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 year old female with a history of congestive heart failure, coronary artery disease, reported myocardial infarction, transferred to from after being intubated there for respiratory distress. the patient had been admitted to four weeks ago and had reportedly ruled in for myocardial infarction there and refused further intervention. after discharge, the patient had tried treatment with sublingual nitroglycerin but had recurrent and more frequent anginal episodes. the patient also had been discharged on bumex but had skipped doses. in the past day prior to admission, the patient had increasing symptoms of congestive heart failure including paroxysmal nocturnal dyspnea as well as increasing angina not relieved by sublingual nitroglycerin. the patient was taken to . initial blood pressure there was 200/79. the patient received 4 mg of morphine, 100 mg intravenous lasix, intravenous nitroglycerin, bumex 2 mg with no improvement. chest x-ray done there showed congestive heart failure. electrocardiogram done there showed left bundle branch block, heart rate in the 120s. the patient was intubated with subsequent drop in her blood pressure to 104/44. the patient was then transferred to for ccu evaluation. past medical history: 1. aortic stenosis and insufficiency. 2. recurrent pneumonia. 3. status post total abdominal hysterectomy. 4. left bundle branch block. 5. congestive heart failure. medications on admission: 1. aspirin 81 mg p.o. once daily. 2. isordil 45 mg p.o. three times a day. 3. digoxin 0.125 mg p.o. once daily. 4. bumex 2 mg p.o. once daily. allergies: penicillin. social history: no tobacco, no alcohol. family history: no coronary artery disease as per husband. physical examination: on physical examination, vital signs revealed temperature of 97.4, pulse 76, blood pressure 127/36, respiratory rate 10, ot 100% on ventilator assist control, tidal volume 500, respiratory rate 10, peep 8, fio2 0.6. generally, an elderly female intubated, sedated and unresponsive. head, eyes, ears, nose and throat examination - dry mucous membranes. the pupils are equal, round, and reactive to light and accommodation. neck - increased jugular venous distention, no carotid bruit. cardiovascular - iii/vi diamond shaped murmur at right upper sternal border, iii/vi diastolic decrescendo murmur at right upper sternal border, positive parasternal heave. pulmonary - coarse breath sounds anteriorly. abdomen is soft, nondistended, nontender. patches of dry skin. decreased bowel sounds. extremities - 1+ lower extremity edema, warm, 2+ dorsalis pedis pulses bilaterally. laboratory data: white blood cell count 12.5, hematocrit 32.0, platelet count 134,000, 89% neutrophils, 6% lymphocytes. chem7 revealed sodium 140, potassium 5.2, chloride 107, bicarbonate 21, blood urea nitrogen 39, creatinine 1.6, gap 12.0, glucose 239. digoxin level 1.9. prothrombin time 14.0, partial thromboplastin time 33.0, inr 1.4. ck 88. chest x-ray showed bilateral pulmonary edema, right layer diffusion, left lower lobe consolidation. electrocardiogram showed normal sinus rhythm at 74 beats per minute, left bundle branch block, increased q-tc interval, st depression and t wave inversions in i, avl, v5 and v6. initial assessment: a year old female with aortic valve disease who comes to with respiratory decompensation, most likely due to poor cardiac forward flow and also with left lower lobe pneumonia. hospital course: 1. cardiovascular - pump - the patient is known to have both aortic insufficiency and aortic stenosis. the patient was diuresed to decrease pulmonary edema and to decrease afterload. blood pressure was initially supported with dopamine but this was able to be weaned easily. the patient had an echocardiogram on , which showed a left ventricular ejection fraction of less than 20%, elongated left atrium, severe symmetric left ventricular hypertrophy, overall severely depressed left ventricular systolic function, small right ventricular cavity, markedly dilated ascending aorta, severe 4+ aortic regurgitation and moderate to large size pericardial effusion with right ventricular compression and sustained right atrial collapse consistent with elevated pericardial pressure or tamponade. upon further investigation, it was discovered that this pericardial effusion had been present for several years and it was not drained as per patient request. the patient also refused a coronary catheterization. the patient also refused swan-ganz catheter monitoring to see if she had tamponade physiology. beta blockers were avoided as this patient has aortic insufficiency. the patient was started on an ace inhibitor and was switched to imdur and was placed on a daily dose of lasix. rhythm - the patient was monitored on telemetry. no significant events were noted. coronary - the patient refused catheterization so thus unsure of coronary status. the patient most likely has coronary artery disease. the patient was kept on aspirin. the patient was initially placed on heparin and this was soon discontinued. 2. pulmonary - the patient was intubated for pulmonary edema and effusion and pneumonia with decreased respiratory status. the patient was treated with diuresis and levofloxacin. the patient was able to be weaned off ventilation on hospital day two with no ill effects. the patient continued to improve her oxygen saturation throughout her hospital course and was able to tolerate room air by the time of discharge. 3. infectious disease - the patient was treated empirically for community acquired pneumonia with levofloxacin. the patient did receive a dose of ceftriaxone on day one. overall course, the patient was able to be extubated and weaned off all pressors after diuresis and initiation of antibiotic therapy. the patient was able to work with physical therapy and was felt to be ready for discharge to a nursing facility by the end of hospital course. discharge diagnoses: 1. pulmonary edema secondary to congestive heart failure. 2. severe aortic insufficiency. 3. pericardial effusion. 4. left lower lobe pneumonia. 5. left bundle branch block on electrocardiogram. medications on discharge: 1. imdur 30 mg p.o. once daily. 2. lisinopril 20 mg p.o. once daily. 3. lasix 40 mg p.o. once daily. 4. potassium chloride 20 meq p.o. once daily. 5. aspirin, enteric coated, 325 mg p.o. once daily. 6. levofloxacin 250 mg p.o. once daily until , and then stop. 7. colace 100 mg p.o. twice a day, hold for loose stools. 8. heparin 5000 units subcutaneous q12hours. 9. tylenol 325 mg to 650 mg p.o./pr q4-6hours p.r.n. condition on discharge: good. discharge status: to nursing facility on . the patient is to call primary care physician and cardiologist for follow-up appointments. cardiologist faxed over copy of electrocardiogram and echocardiogram reports. , m.d. dictated by: medquist36 procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours insertion of endotracheal tube diagnoses: pneumonia, organism unspecified coronary atherosclerosis of native coronary artery congestive heart failure, unspecified aortic valve disorders acute myocardial infarction of unspecified site, subsequent episode of care 

Answer: The patient is high likely exposed to