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 known allergies / adverse drug reactions attending: chief complaint: dry heaves, right-sided neck pain and hypotension major surgical or invasive procedure: cardiac cath history of present illness: 88-year-old female w/ htn, hl, dm 2 who was admitted with dry heaves and right- sided neck pain to . she was seen initially seen by neurology, dr. , who diagnosed her with multifactorial cervical degenerative joint disease with resultant cervical radiculopathy. he recommended gabapentin and lidoderm patch if tolerated. however, the patient's renal function started to deteriorate. her creatinine went from 1.4 to 2.2 and then to 2.7. her bun rose to 34, anion gap rose to 16, and her lactic acid level was 5.0. in addition, her liver function worsened with alt going up from 87 to 189 despite her abdominal ultrasound not showing any true liver disease. there was some trace free fluid in the abdomen and right pleural effusions but nothing acute. her chest x-ray showed a right-sided pleural effusion. her white count did go up from 8.9 to 11.8 despite being on empiric antibiotics. there was no true source of infection identified. her ua was negative. there was no infiltrate. her blood cultures were taken and are pending. her glucose was out of control in the mid 200 range. lantus was added despite her fasting. the patient's overall clinical status deteriorated. her blood pressure continued to trend down into the high 80s. her troponin t was sent which was 3.42 and creatine kinase was 377. her ekg was difficult to interpret given her paced status. her hemoglobin was stable at 12.3, potassium 5.3. b12, tsh, and folate were normal. she was treansferred to on heaprin drip. . on review of systems, s/he denies any prior history of stroke, tia, deep venous thrombosis, pulmonary embolism, bleeding at the time of surgery, hemoptysis, black stools or red stools. s/he denies recent fevers, chills or rigors. s/he denies exertional buttock or calf pain. all of the other review of systems were negative. past medical history: 1. diabetes type 2 complicated by neuropathy. 2. sah bilateral frontal with hemorrhagic contusion. 3. djd of the c-spine. 4. vertigo. 5. hypertension. 6. orthostatic hypotension, 7. pacemaker for sick sinus syndrome/afib. 8. dyslipidemia. 9. skin cancer status post mohs. 10. left mastectomy. 11. hypertension. 12. depression. 13. hearing loss social history: she lives in independent living in village. she was just recently at rehab in . she is usually independent with her adls. no smoking, no alcohol or drugs. family history: non-contributory physical exam: on admission: general: oriented x3. mood, affect appropriate. appears to be in dpain and distress heent: ncat. sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. no xanthalesma. neck: supple with jvp not visualised. cardiac: pmi located in 5th intercostal space, midclavicular line. rr, normal s1, s2. no m/r/g. no thrills, lifts. no s3 or s4. heart sounds were muffled overall. 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: no c/c/e. no femoral bruits. skin: no stasis dermatitis, ulcers, scars, or xanthomas. neuro: aaox3, cnii-xii intact, 5/5 strength biceps, triceps, wrist, knee/hip flexors/extensors, 2+ reflexes biceps, brachioradialis, patellar, ankle. 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: abgs 11:29pm blood type-art po2-119* pco2-23* ph-7.07* caltco2-7* base xs--22 12:55am blood type-art po2-84* pco2-32* ph-7.13* caltco2-11* base xs--17 04:49am blood type-central ve temp-34.4 po2-29* pco2-38 ph-7.15* caltco2-14* base xs--16 intubat-not intuba 06:48am blood type- po2-33* pco2-46* ph-7.06* caltco2-14* base xs--18 10:15am blood type- po2-158* pco2-43 ph-7.17* caltco2-17* base xs--12 comment-peripheral 10:43am blood type-art po2-175* pco2-34* ph-7.03* caltco2-10* base xs--21 12:24pm blood type-art po2-226* pco2-28* ph-7.08* caltco2-9* base xs--20 03:57pm blood po2-230* pco2-28* ph-7.04* caltco2-8* base xs--22 05:38pm blood type-art po2-216* pco2-17* ph-7.08* caltco2-5* base xs--23 lactate 11:29pm blood lactate-9.6* 12:55am blood glucose-174* lactate-9.6* na-136 k-5.4* cl-108 04:49am blood lactate-6.7* 06:48am blood lactate-8.5* 10:15am blood lactate-13.4* k-5.6* 10:43am blood glucose-187* lactate-14.6* na-138 k-4.4 cl-109* 03:57pm blood lactate-19.3* chemistry 10:15pm blood glucose-157* urean-44* creat-2.9* na-134 k-7.0* cl-109* hco3-8* angap-24* 04:00am blood glucose-204* urean-50* creat-3.1* na-137 k-6.0* cl-103 hco3-13* angap-27* 06:39am blood glucose-203* urean-49* creat-2.9* na-142 k-6.4* cl-103 hco3-11* angap-34* 10:34am blood glucose-212* urean-41* creat-2.4* na-142 k-4.7 cl-105 hco3-8* angap-34* 12:10pm blood glucose-225* na-140 k-5.3* cl-109* hco3-7* angap-29* 05:40pm blood glucose-304* urean-43* creat-2.9* na-141 k-5.7* cl-100 hco3-11* angap-36* cbc 10:15pm blood wbc-13.1* rbc-4.08* hgb-12.5 hct-42.6 mcv-104* mch-30.5 mchc-29.2* rdw-16.0* plt ct-295 05:36pm blood wbc-10.9 rbc-3.05*# hgb-9.5* hct-32.9* mcv-108* mch-31.1 mchc-28.8* rdw-16.4* plt ct-173 cardiac cath 1. selective coronary angiography in this right-dominant system demonstrated one-vessel and branch vessel disease. the lmca was patent. the lad had mild plaquing and a large diagonal branch had a focal 70% stenosis with normal flow. the distal lad had an intramyocardial segment. the lcx had a 40% proximal stenosis and a large obtuse marginal branch had a 70% stenosis. the rca was totally occluded after the first acute marginal branch. 2. resting hemodynamics revealed elevated right- and left-sided filling pressures, with an rvedp of 25 mm hg and a pcwp of 32 mm hg. there was moderate pulmonary arterial systolic hypertension, with a pasp of 42 mm hg. the cardiac index was depressed at 1.4 l/min/m2. the systemic arterial blood pressure was normal on three vasopressors. there was no gradient upon pullback of the catheter from the left ventricle to the aorta. 3. successful iabp placement via the left common femoral artery with improvement of cardiac index to 2.2 l/min/m2. final diagnosis: 1. one vessel coronary artery disease. 2. elevated left- and right-sided filling pressures. 3. cardiogenic shock. 4. successful iabp placement. tte the left atrium is normal in size. left ventricular wall thicknesses and cavity size are normal. due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. overall left ventricular systolic function is low normal (lvef 50%). the right ventricular cavity is markedly dilated with severe global free wall hypokinesis. there is abnormal septal motion. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic stenosis or aortic regurgitation. the mitral valve leaflets are mildly thickened. no mitral regurgitation is seen. there is no pericardial effusion. impression: suboptimal image quality. markedly dilated right ventricular cavity with severe global free wall hypokinesis c/w acute pulmonary process (e.g., pulmonary embolism or primary right ventricular process (infarction or cardiomyopathy). normal left ventricular systolic function with low normal systolic function. brief hospital course: 88f w/ htn, hl, dm2 who presented w/ hypotension and from . on arrival to ccu, was found to be hypotensive to the 80s, and hypothermic. creatinine had risen from 1.4 at osh to 2.9 on presentation here. bedside tte showed markedly dilated right ventricular cavity with severe global free wall hypokinesis. given echo findings and her elevated but downtrending cardiac enzymes, she most likely had a missed rca infarct. cta unable to be done to evaluate for pe given renal function, was started empirically on heparin drip. she was started on dopamine drip initially with some stabilization of bp. vancomycin and cefepime were started given sepsis as possible cause of her hypotension and hypothermia. her bp did not improve, lactate continued to rise, acidosis unable to be corrected. patient received multiple amps of sodium bicarbonate, was placed on sodium bicarbonate drip. crrt was started in attempt to correct electrolyte abnormalities, dialysate changed to include sodium bicarbonate in attempt to fix acidosis. blood ph did not respond to any of these measures. patient quickly became progressively hypotensive to the 40's and bradycardic to the 30's. a second and third pressor was started, multiple pushes of bicarbonate were given, and ep was called to changed her pacer so that she was be paced at a pace of 100. family meeting was held by the ccu team with attending present. decision was made to go for right and left heart catheterization, which showed that she was in cardiogenic shock, with elevated left and right filling pressures. her coronaries had one vessel disease. cardiac index was depressed at 1.4 l/min/m2, so iabp was placed, with improvement of ci to 2.2. patient transferred back to ccu, patient found to have runs of vt during which iabp would not be able to synchronize with her heart rate, resulting in severe drops in her bp despite pressor support. received amiodarone boluses and started on amiodarone drip, but still with breakthrough episodes of vt. again, multiple pushes of sodium bicarbonate were administered, along with calcium and magnesium, but without any improvement in ph. repeat family meeting was held with the ccu attending. decision was made by family to stop all aggressive measures. pressors, crrt, and ventilator were discontinued. ep turned off the pacer. family was at bedside after patient was pronounced, they declined autopsy. patient passed away at 6:15 pm on . medications on admission: 1. alaway 1 drop every 12 hours. 2. altace 110 mg p.o. daily. 3. amlodipine 2.5 mg p.o. daily. 4. celexa 10 mg p.o. daily. 5. clonazepam 0.5 mg p.o. daily as needed. 6. humulin regular as directed sliding scale. 7. lantus 0.2 ml daily at bedtime, that is 20 units. 8. lipitor 40 mg p.o. at bedtime. 9. metformin 500 mg p.o. b.i.d. 10. timolol 1 drop every day. 11. tricor 145 mg p.o. daily. 12. wellbutrin sr 150 mg p.o. daily. discharge medications: expired discharge disposition: expired discharge diagnosis: myocardial infarction discharge condition: expired discharge instructions: expired followup instructions: expired md, procedure: combined right and left heart cardiac catheterization coronary arteriography using two catheters hemodialysis venous catheterization for renal dialysis aortography implant of pulsation balloon arteriography of pulmonary arteries diagnoses: acidosis hyperpotassemia coronary atherosclerosis of native coronary artery acute kidney failure, unspecified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified other chronic pulmonary heart diseases personal history of malignant neoplasm of breast diabetes with neurological manifestations, type ii or unspecified type, not stated as uncontrolled polyneuropathy in diabetes chronic kidney disease, unspecified paroxysmal ventricular tachycardia other and unspecified hyperlipidemia disorders of phosphorus metabolism cardiogenic shock acute myocardial infarction of unspecified site, initial episode of care fitting and adjustment of cardiac pacemaker chronic total occlusion of coronary artery cervical spondylosis without myelopathy 

Answer: The patient is high likely exposed to