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: quinine / captopril / iodine; iodine containing / reopro / amoxicillin / amlodipine attending: chief complaint: increasing shortness of breath/ positive stress mibi major surgical or invasive procedure: cardiac catheterization history of present illness: pt is a 78 yo female, h/o cad s/p multiple caths (stents x 5), most recently in (mid-lad drug eluding stent) who presents to the ed after having increasing sob. pt says that since , she has noticed a slow decline in her functional status. for the past two days, she has increasing dyspnea on exertion than in the past, not even able to walk 50 feet before stopping; prior to , she could walk a few blocks. she notes that she has increased her lasix dose recently without effect. this shortness of breath only occurs during walking and is relieved by rest. of note, pt has not had chest pain, or jaw pain at this time. additionally, in the past prior to stenting, she has never had chest pain, only jaw pain when she presented in . no recent swelling in the legs. +pnd. +stable 5 pillow orthopnea. +occasional palpitations. +12 pound weight gain past month but this is attributed to recently starting actos and having to increase food consumption to regulate blood sugars. pt went to see pcp and was sent to ed. ekg was unchanged from previous, and two sets of cardiac enzymes were flat. pt had a stress mibi test done today. stress part showed no anginal with no ischemic ecg changes. thalium nuclear showed a moderate reversible defect in the anterior wall, severe reversible defect in the apex, all similar to mibi pre stenting of the mid-lad. pt's last cardiac catheterization from showed ef 60%, mid lad 70% stenosis, subtotally occluded diagonal. lcx patent with 60-70% of the om1 and om2. the rca had mild lumenal irregularities. there was mildly elevated left sided filling pressures (lvedp=19 mmhg). mid lad was stented. past medical history: 1. coronary artery disease as above 2. history of cardiac stent placement as above. 3. asthma-h/o intubation 4. congestive heart failure ef reduced 51->38 at last mibi . mibi from could not calculate ef. 5. hypertension. 6. h/o deep venous thrombosis. 7. panic attacks. 8. diabetes type 2. 9. s/p cholecystectomy. 10. ventral hernia repair. 11. anaphylactic reactions to contrast dye used in cardiac catheterizations social history: pt is married, lives with husband. she is a retired floral arranger. quit smoking at age 47. smoked <1 ppd x 10 years. no etoh. no drugs. family history: b: heart transplant uncles (paternal): mis in 70s m: died of ca f: died of mi at 48 no htn. no dm. physical exam: t: 98.6; bp: 135/65; hr: 67; rr: 18; o2: 97% ra gen: older female sitting on bed able to speak in full sentences in nad heent: eomi; sclera anicteric; op no exudate. neck: no jvd. cv: rrr s1s2. no murmurs. lungs: cta b/l. good air entry throughout though slightly decreased at bases b/l. no crackles/wheezes/rales. abd: soft. +large ventral hernia protruding from midline and small clotted blood. non-tender. non-distended. ext: dp 2+. no edema. neuro: cn ii-xii grossly intact. ms preserved. pertinent results: labs on admission: 03:30pm blood wbc-7.5 rbc-4.35 hgb-12.3 hct-37.9 mcv-87 mch-28.3 mchc-32.6 rdw-15.4 plt ct-234 03:30pm blood neuts-71.4* lymphs-19.3 monos-6.4 eos-2.5 baso-0.4 03:30pm blood glucose-119* urean-35* creat-1.0 na-145 k-4.7 cl-107 hco3-30* angap-13 06:55am blood calcium-10.2 phos-3.4 mg-1.9 _____________________ cardiac labs: 05:46am blood triglyc-52 hdl-58 chol/hd-2.2 ldlcalc-59 03:30pm blood ck-mb-notdone ctropnt-<0.01 09:30pm blood ck-mb-notdone 09:48pm blood ctropnt-<0.01 03:30pm blood ck(cpk)-46 09:30pm blood ck(cpk)-25* _____________________ labs on discharge: 06:05am blood wbc-8.5 rbc-3.63* hgb-10.4* hct-32.0* mcv-88 mch-28.6 mchc-32.5 rdw-15.5 plt ct-218 06:05am blood glucose-108* urean-19 creat-0.8 na-144 k-4.2 cl-107 hco3-33* angap-8 06:05am blood calcium-9.9 phos-3.0 mg-1.9 _____________________ radiology - cxr pa/lat-stable radiographic appearance of the chest. cardiomegaly without definite evidence of congestive heart failure. - - - - - - - - - - persantine mibi-there is a severe decrease in counts within the apex on the stress images. counts in this area are normal on the rest images. there is a moderate decrease in counts in the anterior wall on the stress images. this region also normalizes on the resting images. there is suboptimal imaging of the septum. gated images reveal normal left ventricular wall motion, but there are not enough counts to accurately calculated an ejection fraction. review of the patient's prior examination dated shows severe ischemia in a similar distribution. the patient underwent cardiac catheterization on and had a stent placed in the lad. no interval studies have been performed at our institution. protocol stress- 4 min; rpp . max hr was 64%. there was no chest, arm, neck or back pain. there were no ecg changes. the rhythm was sinus without ectopy. the blood pressure and heart rate responses were appropriate. the persantine was reversed with 125mg aminophylline iv. impresssion: no angina with no ischemic ecg changes. nuclear report will be sent separately. - - - - - - - - - - - cardiac catheterization- 1. selective coronary angiography of this right dominant system revealed branch coronary disease. the lmca was widely patent. the lad was patent, including the previously placed stents. the first diagonal branch was occluded as in her previous angiograpms. the rca was a large caliber, dominant vessel without critical stenoses. 2. left venitrculography revealed a calculated ejection fraction of 55%. 3. resting hemodynamics were widely varied throught out the case. a swan catheter was placed when the patient became hypoxic. initially, the mean pcpw was 24mmhg and the pa sat was 48%. after treatment with lasix and nitroglycerine, the pa sat improved to 85%. 4. after completion of the lv gram, the patient complained of headache and shortness of breath. he sbp subsequently dropped from the 120s to the 80s. she was given 0.3mgsq epinepherine which improved her blood pressure. she continued to complain of shortness of breath. she was severely agitated throughout the case. because of the hypotension and shortness of breath, a pa catheter was placed. the patient was given a nitro gtt and lasix iv. a 100% nrb was transiently placed for o2 sats in the 70s and 80s. after approximately 20 minutes, her breathing improved and by the end of the case, she had a good o2 sat on 3l nc. her symptoms were believed to be secondary to allergic reaction to contrast dye despite pre-treatment with 80mg iv solumedrol, 25mg benadryl, and 20mg pepcid. during the case, she was given an additional 125mg iv solumderol. - - - - - - - - - - - right femoral u/s-flow in the common femoral artery and vein is identified. no pseudoaneurysm or hematoma is identified. _______________________ ekg-ekg: sinus at 58. lad. lafb. poor rwp. no st changes. unchanged from previous. brief hospital course: 78 yo female, h/o cad s/p multiple caths (stents x 4), most recently in (mid-lad drug eluding stent) who presents to the ed after having increasing sob. stress mibi showed reversible defects in the anterior wall, reversible defect in the apex, all similar to mibi pre stenting of the mid-lad. 1. cad pt had increasing dyspnea on exertion. ekg was unchanged from previous here and cardiac enzymes were negative. however, what was of great concern was the mibi on showing moderate-severe reversible defects in the anterior wall and a reversible defect in the apex, which were all similar to the pre-cath mibi in when pt had her mid-lad stented. therefore, there was a great concern for an occlusion of the stent with a subacute occlusion in the two days prior to admission. pt was started on heparin gtt prior to intervention. pt had a cardiac catheterization on . it showed that: lmca was widely patent, lad patent (including previously placed stents), d1 was occluded as in previous angiograms, and the rca was open. ef was calculated at 55%. no intervention was performed. the pt however, had a severe anaphylactic reaction (see below). we continued outpatient regimen of , , statin, beta blocker and long acting nitrate. 2. anaphylactic reaction- pt with dye allergy--> angioedema in catheterizations in the past. for this cardiac catheterization, pt was premedicated again with prednisone (40 initially), famotidine, and benadryl. during the catheterization, though, pt again developed acute shortness of breath. she was given epinephrine iv but became hypertensive to 200 then dropped her oxygen saturations requiring ntg gtt and lasix. gradually, her hypoxemia and shortness of breath resolved and she was transferred to ccu for overnight monitoring. in the ccu she received solu-medrol iv and lasix. pt was hypoxemic likely from a mixed reaction from the contrast and pulmonary edema after hypertension was induced by the episode and by epinephrine. pt was given iv lasix on the floor as well, though she was satting well and was euvolemic on discharge. mrs. was complaining of swollen upper lip, palate irritation, whole mouth pain, and painful swallowing in the days following the reaction. the team called dr. (an allergic who pt has seen in the past and has consulted on her anaphylactic reaction). he emailed the team previous consult notes which were re-put in to omr. allergy service was curbsided and pt was given benadryl and famotidine, for symptomatic relief as it could take a long time for symptoms to go away. pt was started on prednisone (40 mg po) here with the goal to taper as an outpt. she was never in respiratory failure and airway was never compromised once pt came back to the floor. she satted well and was able to breath without any problem. 3. chf as above. pt slightly fluid overloaded after her reaction and got diuresed in the ccu and lasix iv x 1 on the floor in addition to pt's normal dose of lasix. pt was euvolemic on discharge. 4. htn- as above. 5. dm- glipizide, actos initially held for catheterization and then restarted. pt was on qid fingersticks with a riss. blood sugars were in the 200s-300s secondary to the prednisone. pt was sent home with regular insulin (modified scale starting at 200) for breakfast, lunch, and dinner. husband and wife have prior knowledge of this as she has been on insulin in the past with prednisone. 6. pt had ipratropium mdi prn. 7. pt was ambulating and on a ppi. 8. access- piv 9. code status- code status was full code. medications on admission: 325 mg qday 75 mg qday lipitor 10 mg qday ativan 0.5-1 mg prn isosorbide mononitrate 90 qday metoprolol 75 mg lisinopril 40 mg glipizide 5 mg pioglitazone 30 qday protonix 40 qday lasix 40 qam ipratropium inhalers. discharge medications: 1. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 2. clopidogrel bisulfate 75 mg tablet sig: one (1) tablet po daily (daily). 3. atorvastatin calcium 10 mg tablet sig: one (1) tablet po daily (daily). 4. isosorbide mononitrate 30 mg tablet sustained release 24hr sig: three (3) tablet sustained release 24hr po daily (daily). 5. lisinopril 20 mg tablet sig: two (2) tablet po daily (daily). 6. furosemide 40 mg tablet sig: one (1) tablet po daily (daily). 7. pantoprazole sodium 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 8. diphenhydramine hcl 25 mg capsule sig: one (1) capsule po every six (6) hours as needed for allergy symptoms. disp:*30 capsule(s)* refills:*0* 9. ipratropium bromide 18 mcg/actuation aerosol sig: two (2) puff inhalation q4-6h (every 4 to 6 hours) as needed. 10. prednisone 5 mg tablet sig: one (1) tablet po per schedule below: 2/9/05-30 mg-6 pills 2/10/05-20mg-4 pills 2/11/05-15mg-3 pills 2/12/05-10mg-2 pills 2/13/05-10mg-2 pills 2/14/05-5 mg-1 pill - stop. disp:*20 tablet(s)* refills:*0* 11. metoprolol tartrate 25 mg tablet sig: three (3) tablet po bid (2 times a day). 12. pioglitazone hcl 30 mg tablet sig: one (1) tablet po daily (daily). 13. glyburide 5 mg tablet sig: one (1) tablet po bid (2 times a day). 14. fluticasone propionate 110 mcg/actuation aerosol sig: two (2) puff inhalation (2 times a day). 15. lorazepam 0.5 mg tablet sig: 1-2 tablets po hs (at bedtime) as needed. 16. insulin regular human 300 unit/3 ml syringe sig: per scale subcutaneous per scale. disp:*qs qs* refills:*0* 17. regular insulin sliding scale check blood sugar breakfast, lunch, and dinner time administer insulin if: 201-250 2 units 251-300 4 units 301-350 6 units 351-400 8 units call your pcp discharge disposition: home discharge diagnosis: primary diagnosis: cad chf anaphylactic reaction secondary: asthma htn anxiety t2dm discharge condition: stable. pt is able to swallow without problems and is breathing well. discharge instructions: weigh yourself every morning, md if weight > 3 lbs. adhere to 2 gm sodium diet return to the emergency room or call your primary care physician/cardiologist if you have increasing shortness of breath, chest pain, palpitations, or any other symptom that bothers you. if you feel like your throat is closing up, and you cannot breathe, or cannot swallow please go to the ed. followup instructions: please call dr. at for a follow up appointment within one week of discharge from the hospital. please also call dr. office for an appointment within one week of discharge. -call dr. office for an appointment in the next week. provider: lab testing where: gz building (felbeerg/ complex) cardiology phone: date/time: 1:00 procedure: combined right and left heart cardiac catheterization coronary arteriography using two catheters angiocardiography of left heart structures pulmonary artery wedge monitoring diagnoses: coronary atherosclerosis of native coronary artery congestive heart failure, unspecified unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled asthma, unspecified type, unspecified percutaneous transluminal coronary angioplasty status cardiac catheterization as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure other drugs and medicinal substances causing adverse effects in therapeutic use other anaphylactic reaction 

Answer: The patient is high likely exposed to