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: patient recorded as having no known allergies to drugs attending: chief complaint: sob, respiratory failure major surgical or invasive procedure: intubation and mechanical ventilation cardiac catheterization history of present illness: 58yo f w/ pmh of diastolic chf and paf who presents to ed tonight after developing sob. had been out to dinner w/ friends and on return home at midnight, felt like she was having another episode of chf. told her husband that she felt like she was "filling up" again and was brought to er by husband. en route, sob became progressively worse and on arrival in ed, she went from being tachycardic to bradycardic. she then became cyanotic and went unresponsive. she was given atropine x2 with restoration of a normal hr but she was intubated for respiratory failure. . ros: husband denies any preceding chest pain, pressure or discomfort; no fatigue, orthopnea, doe, pnd; no dizziness, lightheadedness, ha; no cough, sore throat, sinus congestion or uri sx, no fevers or chills; no n/v/d/brbpr; no dysuria, hematuria past medical history: 1. paf s/p pvi, w/ recurrence s/p radiation, now on amiodarone. 2. chf - diastolic, with lv ef 62% by mri 3. breast cancer - stage ii s/p r mastectomy and s/p 6mo tamoxifen therapy, now s/p xrt 4. hypertension 5. hyperlipidemia social history: patient is married and lives with her husband and 17yo son in . no tob, occ etoh. used to work as mortgage analyst but has not worked in last year. currently babysits nieces and nephews several times/wk, ? unclear if any of the kids are currently sick. family history: not able to be obtained pt being intubated and sedated. physical exam: vs - t , bp 168/84, hr 70s, rr 18, sats 100% on vent vent: ac 450x18, 100%, peep 10 gen - sedated, intubated heent - sclera anicteric. pupils 4 -> 2mm bilaterally, rxtive to light. mmm. cv - rr, normal s1, s2. no m/r/g. lungs - crackles throughout, no wheezes or rhonchi. abd - soft, ntnd. + bs. no masses. ext - 1+ pitting edema to mid calf bilaterally. ext cool, nonpalpable pulses. neuro - sedated, intubated. moves all 4 extremities. skin - no rashes. scars abdomen, breast. pertinent results: labs on admission: wbc 10.9, hct 43.7#, mcv 90, plt 266 (diff: neuts-61.6 lymphs-30.4 monos-4.4 eos-2.5 baso-1.2, hypochr-1+) pt 25.6*, ptt 24.9, inr(pt) 2.6* na 140, k 3.3, cl 105, hco3 25, bun 23, cr 1.0, glu 137 alt 155*, ast 85*, ldh 315*, alkphos 117, amylase 90, lipase 35, tbili-0.5 calcium 8.6, phos 4.9*, mg 1.7 abg: 7.36/45/214 lactate 2.2*, freeca 1.09* . cardiac enzymes: 02:26am ck(cpk)-59 ctropnt-<0.01 05:50am ck(cpk)-57 ck-mb-notdone ctropnt-<0.01 04:31pm ck(cpk)-151* ck-mb-4 ctropnt-<0.01 11:10pm ck(cpk)-13 ck-mb-3 ctropnt-<0.01 03:27am ck(cpk)-125 ck-mb-2 ctropnt-<0.01 . labs on discharge: 06:40am blood wbc-5.8 rbc-3.63* hgb-10.5* hct-30.6* mcv-84 mch-29.0 mchc-34.4 rdw-15.4 plt ct-167 06:40am blood glucose-96 urean-11 creat-0.7 na-140 k-4.0 cl-105 hco3-28 angap-11 06:40am blood calcium-8.8 phos-3.5 mg-2.0 . micro: : blood cx ngtd x2 . imaging: echo : regional left ventricular wall motion is normal. overall left ventricular systolic function is low normal (lvef 50-55%). right ventricular chamber size and free wall motion are normal. there is no pericardial effusion. . cxr : comparison with . the ng tube extends below the hemidiaphragm. the endotracheal tube is in satisfactory position above the carina. the cardiac contour is enlarged. there are diffuse opacities throughout the lungs, consistent with pulmonary edema. there are also probable bilateral pleural effusions. there is no pneumothorax. impression: pulmonary edema. . cxr : endotracheal tube terminates 3.5 cm from the carina. nasogastric tube tip is below the borders of the radiograph. the heart size and mediastinal contours are unchanged. the heart is within normal limits in size. allowing for lower lung volumes, the degree of marked pulmonary edema is probably not significantly changed. there is no pneumothorax. diffuse hazy opacity suggests layering bilateral pleural effusions. note is made of gaseous distention of the stomach. . cxr : low lung volumes with perihilar alveolar and interstitial opacities bilaterally, which have slightly improved on the short interval study. endotracheal tube tip in stable position. ng tube tip in the proximal duodenum. impression: slight improvement of pulmonary edema on the short interval followup study. . ct head : no intracranial hemorrhage. there may be mild effacement of the sulci consistent with early cerebral edema. . cxr : resolution of the pulmonary edema without signs of acute cardiopulmonary process. . cardiac cath : final diagnosis: 1. coronary arteries are normal. 2. severe elevation of right and left filling pressures consistent with diastolic dysfunction. 3. no definitive evidence of constriction but can not exclude. . cxr : impression: ap chest compared to and 26: pulmonary edema has resolved. heart size is normal, and there is no pleural effusion. brief hospital course: patient is a 58 year old woman with past medical history of breast cancer, status post resection, radiation, chemotherapy, diastolic chf and paf, who initially presented in respiratory failure secondary to chf exacerbation. . patient initially presented in hypoxic respiratory failure with radiographic and clinical evidence of flash pulmonary edema. given the patient's history of atrial fibrillation and her elevated heart rate on presentation, it was believed that her flash pulmonary edema was due to her atrial fibrillation with rapid ventricular response. . the patient was initially intubated for respiratory support and diuresed with iv lasix. the patient was then extubated less than 24 hours after admission without complication. the patient continued to be diuresed with iv lasix prn to achieve a fluid goal of 1 liter negative/day throughout her hospital course. . patient's post-extubation was complicated by a low grade fever spike and a question of infiltrate on cxr, and therefore the patient was empirically started on antibiotics for aspiration pneumonia. however, repeat cxr following further diuresis demonstrated resolution of any intrapulmonary process and the antibiotics were discontinued. . the patient's heart rate was controlled medically with metoprolol 50mg tid (changed from her outpatient dose of 75mg ), which kept the patient in good rate control with heart rate in 50's and 60's throughout remainder of hospital course. she was also maintained on her outpatient dose of amiodarone 400mg qd which maintained the patient in normal sinus rhythm following her initial presentation. . other cardiac work up throughout her hospital course included an echo that demonstrated ef of 55%, diastolic dysfunction, and could not rule out a wall motion abnormality due to the quality of the study. therefore, the patient proceeded to undergo cardiac catheterization to evaluate if she had cad that could cause her cardiac dysfunction. the cath demonstrated clean coronary arteries, severe diastolic dysfunction, no definite evidence of constrictive physiology. . the patient was otherwise maintained on a number of cardiac medications throughout her hospital course. these medications included metoprolol 50mg tid (changed from her outpatient dose of 75mg ), her outpatient dose of statin, her outpatient dose of amiodarone, her outpatient dose of coumadin for her atrial fibrillation (which was held peri-cath), her outpatient ace i which was uptitrated as her blood pressure tolerated (and therefore she was discharged on lisinopril increased from 10mg qd to 20mg qd), an increased dose of lasix (from 20mg qd to 40mg qd), potassium repletion (20meq qd) and her outpatient dose of aspirin. . the patient was discharged in stable condition, clinically and radiographically euvolemic, with the diagnosis of diastolic heart failure of unknown etiology, atrial fibrilation (although remained in nsr throughout majority of her hospital course), with evidence of apparent very sensitive response to rapid ventricular response that appears to put her into flash pulmonary edema. . the patient was therefore discharged on the above medications with plans to obtain a cardiac mri next week, followed by an attempted ablation of possible ectopic focus per ep on . this has been attempted before (2 years ago) without success. future considerations include discussions over av nodal ablation with permanent pacemaker placement pending failure of ablation attempt, due to the patient's volume status sensitivity to elevated heart rate. the patient will also follow up with her primary care physician for close of her inr (on coumadin) and her electrolytes (on higher dose of lasix and potassium repletion). medications on admission: aspirin 325mg po daily pravastatin 40mg po daily folic acid 1mg po daily omega-3 fatty acids 120-180-1.8mg-mg-unit capsule 1 cap po bid lasix 20mg po qd lisinopril 20mg po daily amiodarone 400 mg tablet po daily warfarin 1-2mg qd (2mg m -> f, 1mg sat/sun) metoprolol tartrate 75 mg tablet po bid discharge medications: 1. aspirin 325 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). disp:*30 tablet, delayed release (e.c.)(s)* refills:*0* 2. aspirin 325 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po once a day. disp:*90 tablet, delayed release (e.c.)(s)* refills:*3* 3. amiodarone 200 mg tablet sig: two (2) tablet po daily (daily). disp:*60 tablet(s)* refills:*0* 4. amiodarone 200 mg tablet sig: two (2) tablet po once a day. disp:*180 tablet(s)* refills:*3* 5. metoprolol tartrate 50 mg tablet sig: one (1) tablet po tid (3 times a day). disp:*90 tablet(s)* refills:*0* 6. metoprolol tartrate 50 mg tablet sig: one (1) tablet po three times a day. disp:*270 tablet(s)* refills:*3* 7. pravastatin 20 mg tablet sig: two (2) tablet po daily (daily). disp:*90 tablet(s)* refills:*3* 8. lisinopril 20 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*0* 9. lisinopril 20 mg tablet sig: one (1) tablet po once a day. disp:*90 tablet(s)* refills:*3* 10. warfarin 2 mg tablet sig: one (1) tablet po once a day: please take 5 days per week, take the 1mg tablet 2 days per week. 11. warfarin 1 mg tablet sig: one (1) tablet po once a day: please take 2 times per week, take the 2mg tablet 5 times per week. 12. potassium chloride 20 meq tab sust.rel. particle/crystal sig: one (1) tab sust.rel. particle/crystal po once a day. disp:*30 tab sust.rel. particle/crystal(s)* refills:*0* 13. potassium chloride 20 meq tab sust.rel. particle/crystal sig: one (1) tab sust.rel. particle/crystal po once a day. disp:*90 tab sust.rel. particle/crystal(s)* refills:*3* 14. lasix 40 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*0* 15. lasix 40 mg tablet sig: one (1) tablet po once a day. disp:*90 tablet(s)* refills:*3* 16. outpatient lab work inr, electrolyte panel discharge disposition: home discharge diagnosis: diastolic heart failure atrial fibrillation discharge condition: good. patient with good rate control, no evidence of volume overload on exam, no other complaints at time of discharge. discharge instructions: please contact physician if develop shortness of breath, chest pain pressure, weight gain of greater than 3 lbs. please take medications as directed. your medication changes include: you will be taking double the dose of lisinopril (10mg daily changed to 20mg daily) you will be taking double the dose of lasix (20mg daily changed to 40mg daily) you will be taking a different dose of metoprolol (75mg two times a day changed to 50mg three times a day) you will be taking your usual dose of coumadin (2mg 5 times a week and 1mg 2 times a week) - however, for the first 2 days after leaving the hospital, take 5mg daily you will be taking the same dose of amiodarone (400mg daily) you will be taking a new medication, potassium chloride, 20meq daily please follow up with appointments as directed weigh yourself every morning, call your physician if you have a greater than 3 lb weight gain please adhere to a low salt diet - no more than 2000mg salt/day please refrain from heavy lifting or strenuous activity for 2 weeks followup instructions: 1.) please see dr. on thursday, at 1:30pm for follow up after hospitalization and to have your inr and electrolytes checked. 2.) please have cardiac mri on at 11am - you will be mailed an information sheet. 3.) you are scheduled to have an attempted ablation on - you will be called with additional information. 4.) provider: , m.d. phone: date/time: 2:15 5.) please follow up in the heart failure clinic at 9am - of shapire building procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours combined right and left heart cardiac catheterization coronary arteriography using two catheters insertion of endotracheal tube diagnoses: coronary atherosclerosis of native coronary artery pure hypercholesterolemia congestive heart failure, unspecified unspecified essential hypertension atrial fibrillation personal history of malignant neoplasm of breast acute respiratory failure pneumonitis due to inhalation of food or vomitus unspecified sleep apnea acute diastolic heart failure 

Answer: The patient is high likely exposed to