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: ibuprofen / lipitor / scallops attending: chief complaint: transferred from osh major surgical or invasive procedure: percutaneous coronary intervention history of present illness: ms. is a 84 yo female with history of htn, hld, ckd, known lbbb who presented to after waking up at 2am with sudden onset shortness of breath. had 2 other similar episodes that were less intense in the last two weeks. per daughter, patient has been less active in the last 6 months, and especially in the last week. on the night prior to presentation, she felt warm and was sweating, some chills no fevers. previous baseline, pt reports that she is very active, exercises 30 min daily and walks 1 hr daily. . in the ed at ( 4am), pt initially required bipap. 199lbs (90.4kg), 97.6 temp, wbc = 14.4, 110s-120s/50s-60s, hr 70s-80s, bnp 421, bun 27, cr 1.3, tni < .06, per their read cxr right upper and right lower lobe pna with some background edema, started on ceftrixone, azithro (day 1 ). admitted to their icu for bipap. cards was consulted on there who rcommended second set of enzymes. 2nd set of card enzymes at 8am show troponini 2.95, no chest pain, ekg showed ? => started on heparin gtt, asa 325, plavix 300mg, deemed not candidate for cath due to pna and on abx and "even patient refuses" . records "old echo shows ef 35-40%" on had rapid response at when patient complained of right shoulder pain and sob. vitals were 160/90, hr 88-120, rr 30, spo2 98% on nrb, cold/clammy, received duonebs, "ekg showed changes consistent with old ekg" then started on heparin drip and enzymes ordered, "pt refused cardiac cath". on am deemed to require cath at , made aware to dr. . kept on heparin, asa, plavix, beta blockade on transfer. . meds at prior to tx 8am: lasix 40mg po daily, plavix 75mg daily, metoprolol tartrate 25mg , atorva 80, asa 325mg, heparin gtt, pantoprazole 40/day, naproxen 500mg/day, azithro 500mg q 24, ceftriaxone 1gm q 24, ativan .5mg q4:prn labs at am: inr 1.2, ptt 70, wbc 10.3(14.4 on admit), hct 31.9, plt 187, bun 20, cr .9, tni 4.15 <- 1.67 ( pm), . on arrival to the floor, patient was 150/81, hr 96, on nrb 50% sao2 95-100%, rr 22, using accessory muscles but comfortable, would take nrb off to speak but not in full sentences, warm, non toxic, aaox3. daughter at bedside. full code verified. past medical history: htn hld ckd lbbb anemia spinal fusion , daily pt, walks with cane at baseline diverticulosis ligation of left leg vein appendectomy diverticulosis surgery- social history: former nurse, widowed, 6 children, 15 grandchildre, 6 great grandchildren, lives in village non smoker, exposed to second hand smoke from husband for 10 . no alcohol use. family history: parents with mi in their 60s physical exam: admission: vs: t= 98.8 bp= 150/81 hr= 92 rr= 22 o2 sat= 95-100% on nrb general: white caucasian female in nad. oriented x3. mood, affect appropriate. answers all questions. sister at bedside. heent: ncat. sclera anicteric. eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. neck: supple with jvp of cm. cardiac: pmi located in 5th intercostal space, midclavicular line. rr, normal s1, s2. no m/r/g. lungs: on nrb, no chest wall deformities, scoliosis or kyphosis. resp were labored with abdominal breathing. decreased bs b/l, basilar crackels. abdomen: obese, soft, ntnd. no hsm or tenderness. extremities: warm, no edema skin: no stasis dermatitis, ulcers. pulses: right: carotid 2+ femoral 2+ popliteal 1+ dp 1+ pt 1+ left: carotid 2+ femoral 2+ popliteal 1+ dp 1+ pt 1+ discharge: general: white caucasian female in nad. oriented x3. mood, affect appropriate. answers all questions. heent: ncat. sclera anicteric. eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. neck: supple with jvp of cm. cardiac: pmi located in 5th intercostal space, midclavicular line. rr, normal s1, s2. no m/r/g. lungs: ctab, no wheezing, rales, rhonchi. abdomen: obese, soft, ntnd. no hsm or tenderness. extremities: warm, no edema skin: no stasis dermatitis, ulcers. pulses: right: carotid 2+ femoral 2+ popliteal 1+ dp 1+ pt 1+ left: carotid 2+ femoral 2+ popliteal 1+ dp 1+ pt 1+ pertinent results: labs: 01:20am blood wbc-10.1 rbc-3.70* hgb-10.7* hct-33.1* mcv-90 mch-29.1 mchc-32.5 rdw-13.7 plt ct-210 01:20am blood pt-12.7* ptt-70.7* inr(pt)-1.2* 01:20am blood glucose-110* urean-19 creat-1.2* na-146* k-4.2 cl-107 hco3-32 angap-11 01:20am blood ck-mb-9 ctropnt-0.94* probnp-5701* 01:20am blood calcium-8.8 phos-3.3 mg-2.1 . . studies: echo: the left atrium is elongated. there is mild symmetric left ventricular hypertrophy with normal cavity size. there is severe global left ventricular hypokinesis. overall left ventricular systolic function is severely depressed (lvef= 20 %). there is considerable beat-to-beat variability of the left ventricular ejection fraction due to an irregular rhythm/premature beats. a left ventricular mass/thrombus cannot be excluded. right ventricular chamber size is normal. with moderate global free wall hypokinesis. there is abnormal septal motion/position. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. no mitral regurgitation is seen. the estimated pulmonary artery systolic pressure is normal. significant pulmonic regurgitation is seen. there is an anterior space which most likely represents a prominent fat pad. impression: mild symmetric left ventricular hypertrophy with severe global hypokinesis. moderate right ventricular hypokinesis. . cardiac catheterization: 1. selective coronary angiography of this right dominant system demonstrated three vessel coronary artery disease. the lmca had no angiographically-apparent flow-limiting disease. the mid lad had a long 70% stenosis. the ramus was irregular with an 80% stenosis. the mid lcx had a 50% stenosis. there was a subtotal occlusion of the mid rca. 2. resting hemodynamics revealed significantly elevated right and left sided filling pressures with an rvedp of 23 mmhg and pcwp of 36 mmhg. there was significant pulmonary artery systolic hypertension with a pasp of 61 mmhg. the cardiac output and cardiac index were depressed at 3.38 l/min and 1.85 l/min/m2 respectively. there was mildly elevated systemic arterial hypertension with a central aortic pressure of 148/66 mmhg. 3. successful pci of the right coronary artery with a 2.5 x 12mm integrity otw bare metal stent. final angiography revealed no residual in-stent stenosis, no angiographically apparent dissection, and timi 3 flow. final diagnosis: 1. three vessel coronary artery disease. 2. elevated left and right sided filling pressures. 3. elevated pulmonary artery systolic pressure. 4. depressed cardiac output and cardiac index. 5. successful pci of the right coronary artery with bare metal stent placement. brief hospital course: 84 y/o female admitted to for acutely worsening pnd/doe, stay complicated by acute onset chest pain with elevated tni and chronic lbbb changes. transferred to for potential pci in the morning. . # coronaries: acute nstemi/ua given rise in troponin after admission, no prior cath history or cardiac hx, ekg with old lbbb, sinus. no arrhythmia, chest pain non-refractory, hd stable, unclear if chf worsening. non-emergent cath indicated. shwe was started on atorvastatin 80, asa 325 and heparin gtt. she was loaded with plavix (300mg) and continued on 75mg daily. in the cath lab, she was found to have three vessel cad with with 70% stenosis of the mid-lad, 80% stenosis of the ramus, and 99% occlusion of the mid lcx with 50% stenosis. she had elevated right and left sided filling pressures with a rvedp of 23 and pcwp of 36. there was significant pulmonary artery systolic hypertension with a pasp of 61 mmhg. the cardiac output and cardiac index were depressed at 3.38 l/min and 1.85 l/min/m2 respectively. she received a bms to the rca. she was d/c home on the aforementioned medications including metoprolol, lisinopril, plavix, asa, crestor, spironolactone and lasix. # pump: old echo ef 35-40% notes, symptoms (pnd, doe) suggestive of systolic chf decompensation. exam positive for crackles and decreased breathsounds b/l suggestive of overload. cxr here also suggestive of overload. (at home on furosemide 40mg/day and lisinopril 40mg/day, was on lasix 40mg po daily at ). an echo on showed mild symmetric left ventricular hypertrophy with severe global hypokinesis (ef 20%). moderate right ventricular hypokinesis. she was treated with diuresis and her acei was restarted prior to discharge. # acute resp distress - requiring bipap at , currently on nrb, multifactorial, decompensated schf with potentially pna. no h/o copd/asthma or smoking. wbc at 14.4 on admission, 10.4 on transfer, afebrile while at , afebrile here. she had a negative swallow evaluation at osh. on transfer she was on azithro/ceftriaxone for possible cap which could not be excluded on cxr from osh d/t severe pulmonary edema. however, repeat cxr did not show focal consolidation and abx were discontinued. she was treated with nebs prn and diuresis with improved her respiratory status and prior to discharge she was 97-99% on ra and lungs were ctab. # atrial fibrillation - she developed af with rvr treated with metoprolol iv. she was then started on po metoprolol and it was titrated up. she was d/c home on metop xl 200mg daily. due to her chads2 = 3, she was bridged from heparin gtt to coumadin and d/c on lovenox until her inr is therapeutic with a goal inr of . . # sirs (wbc > 12, rr > 20)- pna suggested on cxr at , on abx which were d/c when once diuresed and there was no evidence of focal lung consolidation. in addition, she was afebrile and wbc was down trending on day of discharge. . # htn - chronic, currently normotensive 120s-130s, hr 70s-90s, at home on lasix, verap, lisinopril. on transfer metop 25 added given cardiac injury. she was discharged on metoprolol, lisinopril, spironolactone and lasix. she was scheduled to follow up with dr. in cardiology and with her pcp for hospital . medications on admission: preadmission medications listed are correct and complete. information was obtained from patient. 1. pravastatin 20 mg po daily 2. verapamil 180 mg po q8h 3. furosemide 40 mg po daily hold for sbp < 100, hr < 55 4. lisinopril 20 mg po daily hold for sbp < 100, hr < 55 discharge medications: 1. furosemide 40 mg po daily hold for sbp < 100, hr < 55 2. lisinopril 40 mg po daily 3. aspirin 325 mg po daily rx *aspirin 325 mg one tablet(s) by mouth daily disp #*30 tablet refills:*2 4. rosuvastatin calcium 40 mg po daily rx *rosuvastatin 40 mg one tablet(s) by mouth daily disp #*30 tablet refills:*2 5. clopidogrel 75 mg po daily rx *clopidogrel 75 mg one tablet(s) by mouth daily disp #*30 tablet refills:*2 6. enoxaparin sodium 80 mg sc bid rx *enoxaparin 80 mg/0.8 ml one syringe twice a day disp #*8 syringe refills:*2 7. metoprolol succinate xl 200 mg po daily rx *metoprolol succinate 200 mg one tablet(s) by mouth daily disp #*30 tablet refills:*2 8. spironolactone 12.5 mg po daily rx *spironolactone 25 mg 0.5 (one half) tablet(s) by mouth daily disp #*30 tablet refills:*2 9. tramadol (ultram) 25 mg po q6h:prn back pain rx *tramadol 50 mg 0.5 (one half) tablet(s) by mouth every 6 hours disp #*60 tablet refills:*2 10. warfarin 5 mg po daily16 rx *warfarin 2 mg 2.5 tablet(s) by mouth daily disp #*75 tablet refills:*2 11. outpatient lab work check chem-7 and inr on monday with results to dr. phone: fax: icd9: 428 discharge disposition: home with service facility: discharge diagnosis: acute on chronic systolic congestive heart failure non st elevation myocardial infarction acute on chronic kidney injury atrial fibrillation with rapid ventricular response discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - requires assistance or aid (walker or cane). discharge instructions: dear ms. , it was a pleasure taking care of you at . you were transferred from after having a heart attack and trouble breathing. you needed a stent to open one of the arteries in your heart. you will need to take aspiring and plavix every day for at least one month and probably longer. do not stop taking aspirin and plavix or miss unless dr. says that it is ok. your heart was found to be weaker and fluid had backed up into your lungs making it hard to breathe. you received intravenous lasix and 7 pounds of fluid was removed. your weight at discharge is 192 pounds. you will need to weigh yourself every day in the morning and call dr. if weight increases more than 3 pounds in 1 day or 5 pounds in 3 days. you were started on warfarin (coumadin) to prevent a blood clot/stroke because of the atrial fibrillation. you heart is now in a regular rhythm but you are still at risk for a stroke and for the atrial fibrillation to return. dr. will tell you how much warfarin to take every day. minor bleeding such as bleeding gums, bleeding hemmorrhoids or nosebleeds are common on warfarin. please call dr. if not notice your stool is black or red, you feel weak or dizzy or you have bruising that is getting worse. followup instructions: name: , location: internal medicine associates address: , , , phone: appointment: thursday 2:15pm *please bring your insurance cards and a photo id with you to this appointment. name: , g. location: group- primary care address: , , phone: appointment: thursday 3:30pm procedure: insertion of non-drug-eluting coronary artery stent(s) coronary arteriography using two catheters left heart cardiac catheterization cranial or peripheral nerve graft insertion of one vascular stent excision of lingual thyroid percutaneous transluminal coronary angioplasty [ptca] procedure on single vessel diagnoses: subendocardial infarction, initial episode of care anemia, unspecified coronary atherosclerosis of native coronary artery congestive heart failure, unspecified acute kidney failure, unspecified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified atrial fibrillation chronic kidney disease, unspecified other and unspecified hyperlipidemia other acquired absence of organ other left bundle branch block other postprocedural status acute on chronic systolic heart failure arthrodesis status 

Answer: The patient is high likely exposed to