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: iv dye, iodine containing contrast media attending: chief complaint: shortness of breath major surgical or invasive procedure: left heart catheterization history of present illness: history of presenting illness: ms. is an 86 y/o female with a history of chronic afib (refusing warfarin) and stable angina who presented to on with 3-4 days of progressive cough and shortness of breath. she also had some left sided chest discomfort that was associated with exertion. at the osh her ekg was reportedly normal however troponin trend was 0.04>0.18>0.08. chest x-ray showed findings concerning for pneumonia and she was started on levofloxacin. an echo done on revealed an lv thrombus and ef 27% (prior 62% on persantine st ). thus, the patient was transferred to for cardiac catheterization. vital signs prior to transfer were temp 98.1, bp 118/84, hr afib 80-90's at rest, 130-140's with stimulation, rr 22-24, o2sat 95-98% on 2l nc. . when she arrived to the cath lab she was noted to be very dyspneic and was felt to be volume overloaded. she was transferred to the ccu for further management and diuresis. . on arrival to the floor, patient was comfortable and in nad. she notes that she is feeling better. she denied having any pain. she notes that her breathing has improved. . review of systems on review of systems, she denies any prior history of stroke, tia, deep venous thrombosis, pulmonary embolism, bleeding at the time of surgery, myalgias, joint pains, cough, hemoptysis, black stools or red stools. she denies recent fevers, or rigors. she denies exertional buttock or calf pain. all of the other review of systems were negative. . cardiac review of systems is notable for absence of paroxysmal nocturnal dyspnea, ankle edema, palpitations, syncope or presyncope. past medical history: past medical history: 1. cardiac risk factors: + diabetes, dyslipidemia, + hypertension 2. cardiac history: -cabg: -percutaneous coronary interventions: -pacing/icd: 3. other past medical history: -longstanding angina typically brought on by mod-heavy exertion and relieved by sl ntg or rest -chronic afib (declines warfarin) -borderline t2dm (diet-controled) -htn -s/p umb hernia repair -s/p bowel obstruction resulting in colectomy/colostomy/reversal 7 yrs ago . social history: she lives with her husband who has . she functions independently -tobacco history: negative -etoh: negtive -illicit drugs: negative family history: no family history of early mi, arrhythmia, cardiomyopathies, or sudden cardiac death; otherwise non-contributory. physical exam: admission general: patient was comfortbale and 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 jvp of 12 cm. cardiac: rr, normal s1, s2. no m/r/g. no thrills, lifts. no s3 or s4. lungs: crackles noted bilaterally throughout lungs, no wheezes or rhonchi abdomen: soft, ntnd. no hsm or tenderness. extremities: no c/c/e. skin: no stasis dermatitis, ulcers, scars, or xanthomas. pulses: right: dp 2+ pt 2+ left: dp 2+ pt 2+ neuro: cn2-12 intact, 5/5 strength bilaterally both upper and lower extremities discharge: general: nad, nt/nd sitting at bedside. heent: ncat. sclera anicteric. eomi. neck: supple with jvp of cm. cardiac: irregularly irregular, normal s1, s2. no m/r/g. no thrills, lifts. no s3 or s4. lungs: rales r >> l, worse at bases, no rhonchi, wheeze. no amu, speaks in full sentences. abdomen: soft, ntnd. no hsm or tenderness. ? seroma palpable. extremities: hematoma improved since yesterday and less painful to touch. skin: no stasis dermatitis, ulcers, scars, or xanthomas. pulses: difficult to assess accurately with teds, but dps equal. neuro: fluent, appropriate, linear and prompt. moves all 4 freely without apparent weakness or tremor. pertinent results: 02:00pm pt-13.9* inr(pt)-1.3* 07:55pm pt-13.2* ptt-30.8 inr(pt)-1.2* 07:55pm plt count-206 07:55pm wbc-9.3 rbc-4.62 hgb-14.5 hct-42.1 mcv-91 mch-31.5 mchc-34.5 rdw-13.9 07:55pm calcium-8.8 phosphate-2.7 magnesium-1.8 07:55pm estgfr-using this 07:55pm estgfr-using this 07:55pm glucose-151* urea n-22* creat-1.0 sodium-139 potassium-3.3 chloride-99 total co2-29 anion gap-14 discharge 07:22am blood wbc-11.8* rbc-3.72* hgb-11.6* hct-33.5* mcv-90 mch-31.0 mchc-34.5 rdw-13.9 plt ct-323 02:06am blood neuts-65.2 lymphs-26.1 monos-6.3 eos-2.1 baso-0.3 07:22am blood plt ct-323 07:22am blood glucose-132* urean-41* creat-1.1 na-128* k-3.9 cl-88* hco3-30 angap-14 07:22am blood ck(cpk)-988* 03:55pm blood ck(cpk)-1366* 07:07am blood ck(cpk)-1282* 09:00pm blood ck(cpk)-1130* 07:07am blood ck-mb-6 ctropnt-<0.01 07:55pm blood ck-mb-6 ctropnt-0.07* 07:22am blood calcium-9.3 phos-3.7 mg-2.1 05:41am blood %hba1c-6.7* eag-146* 05:41am blood tsh-7.6* brief hospital course: ms. is an 86 y/o female with a history of chronic afib and stable angina who presented to on with 3-4 days of progressive cough and shortness of breath and new dilated cardiomyopathy transferred to for consideration for catheterization noted to be volume overloaded. acute issues # acute systolic heart failure: she had a reported ef of 60% on which was 27% on tte done at osh. with her chronic angina, we suspected coronary artery disease as likely etiology. the differential also included infectious cardiomyopathy, toxic cardiomypathy, endocrine dysfunction and stress induced cardiomypathy. patient was initially diuresed with lasix and metolazone and put out adequate urine. she was transiently hypotensive so further diuresis was held. given there was a troponin leak at the osh (and small elevation initially here), a cardiac cath was considered to look for cad as the trigger for her chf. however, there was concern in regards to viability of her left ventricle, and also as to whether there was a thrombus present so a cardiac mri was obtained. this study found no lv thrombus and did find viable cardiac tissue. she was then prepped for cath with iv steroids and benadryl given her previous contrast allergy. her cath results from showed no coronary disease, etiology of acute chf likely stress cardiomyopathy/embolism from a fib to coronary/myocarditis. with improved ef improved 40% making stress cardiomyopathy the likely etiology of her actue chf the patient went home on lisinopril metoprolol xl . she was given 5 pills of 20 mg lasix in case she starts gaining weight in the interim before her follow up appointment with dr. . #r lower ext pain: pt began complaining of r le pain after transfer to the floor. she described it as diffuse and worse upon lifting her leg. her cpk was originally 233 on and uptrended to 1366 on . we had initially started her on atorvastatin 80 mg daily in house, but d/ced the medication once she was symptomatic. also taken down for lenis and abi and found to have completely intact arterial and venous flow. on further examination, a large right upper leg hematoma was discovered. cpk downtrended to the 500s and her heparin was d/ced. # coronaries: she has a history of chronic stable angina however appears to have been getting progressively worse. with slight elevation of cardiac enzymes concern for nstemi however no ekg changes were noted. likely etiology of enzymes are demand in the setting of extreme volume overload. we continued aspirin 325mg daily, ace-i, statin # rhythm: she has a history of atrial fibrillation which is currently rate controlled. she declined being on coumadin. chads2 is at least 4 with chf, htn, age and diabetes. she would benefit from anticoagulation however given recent though bleed we felt that she would benefit from starting anticoagulation in an outpatient setting. # hyponatremia: paitent had a low na down into 125. this resolved during hospital stay. chronic issues # hypertension: was well controlled on current regimen. . # type 2 diabetes: patient is apparently diet controlled. there is no a1c in our system. transitional issues: -starting anticoagulation for afib given chads2 4. -f/u on acute chf, will likely need an echo when she follows up with her cardiologist in outpatient setting -f/u a1c -f/u thigh hematoma to see if it is resolving medications on admission: home medications: metoprolol xl 50mg isosorbide 20mg asa 325mg discharge medications: 1. metoprolol succinate xl 100 mg po daily rx *metoprolol succinate 100 mg 1 tablet(s) by mouth daily disp #*30 tablet refills:*3 2. lisinopril 5 mg po daily rx *lisinopril 5 mg 1 tablet(s) by mouth daily disp #*30 tablet refills:*3 3. aspirin 325 mg po daily rx *aspirin 325 mg 1 tablet(s) by mouth daily disp #*30 tablet refills:*3 4. furosemide 20 mg po daily only take if weight goes up 3 kg. rx *furosemide 20 mg 1 tablet(s) by mouth daily disp #*10 tablet refills:*0 discharge disposition: home with service facility: discharge diagnosis: primary diagnosis: acute systolic heart failure: stress cardiomyopathy secondary diagnoses: hyponatremia (euvolemic, high urine osm) hematoma to upper right medial thigh discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: dear ms. , it was a pleasure taking care of you during your stay at the . you were transferred to the from because of several days of shortness of breath. it had been determined that your heart was not contracting as forcefully as is normal. this caused fluid to back up into your lungs and in turn caused your shortness of breath. we gave you medications to get rid of this excess fluid and help you breathe more easily. furthermore, you received a catheterization later in your hospital course that showed that the contractility of your heart had improved. because you have been laying down in the hospital for so long and in addition because you have fluid in your lungs, you will go home with a physical therapist scheduled to work with you to help regain your strength. in addition, imaging of your leg to look at the size of your bruise showed a fluid collection next to your hernia. you and your primary care physician can discuss this on an office visit. your sodium level was temporarily low, but this resolved with fluid restriction. several of your medications have changed. you can refer to the medication discharge list attached to this form, but in brief: start: metoprolol xl 100mg - this is a medication to help your heart. you were previously taking a lower dose. please increase it to 100mg daily. furosemide (lasix) 20mg daily by mouth only as needed if your daily weight increases 3kg from your weight at discharge from the hospital or if you become short of breath. if you have to take these pills, call dr. office to see if he can see you sooner than your regularly scheduled appointment on (see below). lisinopril 5mg daily- this is a medication to help your heart stop: isosorbide 20mg twice daily change: metoprolol xl 50mg daily to metoprolol xl 100mg by mouth daily when you see your phyisician, please discuss the idea of taking coumadin. we feel this is very important for your rhythm, to prevent clots. followup instructions: name: , b. specialty: primary care/cardiology location: internal medicine associates address: , , , phone: when: thursday, at 3:15pm md, procedure: coronary arteriography using two catheters diagnoses: other primary cardiomyopathies other iatrogenic hypotension congestive heart failure, unspecified unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled hyposmolality and/or hyponatremia atrial fibrillation other specified forms of chronic ischemic heart disease other and unspecified hyperlipidemia other and unspecified angina pectoris unspecified accident acute systolic heart failure contusion of thigh eosinophilia 

Answer: The patient is high likely exposed to