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: a.c.e inhibitors attending: chief complaint: respiratory failure major surgical or invasive procedure: 1. intubation 2. a-line history of present illness: yof russian speaking only w/ h/o mi x 3, s/p stemi 10/rca stents placed, ddd pacer who presents now with respiratory failure from rehab. per rehab staff, patient had been in her usual state of health when she became hypertensive to sbp 190's, hr in, sating in 80's requiring nonrebreathing, became unresponsive and was then intubated. in the field, patient was given iv lasix 40mg and narcan. . in ed, creatinine 2.2, ph 7.17, hco3 18, trop 0.06, lactate 2.1. cxr consistent with pulmonary congestion/chf exacerbation. she became hypotensive in the sbp 70's with increase in propofol. patient also on nitro gtt. she was then transferred to the ccu for further management. past medical history: 1. cad 2. pacesetter a-v pacer for sick sinus syndrome 3. htn 4. hyperchol 5. gerd 6. cri baseline 2.2 7. anemia cri 8. constipation 9. hypothyroid 10. afib 11. gout 12. upon discharge in early was dnr/dni to rehab social history: the patient lives alone, but has been at rehab since her prior admission. her daughter is involved with her care. she denies etoh, illicits, tobacco. family history: non-contributory physical exam: vs: t99.8 bp 65/40 -> 111/59 hr 80 rr 21 99% ac 14x500 fi02 0.8 peep 8.0 gen: lying in bed sedated and intubated, somnolent heent: ncat, perrl, neck supple, no bruit, no jvd visible, no lad cv: rrr, nml s1/s2, no extra heart sounds lung: diffuse expiratory wheezes bilaterally, rhonchorous abd: soft, nt, nd, nml bs, ext: no clubbing, cyanosis, nor edema. 2+ dp bilaterally, 1+ pt bilaterally groin: no hematoma neuro: sedated on intubation pertinent results: wbc-10.9 rbc-3.98* hgb-12.3 hct-39.3 plt ct-357 neuts-55.6 lymphs-37.8 monos-2.9 eos-2.9 baso-0.8 pt-20.4* ptt-30.4 inr(pt)-2.9 glucose-350* urean-29* creat-2.2* na-133 k-4.9 cl-102 hco3-18 ck(cpk)-83 ctropnt-0.06* blood ck(cpk)-99 ctropnt-0.22* calcium-8.5 phos-7.0*# mg-2.3 tsh-8.1* free t4-1.4 art rates-14/15 tidal v-400 fio2-100 po2-96 pco2-62* ph-7.17* calhco3-24 base xs--6 aado2-581 req o2-92 -assist/con intubat-intubated lactate-2.1* o2 sat-98 freeca-1.11* urine color-straw appear-clear sp -1.010 nitrite-neg protein-neg glucose-neg ketone-neg bilirub-neg urobiln-neg ph-5.0 leuks-neg chest (portable ap) 10:53 pm 1. et tube is seen, with the tip in the right main stem bronchus. withdrawal is recommended by several cm. 2. diffusely increased prominence of the pulmonary vasculature, consistent with chf. there is asymmetric increased opacity in the right lower lobe, which may represent asymmetric pulmonary edema, or a superimposed infectious process. clinical correlation is recommended. a-v paced rhythm since previous tracing of , further precordial st-t wave changes present intervals axes rate pr qrs qt/qtc p qrs t 80 0 194 444/6 micro: bcx pending sputum cx mixed resp flora brief hospital course: a/p: this is a year old female with history of 3vd s/p rca stents, 80-90% occlusion of lcx and lad. last stented for stemi . presented from rehab after becoming hypertenive, hypoxic and unresponsive, likely had flash pulmonary edema. patient was intubated and brought to . patient was in florid chf with possible aspiration pna after vomitting during ot insertion and trop leak likely secondary to myocardial wall stretching. . #diarrhea: secondary to over-aggressive bowel regimen. held all bowel meds, encouraging po, bolus with fluids as needed. skin care to irritation from diarrhea and frequent turns to avoid sacral decubs. . #cardiac: a) ischemia: the patient had a history of recurrent stenosis of rca, diffuse 3vd on cath. initially received iv heparin on the floor however given more likely troponin elevation was secondary to chf and no other clear signs of ischemia, it was discontinued. continued on asa, plavix, simvastatin. started lopressor 12.5 po tid and isosorbide mononitrate er was changed from 60mg to 30mg qd secondary to hypotension on both bb and nitrate. . b) pump: known history of diastolic chf. now with chf exacerbation on cxr. was not on diuretic as an outpatient. was on lasix gtt with goal of liters negative. switched to po lasix and decreased to lasix 20mg po daily with goal of -500-1l negative. . c) rhythm: the patient has a h/o a/v pacemaker placement in for sinus brady. h/o afib with rvr and av node ablation to prevent tachycardia. in nsr. continued amiodarone 200mg qd. resuming warfarin at 1mg hs given interaction with levoquin.(warfarin 4mg po qhs outpt dose). warfarin dose may need to be adjusted while at rehab and inr levels should be checked regularly. . # pulm: was intubated on ac transitioned to pressure support and eventually weaned over the course of days. now sat'ing in 90's on 2l nc. concern for aspiration pneumonia given patient vomitted with ot tube placement. continued on levoquin and flagyl day to treat aspiration pneumonia for 1 wk course. . # renal: patient's baseline is 2.2-2.6. currently at baseline however elevated bun/cr ratio s/p diuresis. likely element of prerenal azotemia. gave bolus as needed with improvement in cr. . # h/o hypothyroidism: continued synthroid, elevated tsh free t4 wnl. . # fen: low salt cardiac healthly diet, repleted lytes, dc'd iss w/fsqid as glucose <150. . # prophy - therapeutic on coumadin, cont protonix, prn colace/senna . # code: discussed code status with patient in the presence of a russian interpreter and patient requested her status to be dnr but ****can intubate****. was unable to talk to health care proxy regarding code status as she was out of the country at the time of this admission. . # communication: daughter in am ( (home), ( (cell). pt's immediate family out of the country currently. additional family members in town. medications on admission: 1. aspirin 325 mg 2. clopidogrel 75 mg po daily 3. docusate sodium 100 mg po bid 4. levothyroxine sodium 25 mcg tablet po daily 5. simvastatin 80 mg tablet po daily 6. acetaminophen 325 mg 1-2 tablets po q4-6h prn 7. heparin (porcine) 5,000u tid 8. pantoprazole 40 mg e.c. po q12h 9. metoprolol succinate 75 mg sr 24hrs po hs 10. multivitamin po daily 14. amiodarone 200 mg tablet 200mg daily 15. warfarin 4mg po hs 16. metoclopramide 5 mg po tid as needed for ac. 17. ferrous sulfate 325 mg po daily 18. aluminum-magnesium hydroxide 15-30 mls po qid prn 19. zolpidem 5 mg po hs prn 20. isosorbide mononitrate 120 mg po daily. discharge medications: 1. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 2. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). 3. levothyroxine sodium 25 mcg tablet sig: one (1) tablet po daily (daily). 4. simvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 5. amiodarone 200 mg tablet sig: one (1) tablet po daily (daily). 6. multivitamin capsule sig: one (1) cap po daily (daily). 7. trazodone 50 mg tablet sig: 0.5 tablet po hs (at bedtime) as needed. 8. metoprolol tartrate 25 mg tablet sig: 0.5 tablet po tid (3 times a day): hold for sbp<100 or hr<55. 9. acetaminophen 325 mg tablet sig: 1-2 tablets po q4-6h (every 4 to 6 hours) as needed. 10. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q12h (every 12 hours). 11. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed. 12. metronidazole 500 mg tablet sig: one (1) tablet po tid (3 times a day) for 3 days. 13. levofloxacin 250 mg tablet sig: one (1) tablet po q48h (every 48 hours) for 3 days. 14. isosorbide mononitrate 30 mg tablet sustained release 24hr sig: one (1) tablet sustained release 24hr po daily (daily): hold for sbp<100. 15. furosemide 20 mg tablet sig: one (1) tablet po daily (daily): hold for sbp<100. 16. warfarin 1 mg tablet sig: one (1) tablet po qod: please take qod until off levoquin then take qd. discharge disposition: extended care facility: for the aged - ltc discharge diagnosis: primary diagnosis: chf exacerbation secondary diagnosis: aspiration pneumonia coronary artery disease hypothyroidism discharge condition: good discharge instructions: weigh yourself every morning, md if weight > 3 lbs. adhere to 2 gm sodium diet please take your medications as prescribed. please have your inr checked on sunday or monday and have your warfarin accordingly. please get your tsh and free t4 rechecked and have your physician adjust your levothyroxine dose accordingly. if you have any difficulty breathing, chest pain, fevers/chills or any other worrying symptoms, please call your primary care physician or come to the emergency room. followup instructions: please call your cardiologist dr. , m.d. phone: to setup an appointment. please follow up with your pcp at rehab after discharge. md, procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours diagnoses: coronary atherosclerosis of native coronary artery pure hypercholesterolemia congestive heart failure, unspecified unspecified essential hypertension other pulmonary insufficiency, not elsewhere classified unspecified acquired hypothyroidism pneumonitis due to inhalation of food or vomitus diastolic heart failure, unspecified subendocardial infarction, subsequent episode of care 

Answer: The patient is high likely exposed to