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: penicillins / sulfonamides / atenolol attending: chief complaint: chest pain, shortness of breath. major surgical or invasive procedure: cardiac catheterization picc line placed and removed history of present illness: 69 year old female with cad s/p mi and cabg ' presents with intermittent chest pain x 1 week, worse in last 3 days with shortness of breath, lower extremity swelling. patient was recently seen by pcp and aldactazide was d/c'ed on and lasix was d/c'ed on (in setting of worsening renal function -lasix d/c'ed). in past couple weeks she notes increasing sob, 10-lb wt gain and increasing dyspnea on exertion. she also noted intermittent chest pain during this period but worse in past 3 days. she has slept sitting up for the past 8 months. she came to ed after becoming very short of breath on morning of admission. ekg q wave anterior ?st elevation in iii. she was started on heparin gtt and nitro gtt. she went to cath lab and found to have 90%lesion in om which was ballooned opened (couldn't stent). in the recovery area, patient sob lying flat (likely h/o osa although none diagnosed). she was on a non-rebreather satting 97%. . she was transferred to the ccu for further management. abg in the holding area on nrb was 7.29/57/148. on arrival to the ccu she was placed on bipap, ps 10 peep 5, fio2 50%. her abg on noninvasive ventilation was 7.36/53/146. after approximately hours, she was feeling sufficiently less short of breath to be weaned to nasal cannula, at which point her abg was 7.39/49/67. . initial vitals in the ed: 97.8, 98, 152/72, 20, 88% on ra. she was given asa, heparin gtt, lasix and sent to the cath lab. . on review of systems, + for non-productive cough x 3 weeks, and post-nasal drip. she has gained 10 pounds over the past 2 weeks. she denies any prior history of stroke, tia, deep venous thrombosis, pulmonary embolism, bleeding at the time of surgery, myalgias, joint pains, hemoptysis, black stools or red stools. she denies recent fevers, chills or rigors. all of the other review of systems were negative. past medical history: 1. coronary artery disease status post mi in and cabg in 2. diabetes mellitus type ii, requiring large amounts of insulin (last hga1c 7.9) 3. chf, last ef per echocardiogram 55% hypertension 4. hypercholesterolemia 5. history of metastatic left-sided infiltrating ductal breast cancer s/p chemo/xrt (post-cabg) dx'ed 6. hypothyroidism 7. utis (h/o recurrent ecoli uti in past) 8. copd 9. anxiety 10. postmenopausal bleeding status post d&c procedure on 11. obesity social history: +70 pack-year history but quit in , no etoh or other drug use. widowed 5 years ago. three grown children. lives in her own apt in her son's townhouse. her daughter has helped her with her adls over the past couple of days and does help her with her shopping. family history: no family history of premature coronary artery disease or sudden death. brother with both multiple myeloma and "thyroid problems." mother had ?oral cancer. physical exam: vs - 120/64, 86, 19, 100% on cpap 50% fio2 gen: obese, elderly female in nad. oriented x3. mood, affect appropriate. on cpap heent: ncat. sclera anicteric. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. no xanthalesma. neck: supple, unable to appreciate jvd obesity cv: unable to palpate pmi. rr, normal s1, s2. no m/r/g. no thrills, lifts. no s3 or s4. chest: midline surgical scar. resp were unlabored, no accessory muscle use. ctab, no crackles, wheezes or rhonchi anteriorly. radiation skin changes to l breast. abd: obese, soft, ntnd. no hsm or tenderness. abd aorta not enlarged by palpation. no abdominial bruits. ext: 2+ bilateral le edema to mid-shins. no femoral bruits. r femoral sheath with minimal ooze. skin: no ulcers, rash pulses: dopplerable dp/pt pulses pertinent results: labwork on admission: 09:40am wbc-14.3* rbc-4.00* hgb-10.6* hct-33.3* mcv-83 mch-26.4* mchc-31.8 rdw-16.7* 09:40am plt count-273 09:40am pt-13.2* ptt-23.9 inr(pt)-1.2* 09:40am neuts-83.7* lymphs-12.2* monos-3.1 eos-0.3 basos-0.7 09:40am glucose-277* urea n-41* creat-1.2* sodium-141 potassium-4.6 chloride-104 total co2-24 anion gap-18 09:40am ck(cpk)-159* 09:40am ctropnt-.48* 09:40am ck-mb-33* mb indx-20.8* probnp-6666* . pertininent labs: creatinine: baseline 1.1, peak 6.1, on discharge 2.0 hct: baseline 26-27, hct on discharge 24 (prior to receiving 1uprbcs) . imaging . chest (portable ap) this ap bedside radiograph is limited by patient's large size. the heart is probably enlarged with previous cabg. no vascular congestion. i doubt the presence of consolidations. i cannot exclude effusions particularly on the right. other than the equivocal pleural changes on current examination there is a little change from more satisfactory bedside exam . impression: suboptimal exam. no pneumonia and i doubt the presence of chf. . cardiac cath: report pending . echo the left atrium is mildly dilated. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. no masses or thrombi are seen in the left ventricle. overall left ventricular systolic function is moderately-to-severely depressed (30 percent) secondary to global hypokinesis with regional variation (the inferior and posterior walls appear more hypokinetic). there is no ventricular septal defect. right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. mild to moderate (+) mitral regurgitation is seen. there is no pericardial effusion. compared with the findings of the prior study (images reviewed) of , the left ventricular ejection fraction now appears reduced, but the technically suboptimal nature of both studies precludes certainty. brief hospital course: 69 year old female with cad s/p mi and cabg, dmii, obesity, chf p/w nstemi in setting of chf exacerbation. . #. congestive heart failure. ejection fraction on this admission 30% from 45% on last stress test . the patient was volume overload on admission and soon became oliguric as below despite escalating doses of lasix. the patient's oxygen saturations remained stable. the patient was followed by renal and may need dialysis if urine output does not improve. the patient's ace-inhibitor was held for renal failure. the patient has not tolerated a beta-blocker in the past and had one episode of junctional bradycardia during admission. the patient should have a repeat echocardiogram in two months for consideration of icd placement. . #. acute renal failure. the patient remained oliguric/anuric and volume overloaded but oxygen saturations remained stable. the renal failure is likely contrast nephropathy. her diovan and hctz were stopped given renal failure. the patient was followed by renal during admission, and creatinine gradually improved from 6.1 to 2.0 on day of discharge. she will need to follow-up with pcp one week after discharge to have kidney function evaluated and further address resuming and/or diuretics. . #. coronary artery disease. the patient is status post cabg in and admitted with nstemi on this admission now status post cardiac catheterization on with no obvious source for stemi. the patient received pcta to 90% stenosis of om2. the nstemi was likely demand ischemia from chf exacerbation in setting of discontinuation of diuretics. the patient was continued on asa, plavix, statin. the patient received integrilin and heparin gtt on admission. the patient's ace-inhibitor was held for renal failure. the patient has not tolerated a beta-blocker in the past and had one episode of junctional bradycardia during admission. . #. rhythm. sinus rhythm. the patient hd one episode of junctional bradycardia of unclear etiology but no subesequent episodes. electrophysiology followed the patient during admission. . #. hypoxemia, hypercarbic respiratory failure. now resolved. the patient has a 70 pack year smoking history with copd and likely restrictive defect secondary to obesity. the patient had an additional element of pulmonary edema in the setting of anxiety post-cath/lying flat/copious fluids peri-cath. the patient was continued on albuterol/atrovent nebs. . #. anemia. stable. iron studies consistent with iron-deficiency. the patient also has a history of acd and mild b12 deficiency. the patient was started on iron supplementation, and prior to discharge, she was transfused 1u prbc for hct 24 given her extensive cardiac history. after discharge, she was monitored for several hours for sob, worsening doe. she was able to ambulate and dress herself with baseline shortness of breath, oxygenation remained 97%. . #. diabetes mellitus, type 2. not well-controlled based on last hga1c. the patient was continued on lantus and hiss. . # urinary tract infection. the patient was given a dose of levaquin in the ed, but this was changed to ceftriaxone and then cefpodoxime as the patient had a history of quinonlone-resistant uti in the past. urine culture on this admission showed sensitivity to quinolones and cephalosporins. . # hypothyroidism. tsh 3.1 during this admission. the patient was continued on her outpatient levothyroxine. . #. fen : cardiac/ diet . #. access: r picc was placed for blood draws and d/c'd on discharge . #. ppx: - heparin sc . #. code: full (confirmed with patient but would not want prolonged intubation) . post discharge follow-up by pcp : 1) repeat creatinine, hct one week post discharge 2) address whether to restart diovan 160, hctz 25, and/or other diuretics 3) repeat echo in 2 months to reassess ef and need for icd placement medications on admission: diovan 160mg po qday aspirin 325 simvastatin 80 mg qday lantus 100 u/ml--155 units sq every morning levothyroxine 150 mcg--one every day hctz 25mg qday levothyroxine 150mcg qday metformin 1000mg po bid lantus 155u sc qam hiss sliding scale flonase 50 mcg/actuation--2 sprays each nostril once a day lasix 40mg qod (on hold on ) spironolactone 25mg po qday (d/c'ed on ) cranberry tablets (uti prevention) discharge medications: 1. aspirin 325 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 2. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 3. fluticasone 50 mcg/actuation aerosol, spray sig: two (2) spray nasal daily (daily). 4. levothyroxine 75 mcg tablet sig: two (2) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 5. simvastatin 40 mg tablet sig: two (2) tablet po daily (daily). disp:*60 tablet(s)* refills:*2* 6. cyanocobalamin 100 mcg tablet sig: 0.25 tablet po daily (daily). disp:*15 tablet(s)* refills:*2* 7. ferrous sulfate 325 (65) mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* 8. insulin please continue your outpatient insulin (lantus) regimen as before discharge disposition: home with service facility: homecare discharge diagnosis: primary: coronary artery disease non st segment elevation myocardial infarction congestive heart failure acute renal insufficiency urinary tract infection . secondary: diabetes mellitus obesity hypothyroidism iron deficiency anemia discharge condition: stable, saturating at baseline on room air discharge instructions: you had a heart attack as well as congestive heart failure. during cardiac catheterization, you had an occlusion in one of your coronary arteries which was subsequently opened. after this, you also had renal failure, which is now improving significantly. you will need to have your kidney function checked regularly until it returns to baseline. please continue to take all of your medications as prescribed. please weight yourself every day, maintain a low salt diet and call your doctor if you have a greater than 3 pound weight gain in days, worsening swelling in your feet, or shortness of breath. please call 911 or go to the emergency room if you have chest pain, chest pressure, shortness of breath, fever, chills, nausea/vomiting, or any other concerning symptoms. followup instructions: please call , , and schedule an appointment with your primary care physician or nurse practioner, to have your kidney function (creatinine) rechecked early next week. you already have to following appointments scheduled: provider: , md phone: date/time: 2:30 provider: , md phone: date/time: 10:00 procedure: venous catheterization, not elsewhere classified coronary arteriography using two catheters injection or infusion of platelet inhibitor left heart cardiac catheterization excision of lingual thyroid percutaneous transluminal coronary angioplasty [ptca] procedure on single vessel diagnoses: subendocardial infarction, initial episode of care coronary atherosclerosis of native coronary artery acute kidney failure with lesion of tubular necrosis diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled unspecified acquired hypothyroidism chronic airway obstruction, not elsewhere classified coronary atherosclerosis of autologous vein bypass graft personal history of malignant neoplasm of breast chronic kidney disease, unspecified acute respiratory failure long-term (current) use of insulin old myocardial infarction obesity, unspecified acute diastolic heart failure personal history of irradiation, presenting hazards to health other drugs and medicinal substances causing adverse effects in therapeutic use 

Answer: The patient is high likely exposed to