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: history of present illness: the patient is a 75 year old female with a past medical history of hypertropic obstructive cardiomyopathy who presented today for percutaneous intervention to ablate the ventricular septum. the patient was diagnosed with hocm last year after echocardiogram showed a dynamic left ventricular outflow tract gradient. the patient reports that she tires easily with exertion and often feels her heart racing and that she has had these symptoms for several years. her resting left ventricular outflow tract gradient was 160 millimeters of mercury and her septal wall thickness was noted to be 1.9 centimeters; the intra-luminal thickness was 1.7 centimeters. a trial of beta blockade was initially successful in decreasing her symptoms, however, the patient remained symptomatic with shortness of breath upon minimal exertion. the patient was taken to the catheterization laboratory on the day of admission and an ethanol septal ablation was performed. the patient's severe left ventricular outflow tract gradient of greater than 150 was observed with elevated left ventricular and diastolic pressures. the patient's ejection fraction was 60%. the patient's coronary arteries were completely clean with no stenotic lesions noted. the patient was also noted to have persistent left sided supraventricular tachycardia. ethanol ablation of s1 and s2 was performed and the gradient was reduced to 20 millimeters of mercury with persistent post-systolic accentuation. the patient was admitted to the coronary critical care unit without chest pain, shortness of breath or diaphoresis. past medical history: 1. hypertension. 2. hypothyroidism. 3. osteoporosis. 4. hypertrophic obstructive cardiomyopathy (hocm). 5. chronic bronchitis. medications prior to admission: 1. toprol xl 100 mg twice a day. 2. fosamax 10 mg q. day. 3. aspirin. 4. flovent. 5. calcium. 6. atrovent. physical examination: upon admission, revealed an elderly lady who is alert and oriented times three and in no acute distress. heent examination: pupils are equal, round and reactive to light. mucous membranes were moist. the patient's oropharynx was clear. the patient's extraocular movements intact. neck examination: there was no thyromegaly. there was no cervical lymphadenopathy. there was no jugular venous pressure while the patient was lying flat. cardiovascular examination is a regular rate, normal s1, normal s2, iii/vi diamond shaped systolic murmur best auscultated at the apex and radiating to the neck and abdomen. respiratory examination was clear to auscultation bilaterally, no wheezes. abdominal examination was soft, nontender; active bowel sounds were present. the patient's systolic murmur could be auscultated radiating to the abdomen. extremities: the patient had a hematoma on the right catheterization site expanding roughly 4 by 6 centimeters and increasing in size by roughly of an inch in diameter over a two hour period after catheterization. additionally, a bruit was noted at the catheterization site as well. there was no active bleeding at the site. laboratory: the patient's white blood cell count was 12.2, hemoglobin was 11.7, hematocrit was 32.1, platelet count was 211. the patient's sodium is 137, potassium 3.6, chloride 102, bicarbonate 24, bun 13, creatinine 0.6, glucose 171. the patient's ck initially was 1,093 with an mb of 209 and an index of 19.1. the patient's calcium was 8.2, phosphate 3.6, magnesium 1.6. the patient had a femoral artery and vein ultrasound done on the day of admission due to the expanding hematoma over the catheterization site that was read as showing a 1.3 centimeter fluid collection within the right groin which demonstrated an arterial wave form. it appears to be connected with the right common femoral artery. normal arterial wave forms were demonstrated within the right common femoral artery and normal venous wave forms are demonstrated with the right common femoral vein, which led to the impression that a right groin pseudo-aneurysm was present, the size of 1.3 centimeters. echocardiogram on the day after admission, , showed focal akinesis of a segment of the basal septum consistent with controlled infarction, persistent doppler-able with severe resting left ventricular outflow gradient, at least moderate mitral regurgitation, a 70% ejection fraction was noted along with two plus mitral regurgitation. it was also noted that based on the age and endocarditis prophylaxis recommendations, the echocardiogram findings indicate a moderate risk which indicates that antibiotic prophylaxis is recommended in the future for any invasive procedures done on this patient. hospital course: 1. cardiovascular system: a) coronary artery disease: the patient has clean coronary arteries. her lipid profile revealed an ldl of less than 100 and hdl within normal limits. therefore, the patient was not started on a lipid lowering . the patient, however, was continued on her aspirin regimen. b) pump: the patient was restarted on her outpatient beta blockade of toprol xl 100 mg twice a day; the patient's heart rate and blood pressure were closely monitored and these parameters stayed at acceptable ranges. the patient was not started on an ace inhibitor in light of her well controlled blood pressure, heart rate and coronary artery disease. c) rhythm: the patient had a significant amount of ectopy both in the laboratory and in her first few days on the floor. the patient's electrolytes were managed appropriately and verapamil was considered as an additional to go with both her outflow tract gradient and ectopy, however, this was not started during this hospitalization due to a well controlled blood pressure. the patient was on a trans-venous pacer for 48 hours in the unlikely event that the patient could develop complete heart block after a septal ablation. the pacemaker never captured and was discontinued after 48 hours with no evidence of heart block. 2. pulmonary: the patient had no issues. she was able to oxygenate well on room air. the pulmonary examination remained unremarkable throughout her hospitalization despite her diagnosis of acute bronchitis. the patient's flovent was held due to its potential coronary trophic effects, however, the patient was advised that she could continue on this medication when she returned home. 3. renal: the patient's bun and creatinine remained within normal limits despite the large dye load that she received in the catheterization laboratory. 4. fluids, electrolytes and nutrition, gastrointestinal: the patient was started on a regular house diet. she did complain of nausea on the day after her catheterization, which was thought to be her anginal equivalent and was treated with phenergan. the patient also experienced a crampy abdominal pain intermittently throughout her hospitalization which she said was relieved by the passage of flatus. she was given simethicone p.r.n. for flatus and this seemed to help with her symptoms. 5. hematologic; serial hematocrits were monitored throughout the patient's hospitalization due to her expanding hematoma and dropping hematocrit. the patient's hemoglobin was 11.7 right after her first procedure and had been 12.6 prior to the procedure. on hospital day two, , it dropped to 10.7 and then dropped as low as 8.4 on . the patient was transfused one unit of packed red blood cells on the 11th to prepare her for surgery, which was required to repair an arteriovenous fistula that was detected in her right groin on hospital day three, when a repeat femoral artery and vein ultrasound diagnosed this defect. it was also thought that the previously diagnosed pseudo-aneurysm, which was not noted to be present on the second repeat ultrasound may have been mis-recognized as a pseudo-aneurysm, when in fact it was an arteriovenous fistula. the patient's hemoglobin was 9.4 prior to discharge and after her arteriovenous fistula repair. the patient was advised to follow-up with dr. in four to six weeks for examination of her post-surgical scars. she was also advised to follow-up with her primary care physician in two to three weeks to have her staples removed from her right groin. the patient, despite having an arteriovenous fistula, never had symptoms of arterial insufficiency in her right leg. she had one to two plus pulses in the dorsalis pedis and posterior tibialis arteries throughout her hospitalization and had no symptoms of pain or paresthesias throughout her hospitalization. 6. endocrine: a) the patient has no history of diabetes mellitus. b) the patient has a recent history of hyperthyroidism which was treated with iodine therapy. the patient's most recent tsh done a few weeks prior to admission was 0.99 and the patient had no symptoms of hyperthyroidism or hypothyroidism throughout her hospitalization. 7. prophylaxis: the patient was given protonix for peptic ulcer disease prevention and docusate for constipation along with 48 hours of transvenous pacer backup during her hospitalization. 8. activity: the patient was visited by physical therapy who had her up and walking and increased her activity daily. the patient was considered to be able to go home and resume her normal activities upon discharge. 9. vascular: as was previously noted, the patient developed an arteriovenous fistula during her hospitalization as well as a hematoma over the catheterization site. the hematoma, which was initially expanding, stabilized after the first hospital day and then became less indurated and actually began to regress towards the end of the patient's hospitalization. the arteriovenous fistula persisted and was noted to be present on the day prior to discharge. additionally, a bruit was auscultated at various times the her hospitalization at the right groin site, which was thought to be consistent with her radiographic finding of an arteriovenous fistula. the patient was taken to surgery on the day prior to discharge where the arteriovenous fistula was repaired without complications and with minimal blood loss. the patient tolerated the procedure well and was able to ambulate on the day after surgery. the patient's hematocrit stabilized as noted above prior to surgery, and remained stable after surgery. the patient was instructed to follow-up with dr. in four to six weeks and to have her sutures removed in two to three weeks. the patient was maintained on anti-platelet of aspirin upon discharge as there was felt to be a low risk of bleeding after her hematocrit had stabilized. discharge medications: 1. toprol xl 100 mg twice a day. 2. aspirin 325 mg q. day. 3. fosamax 10 mg q. day. 4. flovent two puffs twice a day. 5. atrovent two puffs four times a day. 6. calcium and magnesium supplementation as per outpatient regimen. condition on discharge: good. disposition: the patient was discharged to home. discharge diagnoses: 1. hypertrophic obstructive cardiomyopathy. 2. arteriovenous fistula. 3. pseudo-aneurysm. 4. osteoporosis. 5. chronic bronchitis. 6. mitral regurgitation. , m.d. dictated by: medquist36 procedure: excision or destruction of other lesion or tissue of heart, endovascular approach repair of arteriovenous fistula diagnoses: mitral valve disorders unspecified essential hypertension hematoma complicating a procedure other specified cardiac dysrhythmias osteoporosis, unspecified aneurysm of artery of lower extremity unspecified chronic bronchitis other aneurysm of heart 

Answer: The patient is high likely exposed to