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: sulfa (sulfonamides) attending: chief complaint: right sided vision loss and dizziness. major surgical or invasive procedure: -intravenous tpa -transesophageal echocardiogram history of present illness: patient is a 32 year old right handed woman with no significant past medical history presented with acute onset of right visual loss. symptoms began around noon on the day of admission after taking an exam. she had acute onset of dizziness, headache, and loss of vision over the right visual space. she covered each eye independently and noted similar findings. she also noted diffuse tingling in all limbs. she denies any double vision or slurred speech. she was taken emergently to where head mri revealed a left pca infarct on dwi with abrupt cut-off of the left p2 branch. she was transferred to at 3 hours after symptoms for possible intraarterial intervention. the patient denied any history of ocp use, tobacco use, bleeding or clotting disorders. she has no cardiac disease. last menstrual period 5 days prior to admission. at , nihss was 2. right homonymous hemianopsia was confirmed on exam. she was treated with 20 mg intraarterial tpa at about 5 hr and 15 min after onset of symptoms, resulting in recanalization. the patient subsequently developed a headache. initial read of the emergent ct was concerning for a small occipital bleed, and the patient was admitted to the neuroicu. final read, however, showed no hemorrhage, just an area of increased contrast. past medical history: 1. g6p3 with 3 spontaneous abortions 2. no history of migraines social history: married, lives with her husband and three children. denies tobacco, etoh, illicits. family history: no history of stroke, seizure, or other neurologic disease. no history of blood clots. physical exam: vitals bp 115/70 p 70 r 18 general: well nourished, in no acute distress. neck: supple, no lymphadenopathy or carotid bruits. lungs: clear to auscultation bilaterally. cv: regular rate and rhythm, normal s1/s2 heart sounds, no murmurs/rubs/gallops. neurologic examination: mental status: awake and alert, cooperative with exam, oriented to person, place, date. speech fluent, no dysarthria, no paraphasic errors. naming and repetition intact. normal comprehension. cranial nerves: visual fields show right superior quadrantanopsia, normal acuity. pupils 3 to 2mm bilaterally, directly and consensually. no facial asymmetry, no dysarthria. hearing grossly intact. palate elevated symmetrically. tongue midline without fasciculations. motor: normal bulk and tone bilaterally. no tremor, asterixis, drift. mild right hemiparesis. sensation was intact to light touch, pin prick, temperature(cold), vibration, and proprioception. reflexes: b t br pa pl right 2 2 2 2 2 left 2 2 2 2 2 reflexes brisker on left compared with right. coordination is normal on finger-nose-finger, rapid alternating movements normal. pertinent results: 11:30am blood wbc-5.3 rbc-4.05* hgb-12.6 hct-36.4 mcv-90 mch-31.2 mchc-34.8 rdw-12.7 plt ct-186 11:30am blood pt-13.2 ptt-28.1 inr(pt)-1.1 11:30am blood glucose-81 urean-7 creat-0.7 na-140 k-4.0 cl-109* hco3-25 angap-10 11:30am blood ck(cpk)-72 02:00am blood ck(cpk)-60 05:45am blood ck(cpk)-51 11:30am blood ck-mb-notdone ctropnt-<0.01 02:00am blood ck-mb-notdone ctropnt-<0.01 05:45am blood ck-mb-notdone ctropnt-<0.01 11:30am blood calcium-8.5 phos-2.4* cholest-172 11:30am blood triglyc-58 hdl-56 chol/hd-3.1 ldlcalc-104 11:30am blood fibrino-302 11:30am blood esr-12 11:30am blood facviii-68 11:30am blood lupus-neg at iii-pnd prot c-94 11:30am blood -negative 11:30am blood rheufac-4 crp-0.53* 11:30am blood asa-neg ethanol-neg acetmnp-neg bnzodzp-neg barbitr-neg tricycl-neg 11:30am blood activated protein c -pnd 11:30am blood prothrombin mutation analysis-pnd 11:30am blood factor v leiden-pnd 11:30am blood protein s,functional-pnd 11:30am blood cardiolipin antibody-pnd ----- ct head : there is a small focus of intraparenchymal hemorrhage with associated moderate edema within the left occipital lobe. this high attenuation material represents blood and contrast from the patients recent cerebral angiogram. there is also high attenuation material along the left tentorium cerebelli adjacent to the patient's focus of intraparenchymal hemorrhage. there is no evidence of hydrocephalus, or shift of normally midline structures. bone windows show no suspicious lytic or sclerotic lesions. impression: small left occipital lobe intraparenchymal hemorrhage with associated moderate edema in the distribution of the patient's known left posterior cerebral artery infarction. there is also associated subdural hemorrhage along the left aspect of the tentorium cerebelli in this patient s/p cerebral angiogram with infusion of intra-arterial tpa. alternatively a portion of this hyperdenisty could be due to the contrast itlsef. a follow up ct is recommended in days to assess interval change. ----- angiogram : occlusion of a left p2 branch of the posterior cerebral artery with successful thrombolysis after infusion of approximately 20 mg of intraarterial tpa. the post-procedure angiogram showed significant improvement of flow to the previously occluded left p2 posterior cerebral artery branches. ----- ct head : again demonstrated within the left occipital lobe is an area of low attenuation, not significantly changed since the prior study, consistent with infarction within the distribution of the left posterior cerebral artery. no intra or extra-axial hemorrhage, mass effect, or shift in normally midline structures is present. differentiation of the and white matter is preserved. there is no hydrocephalus. impression: stable appearance of left occipital lobe infarction. no acute intracranial hemorrhage or mass effect. ----- bilateral lenis : no evidence of dvt in the right or left lower extremity. ----- echocardiogram : the left atrium is normal in size. no spontaneous echo contrast or thrombus is seen in the body of the left atrium/left atrial appendage or the body of the right atrium/right atrial appendage. a patent foramen ovale is present. a left-to-right shunt across the interatrial septum is seen at rest. bubble study is positive for right-to-left shunting at rest and with maneuvers. left ventricular wall thickness, cavity size, and systolic function are normal (lvef>55%). right ventricular chamber size and free wall motion are normal. the ascending, transverse and descending thoracic aorta are normal in diameter and free of atherosclerotic plaque. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic regurgitation. the mitral valve appears structurally normal with trivial mitral regurgitation. there is no pericardial effusion. impression: patent foramen ovale. ----- brief hospital course: patient is a 32 year old right handed woman with no significant past medical history presenting with visual field deficits and dizziness. findings on exam and imaging were consistent with left pca infarct. during her hospitalization, the following problems were addressed: 1. stroke: the patient presented with a left pca infarct, confirmed by head ct and mri. she received 20 mg ia tpa at about 5 hr and 15 min after onset of symptoms. there was recanalization. she ruled out for mi by three sets of negative cardiac enzymes. she was monitored on telemetry without findings of arrhythmia. she was treated initially with aspirin, and then was started on coumadin for anticoagulation after absence of intracerebral hemorrhage was confirmed. the post tpa area concerning for a hemorrhage was found to be consistent with contrast dye. goal inr on coumadin is 2-2.5. the patient will follow up in the coagulation clinic affiliated with the medical group and her new primary care physician, . , . given the patient's age and negative risk factors for stroke, a transesophageal echocardiogram was done to look for an embolic source. none was seen; however it was noted that the patient has a patent foramen ovale with right to left shunt. lower extremity dopplers were done to rule out dvt and were negative. a hypercoagulable work-up was initiated, including studies for lupus anticoagulant, protein c and s deficiency, activate protein c mutation, antithrombin iii mutation, factor v leiden, and anticardiolipin antibody. notably, her antithrombin iii level was low. others were pending at the time of discharge. additionally, a rheumatologic work-up was initiated. and rheumatoid factor were negative. goal systolic blood pressure in the acute and subacute phase is 120-130. the patient's blood pressue was lower than this, running in the 90s-110s. she was treated with iv fluids and encouraged to take more po fluid. she will continue on coumadin and aspirin, and follow-up with dr. in neurology at , at which time results of hypercoagulable work up will be reviewed in full. on discharge she continues to have a right homonymous hemianopsia and mild right-sided weakness as demonstrated by mild right pronator drift. she has dizziness and mildly unsteady gait; these are felt to be due to her visual field defects. occupational and physical therapy services were consulted and acute level rehab was recommended. the patient was also provided with information on the drivewise program. she was advised that she can not drive a car until she is properly evaluated given her visual deficits. the drivewise program can be reached at . 2. headache: post ia tpa patient continued to have headache. she was treated transiently with fiorecet and iv morphine. by the time of discharge she required pain medications only once daily. she was told that the pain medications are for short term use as prolonged use can cause tolerance to develop and lead to withdrawal symptoms. 3. cardiology: patient ruled out for myocardial infarction. no arrhythmias were seen on telemetry testing. tee demonstrated a patent foramen ovale. 4. hematology: hypercoaguable panel was sent prior to initiation of anticoagulation. the majority of these results are still pending. they will be reviewed at the patient's follow up appointment with dr. . 5. disposition: the patient was discharged to home after ot and pt evaluations. she will follow-up with her new primary care physician, . , monday in , nh. she follow-up with dr. in the stroke clinic in about 4 weeks to discuss results of the hypercoagulable studies, further anticoagulation, and options for pfo closure. she is a full code. medications on admission: none discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day) as needed for constipation. disp:*60 capsule(s)* refills:*0* 2. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po bid (2 times a day) as needed for constipation. disp:*qs ml(s)* refills:*0* 3. aspirin 325 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). disp:*30 tablet, delayed release (e.c.)(s)* refills:*2* 4. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. disp:*30 tablet(s)* refills:*0* 5. coumadin 5 mg tablet sig: one (1) tablet po at bedtime: goal inr is . disp:*30 tablet(s)* refills:*0* 6. acetaminophen-caff-butalbital mg tablet sig: one (1) tablet po q4-6h (every 4 to 6 hours) as needed. disp:*12 tablet(s)* refills:*0* discharge disposition: extended care facility: - discharge diagnosis: 1. left pca infarct status post ia tpa 2. patent foramen ovale discharge condition: persistent right superior quadrant anopia. right hemiparesis. problems with gait, coordination, and balance likely secondary to visual field defect. discharge instructions: if you develop dizziness, visual changes, persistanct or worsening headache, numbness, or weakness, please call your neurologist, your primary care physician, /or return to the emergency department. please take all of your medications as directed. followup instructions: please follow-up with dr. of the medical group monday at 1:00pm. you will see the nurse in the coagulation clinic first, and then see dr. at 1:30pm. you can call to reach dr. office. please bring all discharge paperwork including a medication list and discharge summary with you to this appointment. please follow-up with dr. in neurolgy at . you can call to make an appointment. you must register with the outpatient hospital administration before an appointment can be scheduled. the secretary you speak with when you call dr. office can help you with this. md, procedure: diagnostic ultrasound of heart injection or infusion of thrombolytic agent arteriography of cerebral arteries diagnoses: ostium secundum type atrial septal defect cerebral artery occlusion, unspecified with cerebral infarction 

Answer: The patient is high likely exposed to