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 67-year-old woman who presented with shortness of breath and heart failure. the patient stated that she had been having worsening lower extremity edema, increasing abdominal girth, weight gain, and increasing shortness of breath over the last ten days. also the patient has been seen in the clinic recently with labs that showed severe prerenal azotemia, in addition to her fluid retention. the patient has a known history of coronary artery disease, diabetes, and hypertension. she has had multiple admissions for severe fluid retention with renal insufficiency. both catheterization and echocardiogram in showed mild left ventricular hypertrophy and mitral regurgitation. since her admission on , she has gained at least 20 lbs, recurrent massive lower extremity edema and exertional shortness of breath. she did not complain of any angina; however, she is now only able to walk ten steps, and at baseline, she is can walk one block. the patient was referred today from the clinic to the ccu for an elective swan-ganz to help assess her intracardiac pressures and adjust her medications accordingly to see if we can prevent her recurrent admissions for congestive heart failure. the patient on admission was also noted to have a hematocrit of 19, but she denied melena and hematemesis. she did note that she has had some blood streaked stools. she had a negative colonoscopy several weeks ago. past medical history: 1. diabetes mellitus. 2. coronary artery disease. she has had multiple catheterizations. she had a ptca of the right coronary artery in . she had ptca of the left circumflex in , and also ptca of the right coronary artery in . 3. history of congestive heart failure. last echocardiogram was , which showed an ejection fraction of 60-65%, left atrial enlargement, right atrial enlargement, trace aortic insufficiency, and mild to moderate mitral regurgitation, with severe pulmonary hypertension. 4. she has a history of paroxysmal atrial fibrillation on amiodarone and coumadin. 5. history of pulmonary embolism in . 6. history of thyroidectomy on synthroid. 7. history of chronic renal insufficiency with a baseline of 1.1. 8. history of osteoporosis. 9. depression and anxiety. borderline personality disorder. 10. sleep apnea. 11. peripheral vascular disease. allergies: penicillin causes a rash. percocet also causes rash. tegretol causes liver abnormalities. she is allergic to bees, ................... which cause anaphylaxis. medications at home: lasix 120 p.o. b.i.d., 75/25 humalog 21 u q.a.m., 18 u q.p.m., regular insulin sliding scale, coumadin, actigall, lipitor 10 q.d., buspar 10 mg t.i.d., celexa 60 mg q.d., folate 1 mg q.d., calcium citrate, neurontin 1200 mg q.a.m. and q.p.m., 800 mg at noon, amiodarone 300 mg q.d., hydrochlorothiazide 25 mg q.d., lisinopril 20 q.d., mirapex 0.25 b.i.d., lopressor 25 mg b.i.d. social history: she lives alone. she has occasional alcohol use. she denied tobacco use. family history: she had a father who died of myocardial infarction at 47 and mother with cancer. physical examination: vital signs: temperature 97.9??????, pulse 51, blood pressure 84/25, respirations 10, oxygen saturation 100% on room air. general: she was a pleasant, pale, female in no acute distress. heent: normocephalic, atraumatic. pupils equal, round and reactive to light. extraocular movements full. oropharynx clear. neck: supple. there was an 11 cm jvp. lungs: clear to auscultation bilaterally. cardiovascular: regular, rate and rhythm. there was a 3 out of 6 systolic murmur at the left sternal border and at the right upper sternal border. abdomen: soft, slightly distended, obese, nontender. normoactive bowel sounds. she also had guaiac positive brown stool. no evidence of blood. extremities: no clubbing or cyanosis, but she had 3+ pitting edema in both lower extremities. neurological: she was alert and oriented times three. laboratory data: on admission white count was 6.4, hematocrit 19.8, platelet count 221,000; inr 4.0, pt 24.6, ptt 45.0; sodium 128, potassium 4.8, bicarb 88, chloride 26, bun 149, creatinine 2.7, glucose 154. assessment and plan: she was a 67-year-old female with a history of coronary artery disease, and congestive heart failure, with multiple admissions, atrial fibrillation on coumadin and amiodarone, diabetes type 2, peripheral vascular disease, and hyperthyroidism, presenting with worsening congestive heart failure symptoms and anemia, as well as elevated bun and creatinine ratio, and anemia with a hematocrit of 19.8. 1. cardiovascular: the patient had an exam consistent with congestive heart failure. we will place a swan-ganz to assess .............. possibility once her elevated inr has been decreased. we will give her vitamin k. 2. hematocrit: the patient has had over a ten-point hematocrit drop with negative guaiac positive stool. we were planning to transfuse her. after discussion with dr. , we decided not to place an ng tube because of elevated inr and the fear of aspiration. 3. endocrine: she has a history of hyperthyroidism on synthroid. 4. renal: she has had worsening renal function with an increase in creatinine. we will continue to diurese anyway and hope that with improved cardiac output, the patient's renal function will improve. 5. gi: we will reverse her inr with vitamin k and start protonix at 40 mg iv q.d. we will also consult gi. hospital course: cardiovascular: the patient's inr was reversed with vitamin k, and a swan was placed. swan numbers revealed pulmonary artery hypertension but also an elevated wedge felt to be due to left heart failure due to diastolic dysfunction. echocardiogram was done which showed an ejection fraction of 55%. the patient was diuresed with lasix, and throughout the hospital course, lost 10 kg with complete resolution of her 3+ lower extremity pitting edema. she remained in normal sinus rhythm throughout the hospital course. her pulse was in the 50s and 60s throughout but stable. once her heart failure resolved, she was restarted on her home medications, lopressor 25 b.i.d. lisinopril was decreased to 10 mg q.d., and she was restarted on lasix 120 mg q.d. she was also restarted on aspirin and placed on lipitor per her home regimen. she was continued on amiodarone and restarted on coumadin after a negative gi work-up. pulmonary: the patient has severe pulmonary hypertension on echocardiogram but has a history of pe. she had negative lower extremity dopplers recently, so this was not repeated. at the time of discharge, the patient had good oxygen saturations on room air. renal: her renal function improved throughout the hospital stay with diuresis. creatinine returned to baseline of 1.1. gi: egd found erosions in the antrum that were small and localized. there was no active bleeding or coffee-grounds and no evidence of recent gi bleed. the patient later had a barium study with small bowel follow through which was a unremarkable small bowel study; barium passed freely through the small bowel reaching the cecum within 45 min. the small bowel was of normal caliber in the mucosal pattern, no mass lesions. terminal ileum and cecum appeared normal. heme: the patient was transfused multiple units of packed red blood cells. hematocrit eventually stabilized around 31 with no evidence of further bleeding. the patient was restarted on her coumadin, as well as aspirin without incident. disposition: the patient saw physical therapy who recommended a short rehabilitation stay of several days with a plan to follow-up with heart failure service on . condition on discharge: stable. discharge medications: lasix 120 mg q.d., lopressor 25 mg b.i.d., lisinopril 10 mg q.d., coumadin 5 mg q.h.s. q.o.d., 2.5 mg q.o.d. q.h.s., zantac 150 mg b.i.d., lipitor 10 mg q.h.s., amiodarone 300 mg q.d., actigall 300 mg b.i.d., buspar 10 mg b.i.d., celexa 60 mg q.d., folate 1 mg q.d., aspirin 81 mg q.d., neurontin 1200 mg q.a.m., 800 mg q.noon, 1200 mg q.h.s., mirapex 0.25 mg b.i.d., 75/25 humalog 21 u q.a.m., 18 u q.p.m., levothyroxine 250 mcg p.o. q.d. follow-up: the patient will follow-up on with the heart failure clinic with , m.d. , m.d. dictated by: medquist36 procedure: other endoscopy of small intestine pulmonary artery wedge monitoring diagnoses: coronary atherosclerosis of native coronary artery congestive heart failure, unspecified diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute kidney failure, unspecified iron deficiency anemia secondary to blood loss (chronic) atrial fibrillation cellulitis and abscess of leg, except foot primary pulmonary hypertension other specified gastritis, without mention of hemorrhage 

Answer: The patient is high likely exposed to