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: patient recorded as having no known allergies to drugs attending: chief complaint: new afib major surgical or invasive procedure: none history of present illness: this is a 89 f w/ pmh of recent admission for lower gi bleed, hypothyroidism, p/w doe and new afib. she has noticed an irregular hr since about monday and had experienced increased doe, although she does have this at baseline. she went to see her pcp today for previously-scheduled visit after recent admission. he did an ekg which showed afib so he sent her to the ed. no cp. + mild sob at rest but she thinks she has this baseline from years of smoking. no pnd or orthopnea. she thinks she has had intermittent afib for ? yrs. . in the ed, initial vitals 97.9, 132/69, 98, 18 96% on ra. had cta given elevated d-dimer but no pe. admitted for new afib and new doe. bedside u/s tr ant effusion past medical history: 1. depression. 2. hypothyroidism. 3. history of bleeding ulcers 30 years ago. 4. hysterectomy for uterine cancer. 5. cataract surgery. 6. hernia surgery. 7. oa 8. tia - tmb on r 9. recent lower gi bleed 10. diverticulosis social history: she is widowed. her husband was an ophthalmologist on-staff here at . she lives alone but has help every day. she walks with a walker. quit smoking 1 yr ago but smoked ppd x 70 yrs. rare etoh. family history: her mother deceased at the age of 89, was healthy. her father deceased at the age of 97, was healthy. her brother had heart disease and died at the age of 80. her sons and daughters are alive and healthy in their 50s. physical exam: vitals: t: 98.3 p: 108 bp: 135/82 r: 16 sao2: 96% on 3l general: awake, alert, nad. heent: nc/at, perrl, eomi without nystagmus, no scleral icterus noted, mmm, no lesions noted in op neck: supple, no jvd appreciated pulmonary: bibasilar crackles cardiac: irreg, tachy, nl. s1s2, no m/r/g noted abdomen: soft, nt/nd, normoactive bowel sounds, no masses or organomegaly noted. extremities: trace pedal edema, 2+ radial, dp and pt pulses b/l. skin: no rashes or lesions noted. neurologic: -mental status: alert, oriented x 3. able to relate history without difficulty. -motor: normal bulk, strength and tone throughout. no abnormal movements noted. pertinent results: mb: 3 trop-t: <0.01 . d-dimer: 1320 . trop-t: <0.01 comments: ctropnt: ctropnt > 0.10 ng/ml suggests acute mi . 141 105 17 ------------< 115 3.7 24 0.7 . ck: 62 mb: notdone trop-t: <0.01 . tsh:0.31 other blood chemistry: probnp: 2901 mcv 77 . 7.5 > 9.5 < 286 --------------- 31.5 n:76.1 l:16.8 m:6.2 e:0.5 bas:0.3 . echo: the atria are moderately dilated. there is mild symmetric left ventricular hypertrophy with normal cavity size and regional/global systolic function (lvef>55%). tissue doppler imaging suggests an increased left ventricular filling pressure (pcwp>18mmhg). diastolic function could not be reliably assessed because of atrial fibrillation. right ventricular chamber size and free wall motion are normal. the ascending aorta is mildly dilated. 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. mild to moderate (+) mitral regurgitation is seen. moderate tricuspid regurgitation is seen. there is moderate pulmonary artery systolic hypertension. there is no pericardial effusion. impression: mild symmetric left ventricular hypertrophy with preserved global and regional biventricular systolic function. mild-moderate mitral regurgitation. moderate tricuspid regurgitation. moderate pulmonary hypertension. . cta chest: impression: 1. no evidence of pulmonary embolism or aortic dissection. 2. marked left and right atrial enlargement, likely related to tricuspid and mitral valve pathology, perhaps on the basis of rheumatic heart disease, as evidenced by moderate mitral annular calcification; the marked left atrial enlargement could certainly account for atrial fibrillation (is this truly "new"?). 3. mild-to-moderate background centrilobular emphysema. 1-2 mm left upper lobe pulmonary micronodule with high probability of being benign; in this patient of advanced age, ct follow-up is likely not necessary. 4. small left pleural effusion and mild interstitial edema. . egd w/ small hiatal hernia . colonoscopy: flat lesions a single medium angioectasia was seen in the cecum measuring 1.5cm.the angioectasia was cauterized with good hemostasis.there was slight oozing upon cauterization that was successfully controlled. excavated lesions multiple diverticula were seen in the sigmoid and descending colon.diverticulosis appeared to be of moderate severity. brief hospital course: 89 f with hypothyroidism, h/o gib bleeds who presented with afib w/ rvr and dyspnea and developed melena and acute blood loss anemia after aspirin started for afib. patient had a micu stay for the gib. hospital course summarize below. patient was found to be in afib on admission. she was rate controlled with metoprolol and started on aspirin only after long discussion given her recent hospitalization for gib. she has a h/o tia and it was thought that maybe she had paf and would benefit from anticoagulation over the risk. after being on aspirin, she developed melana on and acute blood loss anemia with a nadar hct of 21. she received 7 units of prbc in the micu before her hct stabilized at 27. she was transferred to the medical floor at this point. she was prepped and had a colonoscopy which showed an oozing avm in the cecum which was cauderized. she was given 1 more unit of prbc (total 8units) to bring hct up to 30. she will need gi follow up. (during last recent admission for gib, she was treated with cauderization of another avm in the cecum. an egd then showed no source of bleeding.) . # afib: as above, this was thought to be likely paroxysmal given her history of tia. she could not have a cardioversion as it was thought the paf was going on for at least one week. the cause of her afib is likely atrial dilitation secondary to lung disease from tobacco use. she was started on aspirin only given her history of gib (rather than coumadin), but as above, this was complicated by another gib. she was initially rate controlled with metoprolol which was discontinued in the setting of the gib and restarted once that was stable. she likely can not be anticoagulated in the near future. this issue of anticoagulation should be addressed as an outpatient. metoprolol was restarted once bleeding was stabilized. she was discharged on metoprolol 25mg tid. . # dyspnea: mild acute on chronic diastolic chf on exam initially was likely from afib with rvr. cta in the ed ruled out pe, but did show some emphysema. echo suggested chronic diastolic dysfunction. again the bb will help the cardiac function. no acei given no systolic dysfunction and bp range around 100 systolic. furosemide was started to help control her fluid status (20mg every other day). . # acute blood loss anemia: as above. hct stable at around 30 at time of discharge. she also given iron at discharge to help with the iron deficiency componenet of her anemia. . # hypothyroidism: continued levothyroxine . # depression: continued fluoxetine discharged home with pt after pt eval. code: full . comm: (daughter) office; cell; . medications on admission: 1. fluoxetine 20 mg capsule sig: one (1) capsule po daily (daily). 2. levothyroxine 100 mcg tablet sig: one (1) tablet po daily (daily). 3. protonix 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po once a day. disp:*30 tablet, delayed release (e.c.)(s)* refills:*2* discharge medications: 1. levothyroxine 100 mcg tablet sig: one (1) tablet po daily (daily). 2. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 3. ferrous sulfate 325 mg (65 mg iron) tablet sig: one (1) tablet po daily (daily). 4. furosemide 20 mg tablet sig: one (1) tablet po every other day (every other day). disp:*15 tablet(s)* refills:*2* 5. metoprolol tartrate 25 mg tablet sig: one (1) tablet po tid (3 times a day). disp:*90 tablet(s)* refills:*2* 6. fluoxetine 20 mg tablet sig: one (1) tablet po once a day. discharge disposition: home with service facility: homecare discharge diagnosis: primary diagnosis: atrial fibrillation acute blood loss anemia angioectasia in the cecum acute on chronic diastolic congestive heart failure secondary diagnosis: diverticulosis hypothyroidism h/o transient ischemic attack discharge condition: hemodynamically stable. ambulatory. discharge instructions: you were admitted with atrial fibrillation and shortness of breath and received diuresis to remove fluid. you were also started on a beta blocker to help control your heart rate and lasix to control the fluid. please take your medications as prescribed. often with atrial fibrillation, patients need blood thinners. you have had significant bleeding complications while on coumadin in the past and aspirin this time. you should discuss this further with your cardiologist, gastroeneterologist and pcp. . you had bleeding while on aspirin, which was likely from the avm found in your colon. you had colonoscopy and the gi doctors were to hopefully stop the bleeding. you had 8 units of prbcs to bring your blood levels back up. . please seek medical attention immediately if you develop increased shortness of breath, fever, chest pain, bleeding or any other concerning symptoms. followup instructions: please make a follow-up appointment with , s. within the next week. . previously scheduled appointments: provider: , md phone: date/time: 11:30 provider: ,room gi rooms date/time: 11:30 provider: , m.d. phone: date/time: 11:45 md, dmd procedure: endoscopic destruction of other lesion or tissue of large intestine transfusion of packed cells diagnoses: urinary tract infection, site not specified congestive heart failure, unspecified acute posthemorrhagic anemia unspecified acquired hypothyroidism atrial fibrillation acute on chronic diastolic heart failure personal history of malignant neoplasm of other parts of uterus other emphysema angiodysplasia of intestine with hemorrhage diverticulosis of colon (without mention of hemorrhage) salicylates causing adverse effects in therapeutic use 

Answer: The patient is high likely exposed to