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: sulfa (sulfonamides) attending: chief complaint: diffiuculty speaking, right arm weakness major surgical or invasive procedure: iv t--esophageal echocardiogram carotid duplex history of present illness: ms. is a 67 yo rh female with hx of smoking, htn, hypothyroid (due to radio iodine thyroid ablation), high cholesterol who was transfered from to tonight after she was given iv t-pa for an acute stroke. she was transfered due to lack of icu beds at oh. she says that she has been feeling unwell for several days. she complained of malaise and productive cough during this time. she had an episode of nausea and vomiting last night. today, at 6:00pm-she had witnessed onset of non-fluent aphasia and right arm weakness. she was wrapping presents when she noticed that she was drooling from her mouth. when she reached for a tissue, she could not pick it up with her right hand due to clumsiness/weakness. she also felt a "tingling" sensation in her right hand (which she mentions that she has had intermittently over last 2 weeks). when her son asked her what was wrong, she could not respond. she was trying to speak and knew what she wanted to say, but could not say the words. she had no difficulty with comprehension. she kept repeating "no" when she tried to speak and was very frustrated by her inability to communicate. she denied visual symptoms, numbness, leg weakness, difficulty walking, dyphagia. she was taken to . en route, her weakness and speech improved. on arrival bp 182/93 hr 104 rr 18. she was evaluated by neurology and sent for ct scan. after the ct, her speech deteriorated. she was noted to have wrod finding difficulty, flat right nlf, intact strength and extinction of dss on right. head ct was negative for acute bleed/infarct. labs including coags were normal. stool was negative for heme. she was administered ivt-pa at 7:36 pm. bolus of 6mg given, followed by infusion of 57mg over an hour. during infusion of t-pa, her speech improved and returned to baseline. she was transfered to without further events. on review of systems, she denies fever/chills. she denies sob, cp, palpitaions, abdominal pain, or dysuria. social history: + current smoker ppd x many yrs rare etoh, no drugs is a librarian. lives with her son (30 yrs old) family history: no hx of stroke father:cad - mi in 50's physical exam: t 99.1 hr87 bp173/100 rr16 o2 sat 100% gen: sitting on er stretcher, nad neck: supple, normal rom, no thyromegaly, no carotid bruit cv: regular, nl s1 and s2, no 2/6 sem at lsb(no radiation) lung: clear to auscultation bilaterally abd: +bs soft, nontender ext: no edema neurologic examination: mental status: alert, oriented x3. attentive, says backwards in <30 seconds. speech is fluent, comprehension intact, able to repeat and name. no dysarthria. able to read and describe a picture. no evidence of apraxia (toothbrushing) or neglect. cranial nerves: visual fields full to confrontation testing, pupils equally round and reactive to light, 3 to 2 mm bilaterally. gaze midline and conjugate. extraocular movements intact bilaterally without nystagmus. mild right ptosis (old per pt). sensation intact v1- v3 to lt. slight right nlf flattening. hearing intact to finger rub bilaterally. sternocleidomastoid and trapezius normal bilaterally. tongue midline. no fasciculations. motor: normal bulk bilaterally. tone normal. no adventitious movements. ? right pronator drift. power throughout sensation: intact to lt, pin, proprioception, temperature and vibration throughout. no extinction to dss. intact stereognosis. reflexes: b t br pa ach right 2 2 2 2 2 left 2 2 2 2 2 toes were neutral on the right, down on the left coordination: finger to nose task performed accurately, heel to shin normal, normal. pertinent results: 12:20pm blood wbc-6.2 rbc-4.40 hgb-14.0 hct-41.2 mcv-94 mch-31.8 mchc-34.0 rdw-13.3 plt ct-236 12:20pm blood plt ct-236 12:20pm blood pt-12.4 ptt-24.4 inr(pt)-1.0 12:20pm blood glucose-100 urean-18 creat-0.9 na-144 k-4.4 cl-107 hco3-27 angap-14 04:50am blood ctropnt-<0.01 09:59pm blood ck-mb-3 ctropnt-<0.01 04:50am blood ck(cpk)-64 09:59pm blood ck(cpk)-84 04:50am blood %hba1c-6.5* 04:50am blood triglyc-203* hdl-51 chol/hd-3.7 ldlcalc-99 brain mri: on diffusion images, a subtle area of increased signal in the right parietal cortical region with subtle areas of increased signal in the subcortical region. there are no definite abnormalities seen in this region on flair images. the subtle abnormalities could be artifactual, but given the patient's clinical history of aphasia, early infarct cannot be excluded. consider a follow/up examination if the patient's neurologic findings persist. no mass effect or midline shift is seen. the ventricles are normal in size. mra of the head: the heart mra demonstrates normal flow signal within the arteries of anterior and posterior circulation. echo (trans-esophageal) 1. no spontaneous echo contrast or thrombus is seen in the body of the left atrium or small left atrial appendage. no atrial septal defect or patent foramen ovale is seen by 2d, color doppler or saline contrast with maneuvers. the interatrial septum is markedly lipomatous. 2.left ventricular wall thickness, cavity size, and systolic function are normal (lvef>55%). no masses or thrombi are seen in the left ventricle. 3.right ventricular chamber size and free wall motion are normal. 4.there are complex (>4mm), pedunculated, mobile atheroma in the aortic arch. there are simple atheroma in the descending thoracic aorta. 5.the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic regurgitation. no masses or vegetations are seen on the aortic valve. 6.the mitral valve appears structurally normal with trivial mitral regurgitation. no mass or vegetation is seen on the mitral valve. 6.no vegetation/mass is seen on the pulmonic or tricuspid valves. impression: normal biventricular function. markedly lipomatous interatrial septum. there is no evidence of an asd or pfo. there are complex (>4mm), pedunculated, mobile atheroma in the aortic arch and simple atheroma in the descending thoracic aorta. carotid duplex left carotid stenosis >90% right ica stenosis <40% ( ) brief hospital course: 67 yo female with multiple vascular risk factors who p/w acute right ue weakness and non-fluent aphasia. was given iv t-pa 1.5 hours after onset of symptoms. her neuro exam now shows only mild right nlf flattening. 1. neuro: new stroke, s/p iv t-pa at 7:30pm , she was admitted to the neuro-icu for neurologic and blood pressure monitoring. mri/mra was done which showed several areas of restricted diffusion in the left parietal lobe (likley from lysis of mca clot). mra was normal. asa 325mg qd was started 24 hours after t-pa. tee was done to evaluate for intracardiac source. echo revealed multiple, complex, >4mm atheromatous plaques in the aorta. a carotid us showed >90% left ica stenosis. she was evalauted for placement of left carotid stent vs endarterectomy. decision was made to pursue carotid stenting and she was scheduled for the procedure next week. she was continued on lipitor, dose was increased to 40mg qd. 2. cv: she was ruled out for mi with negative cardiac enzymes. no events on telemetry. she was continued on statin, dose was increased. tee showed multiple, mobile atheromatous plaques. 3. endo: tsh was wihtin normal limits, she was continued on synthroid. hba1c was mildly elevated-she should continue to maintain a low sugar, diabetic diet 8. smokoing cessation: risks of smoking discussed and smoking cessation aids were offered. medications on admission: sythroid zetia avapro discharge medications: 1. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed. disp:*30 tablet(s)* refills:*0* 2. levothyroxine sodium 75 mcg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 3. pantoprazole sodium 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). disp:*30 tablet, delayed release (e.c.)(s)* refills:*2* 4. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 5. lisinopril 5 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 6. atorvastatin calcium 40 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 7. clopidogrel bisulfate 75 mg tablet sig: one (1) tablet po daily (daily): take two tablets tomorrow (), and one pill daily thereafter. disp:*30 tablet(s)* refills:*2* discharge disposition: home discharge diagnosis: cerebral infarction (left mca s/p iv-tpa) htn hyperlipidemia carotid stenosis complex, mobile atheromatous plaques in the aortic arch discharge condition: improved, no neurologic deficit discharge instructions: you will be discharged on a new medication regimen. please take plavix, two pills tomorrow, and one pill per day thereafter. you should also take one aspirin daily. please keep your follow up appointments. carotid stenting is scheduled for report to clinical center (same day surgery) at 1230. nothing to eat, drink, smoke, chew after midnight on the 3rd, however, please taking morning medication including aspirin and plavix with small sip of water; if questions, call dr assistant, , . followup instructions: 1. dr. at 10:00am 2. please call to make an appointment to see dr. in 2 months 3. carotid stenting: clinical center . md, procedure: diagnostic ultrasound of heart diagnoses: unspecified essential hypertension other and unspecified hyperlipidemia cerebral artery occlusion, unspecified with cerebral infarction iodine hypothyroidism 

Answer: The patient is high likely exposed to