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: trazodone / risperdal / indocin / flexeril / gantrisin attending: chief complaint: flash pulmonary edema major surgical or invasive procedure: intubation and extubation history of present illness: ms. is a 65yo f with history of af (not on coumadin), diastolic chf, htn, pulm htn, copd on 2l nc, interstitial lung dz, hl and dm who presented to with confusion and ams and found to have opiate overdose with otherwise negative tox screen. she was treated with narcan drip and charcoal infusion. patient also had hyponatremia, ?rhabdo and . her labs were also remarkable for elevated uric acid, anemia to 26 with signs of anemia of chronic disease, mildly elevated ap and ast with normal alt and bili. her lasix was held and she was fluid resuscitated for rhabdo over two days. . on , pt was given echo, which showed ef > 55%, mild la/ra dilation, normal lv size and systolic fxn and borderline pulm htn. overnight, she went into rvr also systolic bp of 200 and developed flash pulmonary edema requiring intubation and cardiac enzymes were checked with initial values of ck 790, mb 3, trop t .21 to 410, 2.3, 0.21. bnp on presentation was 4,000, repeat was 12,000. started on dilt drip, given lasix 80iv and she was transferred to the ccu here for further care. a repeat echo showed mild lv systolic dysfunction and mid andterioseptal wall motion hypokinesis. ekg was unchanged. most recent abg 7.43/47/96/31 on ac fio2 50%, 450x14 with reportedly zero of peep and psv. on admission, she on 50%/500/14/5. of note, pt was started on vanc zosyn at osh for concern for aspiration pna. . unable to obtain ros due to intubation. past medical history: 1. cardiac risk factors: hypertension 2. cardiac history: atrial fibrillation diastolic chf 3. other past medical history: interstitial lung disease secondary to asbestosis copd on chronic o2 on 2l nc seizure disorder obstructive sleep apnea rheumatoid arthritis osteoarthritis on heavy narcotic use chronically chronic low back and shoulder pain s/p laminectomy recurrent urinary tract infection s/p left tkr in s/p laminectomy and periumbilical herniorrhaphy social history: ( notes, pt intubated and unable to confirm) the patient lives alone, apparently has no family. has a distant smoking history of 40 to 50 pack years. no alcohol use. is retired. limited function due to chronic pain and disability. family history: non-contributory physical exam: vs: t= 99 bp= 121/68 hr= 96 rr 15 o2 sat=98% on 50% general: nad. oriented x3. mood, affect appropriate. heent: ncat. sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. no xanthalesma. neck: supple with jvp of 6 cm, has triple lumen in r cardiac: , nl s1 and s2, no murmurs rubs or gallops lungs: bibasilar crackles abdomen: mildly tender diffusely. extremities: no c/c/e. no femoral bruits. skin: no stasis dermatitis, ulcers, scars, or xanthomas. pulses: right: carotid 2+ femoral 2+ popliteal 2+ dp 2+ pt 2+ left: carotid 2+ femoral 2+ popliteal 2+ dp 2+ pt 2+ pertinent results: 01:45pm pt-14.7* ptt-28.9 inr(pt)-1.3* 01:45pm plt count-271 01:45pm neuts-84.0* lymphs-10.3* monos-3.3 eos-2.2 basos-0.2 01:45pm wbc-10.0 rbc-2.82*# hgb-8.3* hct-24.5* mcv-87# mch-29.3 mchc-33.8 rdw-14.0 01:45pm calcium-8.8 phosphate-2.5* magnesium-2.1 01:45pm ck-mb-4 ctropnt-0.15* 01:45pm lipase-360* 01:45pm alt(sgpt)-22 ast(sgot)-34 ld(ldh)-189 ck(cpk)-224* alk phos-126* tot bili-0.5 01:45pm estgfr-using this 01:45pm glucose-142* urea n-22* creat-0.9 sodium-135 potassium-4.7 chloride-99 total co2-30 anion gap-11 01:55pm type-art temp-36.6 rates-14/ tidal vol-500 peep-5 o2-50 po2-91 pco2-41 ph-7.49* total co2-32* base xs-7 intubated-intubated vent-controlled 04:31pm type-art temp-36.6 rates-/30 peep-5 po2-100 pco2-38 ph-7.47* total co2-28 base xs-3 intubated-intubated vent-spontaneou 07:53pm plt count-281 07:53pm wbc-10.2 rbc-2.99* hgb-8.8* hct-25.9* mcv-87 mch-29.5 mchc-34.0 rdw-14.0 10:30pm calcium-8.8 phosphate-2.7 magnesium-1.9 10:30pm glucose-153* urea n-19 creat-0.6 sodium-134 potassium-3.9 chloride-97 total co2-30 anion gap-11 . osh imaging: - p-mibi : there is some mild decrease in activity in the anterior wall of the left ventricle which is probably related to soft tissue attenuation. it does not proceed into the apex and no abnormality is seen of the septum. wall motion of the left ventricle appeared entirely normal. the computer calculated left ventricular ejection fraction was 66 percent and the computer calculated left ventricular end diastolic volume was 116 ml. ecg: afib with rate 125, no sttw changes, low voltage. . - echo : the left atrium is mildly dilated. the right atrium is moderately dilated. left ventricular wall thickness, cavity size and regional/global systolic function are normal (lvef >55%). the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. no aortic regurgitation is seen. the mitral valve appears structurally normal with trivial mitral regurgitation. there is borderline pulmonary artery systolic hypertension. there is no pericardial effusion. . there is mild regional left ventricular systolic dysfunction with hypokinesis/near-dyskinesis of the mid septum. due to suboptimal technical quality/limited views, additional focal wall motion abnormalitiescannot be fully excluded. there is considerable beat-to-beat variability of the left ventricular ejection fraction due to an irregular rhythm/premature beats. right ventricular chamber size is normal. the aortic valve leaflets are mildly thickened (?#). the mitral valve leaflets are mildly thickened. trivial mitral regurgitation is seen. the estimated pulmonary artery systolic pressure is normal. there is no pericardial effusion. impression: focused study. mild regional left ventricular systolic dysfunction as described above. no clinically significant valvular regurgitation or stenosis appreciated. normal pulmonary artery systolic pressure. compared with the prior study (images reviewed) of , the left ventricular regional wall motion abnormalities and mild left ventricular systolic dysfunction are new. given the limited nature of the current study, a comparison of all previously measure parameters could not be made. compared with the prior study (images reviewed) of , there is no significant change impression: biatrial enlargement. normal left and right ventricular function. normal valvular function. . cxr the et tube tip is 6.5 cm above the carina. the right internal jugular line tip is at the level of mid-to-low svc. the ng tube tip is in the stomach. cardiomegaly is unchanged. the patient was in moderate-to-severe pulmonary edema represented by bilateral perihilar opacities, and bilateral pleural effusions. followup after diuresis is required. findings were discussed with dr. over the phone by dr. approximately at 5 p.m. on . . brief hospital course: ms. is a 65yo f with history of af, diastolic chf, htn, hl and dm who presented to with confusion and ams and found to have opiate overdose complicated by flash pulmonary edema requiring intubation with elevated cardiac enzymes. . # transient cardiac ischemia: pt was transferred to because of elevated ce. she did not have any evidence of ekg changes from baseline and as per osh report, she was not experiencing chest pain prior to intubation. likely that acute hypertensive state cause elevated coronary perfusion pressures in the setting of a stiff left ventricle resulting in transient ischemia and hence elevated troponins. repeat ce showed resolution of enzyme abnormalities. . acute on chronic diastolic congestive heart failure. at osh, pt was being treated for suspected rhabdomyolysis was given ivf and diuresis held. she became hypertensive and went into flash pulmonary edema. prior to transfer, she had diuresed 500 cc. pt was given 80iv lasix and diuresed 1.5 liters over one day. the following day her respiratory status had improved substantially and she was extubated. pt was transferred to the floor on 80mg lasix po bid. her home dose was 80mg . . # atrial fibrillation: pt has a chads score of 3 and is not anticoagulated due to a bad reaction to coumadin and currently receiving weekly steroid injections. during hospitalization, pt's hr remained elevated to 130-140, so diltiazem was added to current nodal regimen of metoprolol tartrate 150 . one to two second pauses were noted on diltiazem so dose was decreased and changed to sr. pt was also started on dabigatran for anticoagulation. . # opiate overdose: suspected cause of her changed mental status on presentation to , s/p narcan drip. at osh pt was evaluated by psychiatry and it was determined that this was an unintentional overdose and pt is not risk to self or others. she does have chronic pain, so was treated with her documented home dose of oxycodone. she was discharged on this dose and will need to follow up with her pain clinic to redose medications if deemed appropriate. . # htn: pt was restarted on home lisinopril and metoprolol doses. pressures remained normal. . # hld: will continue statin. . # dm: a1c of 7 at . monitored fsbs and was treat with iss while in-house. . # bipolar disorder: pt was continued on home aripiprazole and venlafaxine. she was calm and appropriate during her hospital stay. note that her caretaker at home is on vacation until the beginning of . she is being discharged to at , but will need her home services maximized before she returns home. . # anemia: baseline hematocrit around 30, currently slightly lower with signs of acd on labs at . hematocrit remained stable throughout hospitalization. . transitional: pt needs follow up with pain management clinic and cardiologist, please see "follow-up instructions" for details. medications on admission: aripiprazole 15 mg daily, oxycodone 10 mg four times a day p.r.n., zocor 40 mg nightly, spiriva 18 mcg inhaler inhalation tabs one daily, venlafaxine 75 mg b.i.d., tylenol 500 mg three times a day p.r.n., aspirin 81 mg a day, calcium carbonate 600 mg b.i.d., calcium citrate/vitamin d 215/200 two tablets a day, iron sulfate 325 mg daily, magnesium oxide 400 mg b.i.d., symbicort 160/4.5 two puffs b.i.d., clonidine 0.5 mg b.i.d. p.r.n., digoxin 0.125 mg daily, lasix 80 mg b.i.d., neurontin 600 mg three times a day, methocarbamol 700 mg three times a day, lisinopril 5 mg b.i.d., metoprolol 150 mg b.i.d. discharge medications: 1. aripiprazole 15 mg tablet sig: one (1) tablet po daily (daily). 2. oxycodone 5 mg tablet sig: two (2) tablet po q6h (every 6 hours) as needed for pain. 3. zocor 40 mg tablet sig: one (1) tablet po once a day. 4. spiriva with handihaler 18 mcg capsule, w/inhalation device sig: one (1) inhalation once a day. 5. venlafaxine 75 mg tablet sig: one (1) tablet po bid (2 times a day). 6. acetaminophen 500 mg tablet sig: one (1) tablet po three times a day as needed for pain. 7. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po once a day. 8. calcium citrate + d 315-200 mg-unit tablet sig: two (2) tablet po once a day. 9. iron (ferrous sulfate) 325 mg (65 mg iron) tablet sig: one (1) tablet po once a day. 10. magnesium oxide 400 mg tablet sig: two (2) tablet po twice a day. 11. fluticasone 110 mcg/actuation aerosol sig: two (2) puff inhalation (2 times a day). disp:*1 inh* refills:*2* 12. clonazepam 0.5 mg tablet sig: one (1) tablet po twice a day as needed for anxiety. 13. furosemide 80 mg tablet sig: one (1) tablet po bid (2 times a day). 14. gabapentin 300 mg capsule sig: two (2) capsule po three times a day. 15. methocarbamol 750 mg tablet sig: one (1) tablet po three times a day. 16. lisinopril 5 mg tablet sig: one (1) tablet po twice a day. 17. clotrimazole 1 % cream sig: one (1) appl topical (2 times a day) for 1 weeks. disp:*1 60 gram tube* refills:*1* 18. miconazole nitrate 2 % powder sig: one (1) appl topical tid (3 times a day) as needed for rash for 2 weeks. disp:*1 tube* refills:*0* 19. dabigatran etexilate 150 mg capsule sig: one (1) capsule po bid (2 times a day). 20. diltiazem hcl 120 mg capsule, extended release sig: one (1) capsule, extended release po daily (daily). 21. calcium carbonate 600 mg (1,500 mg) tablet sig: one (1) tablet po twice a day. 22. metoprolol succinate 100 mg tablet extended release 24 hr sig: 1.5 tablet extended release 24 hrs po twice a day. discharge disposition: extended care facility: at discharge diagnosis: acute respiratory failure secondary to pulmonary edema acute on chronic diastolic heart failure hypertensive urgency atrial fibrillation with rapid ventricular response discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - requires assistance or aid (walker or cane). discharge instructions: dear ms. , you were admitted to the hospital because you took too much of your oxycodone. in the future, please be very careful with this medication and do not take more than is prescribed. while in the hospital, you had an episode of high blood pressure and heart rate, which caused your lungs to fill up with fluid. for a period of time you required a breathing tube until we were able to remove some of the fluid in your lungs with diuretics. please weigh yourself every morning, call dr. if weight goes up more than 3 lbs in 1 day or 5 pounds in 3 days. we made the following changes to your home medications: -change metoprolol tartrate to metoprolol succinate 150 mg twice twice daily -stop digoxin -stop symbicort, as this may interact with some of your other medications. -start fluticasone inhaler twice daily to replace symbicort -start clotrimazole cream and miconazole powder for the rash in your groin for 2 weeks - start pradaxa as a blood thinner to prevent a stroke with your atrial fibrillation - start diltiazem to lower your heart rate - start aspirin to prevent a heart attack followup instructions: name: , : internal medicine/endocrinology address: , , phone: **please discuss with the staff at the facility the need for a follow up appointment with your pcp when you are ready for discharge** . cardiology: name: rafit : cardiology address: , , phone: phone: fax: date/time: office will call you with an appt . pain clnic: we have requested that your appt be rescheduled, please call the clinic after you get to to check on the appt status procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours diagnoses: other chronic pain congestive heart failure, unspecified unspecified essential hypertension atrial fibrillation acute on chronic diastolic heart failure other chronic pulmonary heart diseases accidental poisoning by other opiates and related narcotics acute respiratory failure long-term (current) use of other medications poisoning by other opiates and related narcotics bipolar disorder, unspecified home accidents other specified dermatomycoses 

Answer: The patient is high likely exposed to