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: tape "x10yd / morphine attending: chief complaint: shortness of breath major surgical or invasive procedure: - cardiac catheterization history of present illness: 75 f with cad s/p to stent to rca , copd recently started on home oxygen, htn, pvd who inititally presented to hospital after for ongoing sob since the beginning of . pt states that since early , she has been experiencing worsening shortness of breath that has occurred on exercise & at rest. she has been unable to sleep or tolerate recumbency. she has had an ongoing cough productive of clear-white sputum without hemoptysis. she experienced one episode of chest thightness/sharp chest pain roughly 3 weeks ago. this pain was non-radiation; it was not associated with diaphoresis, nausea, vomiting. . she was seen by her pcp and started on inhalers for concern regarding possible uri. on monday, she was started on azithromycin yesterday as well as home oxygen with a plan to increase her prednisone. . early on the morning of admission, she had worsening sob/doe so she called 911 & was brought to hospital. there was iniital concern for a copd exacerbation; she was given 250 mg azithro, 1 gm cftx, albuterol/ipratropium nebs, iv solumedrol 125 mg iv. cxr showed bilateral effusions. cta was negative for pe. . pt ruled in for nstemi (trop 2.76 -> 4.02). she was given 325 mg asa, plavix 75 mg, & she was started on heparin gtt. she was also given 40 mg iv lasix and subsequently transferred to for possible cath. . review of systems: as per hpi. no headache, dizziness, abdominal pain, nausea, vomiting, diarrhea, constipation, melena, hematochezia, dysuria, myalgias, or arthralgias. no history of stroke, tia, deep venous thrombosis, pulmonary embolism, bleeding at the time of surgery. no recent fevers, chills or rigors. all of the other review of systems were negative. . cardiac review of systems is notable for absence of chest pain, pnd, ankle edema, palpitations, syncope or presyncope. past medical history: -hypertension -cad s/p rca stenting in -copd/emphysema -pvd/le claudication ---> fem-fem bypass graft ---> left fem-sfa profunda bypass -carotid artery disease -prior head trauma --->fractured skull at age 14 months after falling out of a second story window --->age 9: hit in the head with an axe by brother -history of fainting spells since childhood -seizure disorder diagnosed in - last seizure -rheumatoid arthritis on chronic steroids -osteopenia -glaucoma -macular degeneration -cataract surgery, left eye -raynaud's phenomenon -s/p cholecystectomy -s/p appendectomy -pernicious anemia-vit b 12 injections monthly -diverticulosis social history: - lives with daughter. - previous 40-50 year smoking history; quit . - no etoh or illicits. family history: no family history of early mi, arrhythmias, cardiomyopathies, or sudden cardiac death. mother had angina. physical exam: admission physical exam: vs: t= 95.6 bp= 135/69 hr= 105 rr= 18 o2 sat= 95% ra general: thin elderly female, resting comfortably but fatigued appearing, nad heent: ncat. sclera anicteric. pupils equal, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. no xanthalesma. slightly dry mucous membranes/ neck: supple with jvd to mandible. cardiac: rrr, normal s1, s2. no m/r/g. distant heart sounds. lungs: resp were unlabored, no accessory muscle use. decreased breath sounds with bibasilar crackles, no wheezing or rhonchi. abdomen: bowel sounds present, soft, non-tender, non-distended, no organomegaly, no guarding or rebound tenderness. extremities: warm, dps 2+ bilaterally, no edema skin: no stasis dermatitis or other rashes. neuro: aaox3, cn 2-12 grossly intact, strength 5/5 throughout, sensation grossly intact to light touch psych: calm, appropriate discharge physical exam: tm: 98.5 100(70-100) 97/50(80-120/40-80) 18 98/2l 24 i/o: 1170/1100 gen: appears frail. heent: ncat. neck: no jvd cor: +s1s2, rrr, no m/g/r. pulm: crackles at bases, do not clear with cough. : +nabs in 4q. soft, ntnd. ext: wwp, no leg edema. r groin with hematoma stable. neuro: maee, weak. pertinent results: admission labs & studies: 06:55am blood pt-13.2* ptt-verified b inr(pt)-1.2* 06:55am blood wbc-9.4 rbc-3.95* hgb-11.8* hct-33.9* mcv-86 mch-29.9 mchc-34.8 rdw-14.2 plt ct-290 06:55am blood glucose-100 urean-23* creat-1.3* na-140 k-3.6 cl-100 hco3-26 angap-18 12:34am blood ck-mb-9 ctropnt-0.33* 06:55am blood calcium-8.8 phos-5.8*# mg-2.1 cxr (): findings: comparison is made with the most recent study at this institution of . the cardiac silhouette remains somewhat enlarged and there is increased opacification at the bases consistent with small pleural effusions and associated compressive atelectasis. there is engorgement of ill-defined pulmonary vessels, consistent with elevated pulmonary venous pressure, as suggested in the clinical history ct abdomen & pelvis (): impression: 1. left groin hematoma, deep to the left common femoral artery. there is mild stranding surrounding the right common femoral artery, though no evidence of hematoma. 2. diverticulosis. 3. new bilateral pleural effusions and smooth intralobular septal thickening, likely indicating volume overload. 4. extensive atherosclerosis. 5. calcified granulomata in the liver and spleen. discharge labs & studies: 08:55am blood glucose-104* urean-25* creat-1.1 na-139 k-4.2 cl-100 hco3-28 angap-15 07:05am blood probnp-9710* 08:55am blood wbc-8.0 rbc-3.28* hgb-9.9* hct-29.1* mcv-89 mch-30.2 mchc-34.0 rdw-14.4 plt ct-291 tte ():the left atrium is mildly dilated. overall left ventricular systolic function is severely depressed (lvef= 25-30 %) secondary to akinesis of the entire septum and apex, and moderate global hypokinesis of the remaining segments. the basal-mid lateral wall contracts best. right ventricular chamber size is normal. with focal hypokinesis of the apical free wall. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic stenosis. mild (1+) aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. moderate (2+) mitral regurgitation is seen. the left ventricular inflow pattern suggests a restrictive filling abnormality, with elevated left atrial pressure. moderate tricuspid regurgitation is seen. there is moderate pulmonary artery systolic hypertension. there is a trivial/physiologic pericardial effusion. impression: severe global left ventricular systolic dysfunction c/w multivessel cad. moderate mitral and tricuspid regurgitation with moderate pulmonary artery systolic hypertension. brief hospital course: reason for hospitalization: 75 f w cad s/p rca stent , copd, ra, seizure disorder, htn, pvd, p/w several weeks of worsening sob. ruled in for stemi at osh & subsequently transferred to for cath. acute diagnoses: # nstemi: found to have peak troponin to 2.76 at osh with t wave changes in v2-v5. transferred on heparin gtt. pt was continued on metoprolol, statin, asa. loaded with plavix prior to cath on which showed minimal in-stent restenosis of rca stent, as well as a tight ostial lad on which pci could not be performed (too difficult). pt had radial access for arterial cath; venous access in groin difficult to obtain. patient hypotensive during case, requiring dopamine gtt temporarily (now off pressors). afterward, patient developed rapidly expanding left groin hematoma. she was given protamine. hematoma now stable, hematocrit 29 on discharge (stable for days). patient also dyspnea, requiring o2 4l per nc, and appears somewhat volume overloaded. patient admitted to ccu for diuresis and observation overnight. b/l le us were negative for hematoma, non-contrast ct abdomen and pelvis were negative for rp bleed. in the ccu, patient was continued on asa 325mg po, atorvastatin 80mg po daily, metoprolol tartrate 50mg po bid, plavix. amlodipine was discontinued and lisinopril was held due to hypotension/low urine output. on the floor, patient started on diovan 40 mg, which should be held if her blood pressure is less than 100. discharged on full asa, plavix, metoprolol succinate 100 mg qd. # left groin hematoma: developed apparent right groin hematoma which was treated with protamine. ct showed pt actually had left groin hematoma, none on right. no pseudoaneurysm/rp bleed. hematoma and hematocrit remained stable throughout ccu & floor course. dps dopplerable bl. patient was maintained on pneumoboots instead of heparin sq prophylaxis. # acute on chronic systolic chf: cxr showed pulmonary engorgement & bilateral effusions with compressive atelectasis. pt was given iv lasix prior to going to the cath lab. a tte was performed that showed severe global hypokinesis & akinesis of entire septum & apex. lvef 25-30%. prior echo shows ef 40-45% in . during catheterization, pt was hypotensive & required dopamine gtt. she was transferred to the ccu for transient hypotension requiring dopamine in the catheterization lab. ms. was normotensive on the floor. diovan was started on the floor as above. lasix will not be reinitiated on discharge. chronic diagnoses: # copd/emphysema: pt was continued on her course of azithromycin. there was no concern for acute exacerbatin given good air movement & lack of wheeze. # pvd: continued on aspirin & plavix. # seizure disorder: last seizure was on . he was continued on home keppra 1500mg , but pharmacy recommended switching her dose based on her renal function. the recommended dose (based on creatinine clearance) is 750 mg . this was explained to the patient as she was nervous about the change in dose. # rheumatoid arthritis: he was continued on prednisone 5mg po daily. her celebrex was held due to nstemi. # osteopenia: he was continued on calcium, vitamin d. transitional issues: # follow-up: upon leaving rehab, the patient should schedule follow up appointments with her cardiologist (dr. ) and her primary care doctor. # code status: dnr/dni. daughter is hcp: medications on admission: aspirin 81mg daily celebrex 100mg daily simvastatin 20mg nightly prednisone 5 mg daily metoprolol 25mg daily omeprazole 20mg daily amlodipine 5mg daily vitamin d 400 units daily calcium carbonate - 6 tabs daily keppra 1500mg b12 injection once per month timolol 0.5% one drop to each eye daily in am (not recently taking) brimodidine 0.15% one drop left eye (not recently taking) optive dry eye solution, both eyes tid (not recently taking) discharge medications: 1. prednisone 5 mg tablet sig: one (1) tablet po daily (daily). 2. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). 3. atorvastatin 80 mg tablet sig: one (1) tablet po daily (daily). 4. sodium chloride 0.65 % aerosol, spray sig: sprays nasal qid (4 times a day) as needed for dry nose. 5. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 6. metoprolol tartrate 50 mg tablet sig: one (1) tablet po bid (2 times a day): please hold for sbp < 100 or hr < 60. 7. citalopram 20 mg tablet sig: 0.5 tablet po daily (daily). 8. valsartan 40 mg tablet sig: one (1) tablet po daily (daily): please hold for sbp < 100. 9. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po once a day. 10. cholecalciferol (vitamin d3) 400 unit tablet sig: one (1) tablet po daily (daily). 11. benzonatate 100 mg capsule sig: one (1) capsule po tid (3 times a day) as needed for cough for 2 weeks. 12. cepacol sore throat 15-2.6 mg lozenge sig: one (1) mucous membrane five times a day as needed for sore throat for 1 weeks. 13. tylenol 325 mg tablet sig: 1-2 tablets po every six (6) hours as needed for pain. 14. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po once a day. 15. calcium citrate 200 mg (950 mg) tablet sig: one (1) tablet po three times a day. 16. medication b12 injections one per month 17. timolol maleate (pf) 0.5 % dropperette sig: one (1) drop ophthalmic qam. 18. levetiracetam 250 mg tablet sig: three (3) tablet po bid (2 times a day). 19. guaifenesin 100 mg/5 ml syrup sig: 5-10 mls po q6h (every 6 hours) as needed for cough. 20. codeine-guaifenesin 10-100 mg/5 ml syrup sig: 5-10 mls po hs (at bedtime) as needed for cough for 1 weeks: do not administer this medication if patient sedated. 21. oxymetazoline 0.05 % aerosol, spray sig: one (1) spray nasal (2 times a day) as needed for congestion for 2 days. 22. fluticasone-salmeterol 250-50 mcg/dose disk with device sig: one (1) inhalation inhalation (2 times a day). discharge disposition: extended care facility: rehabilitation & care center - discharge diagnosis: primary diagnosis: - non-st elevation myocardial infarction secondary diagnoses: - congestive heart failure - coronary artery disease 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: ms. , it was a pleasure to participate in your care while you were at . you came to the hospital for shortness of breath over hte past month. you were transferred from hospital after it was found that you had a small heart attack. while you were here, you had a cardiac catheterization which showed a blockage. we were unable to treat the blockage because your blood pressure was low during the procedure and you need to go to the cardiac intensive care unit. while you were there, you were treated with some intravenous diuretics. your urine output temporarily dropped, but by the time you were transferred back to the medical floor, your urine production improved. you had an ultrasound of your heart that showed slight worsening of your heart failure. weigh yourself every morning, md if weight goes up more than 3 lbs. medication instructions: - medications started: ---> please start taking celexa 10 mg daily ---> please start taking diovan 40 mg daily ---> please start taking atorvastatin 80 mg daily ---> please start taking plavix 75 mg daily ---> please start taking nasal saline spray as needed for dry nose ---> please start taking calcium citrate (instead of calcium carbonate) ---> please start taking your inhaler as indicated - medications stopped: ---> please stop taking lisinopril ---> please stop taking amlodipine ---> please stop taking simvastatin ---> please stop taking calcium carbonate - medications changed: ---> please decrease your dose of keppra from 1500 mg twice a day to 750 mg twice a day (this medication is now dosed safely according to your kidney function) ---> please increase your dose of aspirin from 81 mg to 325 mg daily ---> please increase your dose of metoprolol from 25 mg daily to 100 mg daily followup instructions: after you leave rehab, please call dr. office to schedule a follow-up appointment. procedure: coronary arteriography using two catheters angiocardiography of left heart structures left heart cardiac catheterization diagnoses: other iatrogenic hypotension subendocardial infarction, initial episode of care coronary atherosclerosis of native coronary artery congestive heart failure, unspecified long-term (current) use of steroids atherosclerosis of native arteries of the extremities with intermittent claudication hematoma complicating a procedure personal history of tobacco use unspecified glaucoma percutaneous transluminal coronary angioplasty status other specified surgical operations and procedures causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation other acquired absence of organ macular degeneration (senile), unspecified other emphysema cardiac catheterization as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure other complications due to other cardiac device, implant, and graft rheumatoid arthritis epilepsy, unspecified, without mention of intractable epilepsy hypoxemia do not resuscitate status acute on chronic systolic heart failure disorder of bone and cartilage, unspecified oliguria and anuria other dependence on machines, supplemental oxygen pernicious anemia other diuretics causing adverse effects in therapeutic use glaucoma stage, unspecified 

Answer: The patient is high likely exposed to