecified asthma, unspecified type, unspecified acute myocardial infarction of anterolateral wall, initial episode of care acute respiratory failure other specified cardiac dysrhythmias chronic diastolic heart failure prinzmetal angina 

Answer: The patient is high likely exposed to