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: no drug allergy information on file attending: chief complaint: ekg changes major surgical or invasive procedure: cardiac catheterization history of present illness: 86 yo female with copd, pulm htn, tr who presented to osh after a stranger knocked into her at her facility causing her to fall and fracture her left hip. she did not have any loc. in addition, she sustained a laceration to her right lower leg and received 6 stiches at osh. at osh, pt had ct scan of left hip which showed a cervical neck fracture of the left proximal femur. she had a routine pre-op evaluation; however her pre-op ekg showed st elevations in v2-v4. the patient was completely asymptomatic. she denied chest pain or pressure. her sob was at baseline. she did have some nausea, vomiting and diaphoresis at the osh. she was transferred to for cardiac cath. her cardiac cath earlier today showed clean coronaries. the patient tolerated the procedure without complication. the orthopedic team was consulted for management of her hip fracture. . the patient denies any chest pain or pressure currently. she reports that she does not want to undergo hip repair despite being informed of the risks. she refuses to go to get x-rays for further evaluation. . ros: she denies any prior history of stroke, tia, deep venous thrombosis, pulmonary embolism, bleeding at the time of surgery, myalgias, joint pains, cough, or hemoptysis. she denies recent fevers, chills or rigors. she denies exertional buttock or calf pain. has occasional abdominal pain, alternating diarrhea and constipation but has not had a colonoscopy, occasional blood in stool with straining. . cardiac review of systems is notable for absence of chest pain, dyspnea on exertion, paroxysmal nocturnal dyspnea, orthopnea, ankle edema, palpitations, syncope or presyncope. past medical history: pulmonary htn tricuspid regurgitation cpd osteoporosis c/b thoracic spine fracture resulting in chronic mid back pain hypertension h/o pyelonephritis h/o left hydronephrosis of uncertain eitology h/o pneumonia - required stay in rehab prior to transfer to s/p appendectomy s/p oophrectomy social history: she lives in an facility at . had been living independently until 3 months ago when she had a pneumonia and required inpatient rehab prior to her transfer to . son is an administrator and internist at . has 2 daughters who live locally. -tobacco history: she started smoking as a teenager and quit smoking 3 months ago. -etoh: denies -illicit drugs: denies family history: no family history of early mi, arrhythmia, cardiomyopathies, or sudden cardiac death; otherwise non-contributory. physical exam: admission physical exam vs: t=98.1 bp=102/49 hr=63 rr=15 o2 sat=96% 4l general: thin elderly female in nad. oriented x3. mood, affect appropriate. heent: ncat. sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. no xanthalesma. neck: supple with no jvd. cardiac: pmi located in 5th intercostal space, midclavicular line. rr, normal s1, s2. no m/r/g. no thrills, lifts. no s3 or s4. lungs: no chest wall deformities, scoliosis or kyphosis. resp were unlabored, no accessory muscle use. ctab, no crackles, wheezes or rhonchi. abdomen: soft, ntnd. no hsm or tenderness. abd aorta not enlarged by palpation. no abdominial bruits. extremities: lle shortened and externally rotated. no c/c/e. no femoral bruits. skin: no stasis dermatitis, ulcers, scars, or xanthomas. pulses: right: carotid 2+ femoral 2+ popliteal 2+ dp 2+ pt 2+ left: carotid 2+ femoral 2+ popliteal 2+ dp 2+ pt 2+ pertinent results: 09:28pm blood wbc-10.4 rbc-3.87* hgb-12.0 hct-36.9 mcv-95 mch-31.0 mchc-32.5 rdw-13.5 plt ct-259 03:58am blood wbc-10.5 rbc-3.75* hgb-11.7* hct-35.4* mcv-94 mch-31.2 mchc-33.1 rdw-13.4 plt ct-235 09:28pm blood glucose-123* urean-27* creat-1.2* na-132* k-5.5* cl-101 hco3-26 angap-11 03:58am blood glucose-105 urean-28* creat-1.2* na-133 k-5.5* cl-101 hco3-28 angap-10 01:24pm blood glucose-158* urean-27* creat-1.1 na-135 k-4.2 cl-103 hco3-25 angap-11 09:28pm blood ck(cpk)-52 03:58am blood ck(cpk)-41 01:24pm blood probnp-* 09:28pm blood mg-1.9 03:58am blood calcium-9.0 phos-3.7 mg-2.0 01:24pm blood mg-1.8 02:26pm blood type-art o2 flow-100 po2-319* pco2-58* ph-7.26* caltco2-27 base xs--1 02:46pm blood type-art po2-74* pco2-54* ph-7.27* caltco2-26 base xs--2 intubat-not intuba . cardiac catheterization 1. coronary angiography in this right-dominant system revealed: --the lmca had no angiographically apparent disease --the lad had no angiographically apparent disease --the lcx had no angiographically apparent disease --the rca had a calcified proximal 50% stenosis. 2. limited resting hemodynamics revealed elevated systemic arterial systolic pressures, with sbp 156 mmhg. final diagnosis: 1. no obstructive cad 2. moderate systemic arterial systolic hypertension. . tte echocardiographic measurements results measurements normal range left atrium - four chamber length: 4.7 cm <= 5.2 cm right atrium - four chamber length: 4.3 cm <= 5.0 cm left ventricle - septal wall thickness: 0.9 cm 0.6 - 1.1 cm left ventricle - inferolateral thickness: 0.8 cm 0.6 - 1.1 cm left ventricle - diastolic dimension: 3.1 cm <= 5.6 cm left ventricle - systolic dimension: 1.8 cm left ventricle - fractional shortening: 0.42 >= 0.29 left ventricle - ejection fraction: 70% >= 55% left ventricle - lateral peak e': 0.10 m/s > 0.08 m/s left ventricle - septal peak e': *0.07 m/s > 0.08 m/s left ventricle - ratio e/e': 9 < 15 aortic valve - peak velocity: 1.3 m/sec <= 2.0 m/sec mitral valve - e wave: 0.8 m/sec mitral valve - a wave: 1.3 m/sec mitral valve - e/a ratio: 0.62 mitral valve - e wave deceleration time: 235 ms 140-250 ms tr gradient (+ ra = pasp): *59 to 66 mm hg <= 25 mm hg findings left atrium: normal la size. right atrium/interatrial septum: normal ra size. increased ivc diameter (>2.1cm) with <35% decrease during respiration (estimated ra pressure (10-20mmhg). left ventricle: normal lv wall thickness. small lv cavity. overall normal lvef (>55%). no resting lvot gradient. right ventricle: rv hypertrophy. dilated rv cavity. borderline normal rv systolic function. abnormal systolic septal motion/position consistent with rv pressure overload. aorta: normal aortic diameter at the sinus level. focal calcifications in aortic root. aortic valve: moderately thickened aortic valve leaflets. minimal as. no ar. mitral valve: mildly thickened mitral valve leaflets. no mvp. moderate mitral annular calcification. mild thickening of mitral valve chordae. calcified tips of papillary muscles. no ms. lv inflow pattern c/w impaired relaxation. tricuspid valve: mildly thickened tricuspid valve leaflets. normal tricuspid valve supporting structures. no ts. moderate to severe tr. severe pa systolic hypertension. pericardium: no pericardial effusion. conclusions the left atrium is normal in size. the estimated right atrial pressure is 10-20mmhg. left ventricular wall thicknesses are normal. the left ventricular cavity is small. overall left ventricular systolic function is normal (lvef 70%). the right ventricular free wall is hypertrophied. the right ventricular cavity is dilated with borderline normal free wall function. there is abnormal systolic septal motion/position consistent with right ventricular pressure overload. the aortic valve leaflets are moderately thickened. there is a minimally increased gradient consistent with minimal aortic valve stenosis. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. the left ventricular inflow pattern suggests impaired relaxation. the tricuspid valve leaflets are mildly thickened. moderate to severe tricuspid regurgitation is seen. there is severe pulmonary artery systolic hypertension. there is no pericardial effusion. . cxr the lung volumes are near normal, the hemidiaphragms are relatively low, but not flattened. moderate scoliosis leads to asymmetry of the rib cage. in both lungs, right more than left, a reticular pattern of opacities is seen in both perihilar regions and in the right upper region. without comparison, the nature of these lesions is difficult to determine, they could be the result of fibrotic or a chronic inflammatory process, but could also result from chronic overhydration. moderately enlarged cardiac silhouette, slightly enlarged right and left hilus, potentially suggesting pulmonary hypertension. no evidence of pleural effusions, no acute overhydration. bilateral apical thickening. . lower extremity doppler u/s preliminary report !! wet read !! no dvt seen in either lower extremity . cta chest preliminary report !! pfi !! pulmonary embolus within the right middle lobe segmental artery. bilateral pleural effusions. extensive copd, cardiomegaly, vascular calcifications. areas of increased opacity in the right upper lobe may represent infection. additional areas of opacity in the right middle lobe may represent infarct or atelectasis. brief hospital course: 1) ekg changes - perioperative ekg prior to transfer to showed st elevations in v3-v4 and to a lesser extent in ii,iii,f,v5-v6. tni was 1.9 with normal ck. she was given aspirin, plavix, lovenox, and lopressor. a similar ekg was obtained upon transfer to . cardiac cath revealed a right-dominant system with a calcified 50% proximal stenosis in the rca but no angiographically apparent disease in the lmca, lad, and lcx. tte revealed normal left atrial size with an estimated right atrial pressure 10-20mmhg, normal left ventricular wall thickness and a small left ventricular cavity, normal left ventricular systolic function (lvef 70%), hypertrophied right ventricular free wall, dilated right ventricular cavity with borderline normal free wall function, abnormal systolic septal motion/position consistent with right ventricular pressure overload, moderately thickened aortic valve leaflets with a minimally increased gradient consistent with minimal aortic valve stenosis, mildly thickened mitral valve leaflets, left ventricular inflow pattern suggesting impaired relaxation, mildly thickened tricuspid valve leaflets with moderate to severe tricuspid regurgitation, and severe pulmonary artery systolic hypertension. cardiac enzymes were trended with no elevation in her ck's threfore this was felt not to be cardiac ischemia. . 2) pulmonary embolus - on hospital day 2, the patient had low-grade fever, tachycardia, worsening hypoxemia with resting oxygen saturation in the mid 90's on 6 l nc, new t-wave inversions in v3 and deeper t-wave inversions in v4. cta of the chest revealed right middle lobe segmental pulmonary emboli, right middle lobe pulmonary infarct vs. atelectasis, moderate bilateral pleural effusions, and volume overload. heparin and lasix infusions were started. lower extremity doppler ultrasound was negative for dvt. . 3) left femoral neck fracture - seen in consultation by orthopaedic surgery who recommended proceeding with orif. however, based on the preference of the patient and her family, she was transferred to for further management. medications on admission: celexa 10mg po daily omeprazole 20mg po daily senna 2 tabs daily at 4pm lisinopril 5 mg po daily lidoderm 5% patch, one patch to lower back 12 hrs each day calcium with vit d 600mg po bid tylenol 650mg q4hrs prn for pain compazine 10mg po bid prn nausea/vomiting ibuprofen prn discharge medications: 1. acetaminophen 325 mg tablet sig: two (2) tablet po q6h (every 6 hours): do not exceed 4 grams in 24 hours. 2. citalopram 20 mg tablet sig: 0.5 tablet po daily (daily). 3. senna 8.6 mg tablet sig: two (2) tablet po daily (daily). 4. lidocaine 5 %(700 mg/patch) adhesive patch, medicated sig: one (1) adhesive patch, medicated topical daily (daily): place on between 8 am and 8 pm then remove. 5. heparin (porcine) in ns 10 unit/ml kit sig: asdir units intravenous every six (6) hours: diagnosis: pulmonary embolism patient weight: 40.824 kg initial bolus: 1000 units ivp initial infusion rate: 750 units/hr target ptt: 60 - 100 seconds ptt <40: 1600 units bolus then increase infusion rate by 150 units/hr ptt 40 - 59: 800 units bolus then increase infusion rate by 100 units/hr ptt 60 - 100*: ptt 101 - 120: reduce infusion rate by 100 units/hr ptt >120: hold 60 mins then reduce infusion rate by 150 units/hr. 6. furosemide 10 mg/ml solution sig: 2.5 mg injection infusion (continuous infusion). 7. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po once a day. 8. calcium carbonate 500 mg (1,250 mg) capsule sig: one (1) capsule po once a day. 9. vitamin d 400 unit tablet sig: two (2) tablet po once a day. discharge disposition: extended care discharge diagnosis: 1) left femoral neck fracture 2) pulmonary embolus 3) pleural effusions 4) pulmonary hypertension 5) tricuspid regurgitation 6) emphysema discharge condition: transfer to . discharge instructions: you were admitted to the hospital following a fall and left hip fracture. you declined surgery at and were transferred to at your request. you were diagnosed with blood clots in the lung, also known as pulmonary emboli, and were started on blood thinning medication. followup instructions: please follow the recommendations of your medical and orthopaedic doctors . procedure: left heart cardiac catheterization coronary arteriography using a single catheter angiocardiography of right heart structures diagnoses: hyperpotassemia esophageal reflux unspecified pleural effusion unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled other chronic pulmonary heart diseases osteoporosis, unspecified other emphysema diseases of tricuspid valve other pulmonary embolism and infarction closed fracture of unspecified part of neck of femur nonspecific abnormal electrocardiogram [ecg] [ekg] fall resulting in striking against other object 

Answer: The patient is high likely exposed to