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: presented to the osh with progressive sob and angina; tranferred to for cardiac catheterization major surgical or invasive procedure: cardiac catheterization and placement of two drug eluting stents, . cardiac catheterization history of present illness: 76 y.o. female with pmh significant for known cad (cath in , severe copd (fev1 <1, on home o2), htn who presented to on with symptoms of cough productive of yellow/greenish sputum, runny nose. over the past two months, the patient has also been having progressive sob (both at rest and with exertion) and associated left sided chest tightness. the patient could walk 20 feet at baseline without having to stop and over the last couple of months she noticed that she cannot walk 20 feet w/o having to stop because of sob. she denies associated nausea, vomiting, lightheadedness. denies pnd, orthopnea. no fever/chills. + waxing and le edema. chronic prednisone therapy at home. she was admitted to on . ruled out for ami. no acute ekg changes. she was treated for copd exacerbatoin with ceftaz 1gm q8hrs and levaquin 500mg po daily and solumedrol. cxr showed opacity c/w early infiltrate vs. atelectasis. cath that showed moderate 3vd: 70% in distal lad, 70% in lcx, 40% at origin of rca and 50% mid-distal. no intervention done. past medical history: osteoporosis osteoarthritis bladder ca s/p oophrectomy cad gallstones pancreatitis copd, on home 1l o2 s/p appendectomy anemia h/o mrsa htn son pneumothorax x 2 h/o aspergillosis pneumonitis gerd social history: lives with husband. children live in the area. quit smoking in . denies etoh use. family history: nc physical exam: vs: afebrile, 137/71 90 18 99% at 2l general: alert and oriented, pleasant, nad. neck: jvp not elevated heent: nc, at, clera non-icteric, perrl, eom intact, mm sl dry cv: regular, distant s1s2, no m/g/r pulm: bilateral crackles extr: 1+le edema pertinent results: labs on admission: 04:55am blood wbc-11.8* rbc-3.18* hgb-9.9* hct-29.3* mcv-92 mch-31.3# mchc-34.0 rdw-16.1* plt ct-337 04:55am blood glucose-100 urean-19 creat-0.7 na-141 k-3.4 cl-96 hco3-37* angap-11 04:55am blood calcium-9.4 phos-4.9* mg-1.8 03:47pm blood type-art o2 flow-2 po2-92 pco2-56* ph-7.46* calhco3-41* base xs-13 intubat-not intuba comment-nasal labs on discharge: 05:50am blood wbc-11.7* rbc-3.33* hgb-10.4* hct-30.0* mcv-90 mch-31.4 mchc-34.9 rdw-16.1* plt ct-268 05:50am blood glucose-71 urean-19 creat-0.7 na-144 k-4.4 cl-100 hco3-36* angap-12 05:50am blood calcium-9.5 phos-4.1 mg-2.0 other lab results: 05:20am blood cholest-172 triglyc-190* hdl-69 chol/hd-2.5 ldlcalc-65 03:30pm blood ck(cpk)-30 11:24pm blood ck(cpk)-109 04:55am blood ck(cpk)-152* 09:40am blood ck(cpk)-178* 09:31pm blood ck(cpk)-98 05:20am blood alt-14 ast-28 ck(cpk)-58 03:30pm blood ck-mb-notdone ctropnt-<0.01 11:24pm blood ck-mb-22* mb indx-20.2* 04:55am blood ck-mb-27* mb indx-17.8* ctropnt-0.58* 09:40am blood ck-mb-26* mb indx-14.6* ctropnt-0.54* 09:31pm blood ck-mb-notdone ctropnt-0.46* 05:20am blood ck-mb-notdone ctropnt-0.35* cardiac catheterization : 1. selective coronary angiography of this right dominant system revealed diffusely calcified two vessel coronary artery disease. the lmca had no angiographically apparent disease. the lad gave off three small-caliber diagonal branches, and had diffuse disease after the third diagonal branch up to 50%. the lcx had a 90% stenosis at the origin of the second obtuse marginal branch, and a 50% stenosis at the origin of om3. the right coronary artery was heavily calcified and had an 80% ostial stenosis and a 50% distal stenosis before the bifurcation of the pda and the plb. 2. resting hemodynamics revealed normal right sided filling pressures, mildly elevated pulmonary artery systolic pressure (35 mm hg), normal left sided filling pressures (pcwp mean of 8 mm hg), and mildly elevated systemic arterial pressure (149/71, mean 103 mm hg). cardiac index was low-normal at 2.2 l/min/m2, when calculated by the fick equation (using an assumed oxygen consumption). 3. successful rotational atherectomy of the om1 followed by stenting with a 2.5x12mm taxus des at 14 atms (see ptca comments). 4. successful rotational atherectomy of the ostial rca followed by stenting with a 3.5x13mm cypher with a 3.75mm nc ranger at 22 (see ptca comments). final diagnosis: 1. two vessel coronary artery disease. 2. mild pulmonary artery systolic hypertension, mild systemic arterial hypertension, low-normal cardiac index. 3. successful rotational atherectomy and stenting of the om with a drug eluting stent. 4. successful rotational atherectomy and stenting of the ostial rca with a drug eluting stent. echo : a 4x3cm heterogeneous echogenic mass is seen in close proximity/congruent with the the anterior free wall of the right atrium. this "mass" appears to be somewhat contiguous with epicardial fat and does not appear to originate outside of the pericardial space or from the ivc. there is also no evidence of obstruction to rv inflow. there is mild symmetric left ventricular hypertrophy with normal cavity size and systolic function(lvef>55%). due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. a mild (25mmhg peak) mid-cavitary gradient is identified. right ventricular chamber size and free wall motion are normal. the right ventricular free wall is hypertrophied. the aortic valve is not well seen. trace aortic regurgitation is seen. the mitral valve appears structurally normal with trivial mitral regurgitation. there is an anterior space which most likely represents a fat pad. imperssion: mild symmetric left ventricular hypertrophy with preserved global biventricular systolic function. right atrial mass as described above. mild mid-left ventricular dynamic gradient. if clinically indicated, a tee, chest ct or cardiac mr may be able to better define the right atrial abnormality. chest cta : 1) soft tissue thickening around the right coronary artery, probably in the epicardial space, measuring up to 1 cm on the myocardial side and 2 cm on the pericardial side, which is somewhat hyperdense on the precontrast images. given recent cardiac catheterization, appearances are most concering for epicardial hematoma. if clinically indicated confirmation and further characterization could be performed using cardiac mri. 2) well-circumscribed low-density region of the superior most aspect of the ivc, without definite corresponding findings on the precontrast examination. this probably represents artifact from reflux of contrast through the ivc mixing with nonopacified contrast from the abdomen. this could be further evaluated if indicated in conjunction with cardiac mr, or alternatively abdominal ultrasound could further assess flow within the ivc. 3) severe copd. 4) multifocal vertebral body compression fractures. initial findings were discussed with dr. at 4:15 p.m., . addendum: additional literature review shows that epicardial hematoma is a rare entity which can be associated with regional myocardial infarction due to risk of avulsion of rca perforators. clinical correlation is required. additional comment was discussed with dr. 23:00 . cxr : early congestive heart failure. no evidence for pneumonia. cardiac catheterization : selective coronary arteriography revealed no significant coronary artery disease. the previosuly noticed perforation in the rca is no longer present. us left groin : no evidence of av fistula, pseudoaneurysm, or hematoma within the left groin. brief hospital course: 1. coronary artery disease. the patient had a known 3 vessel disease by catheterization report in . she ruled out for ami at the osh. the patient underwent cardiac catheterization on which revealed tight stenoses in the om1 and rca. the lesions were treated with rotational atherectomy and stented with taxus and cypher stents. the procedure was complicated by a localized small wire perforation of the rv marginal branch that appeared stable without visible hemodynamic sequelae during the procedure. the patient then had an echo performed which revealed an incidental finding of an abnormality in the anterior free wall of the right atrium. this was further investigated by chest cta and was characterized as an epicardial hematoma. the patient continued to be asymptomatic, however, the decision was to have her undergo a re look catheterization which she had on . repeat cath showed no significant coronary artery disease. the previously noticed perforation in the rca was no longer present. the medical regimen included aspirin, statin (normal lfts), plavix, ace inhibitor (started during this admission). norvasc was stopped to optimize anti-ischemic regimen. beta-blocker was not added because the patient has severe copd. she was continued on calcium channel blocker. the patient was discharged home on hd #4. on the day of discharge, a new groin bruit was noted. left femoral us was negative for pseudoaneurysm or hematoma. she was discharged with outpatient follow up. 2. chf, preserved ef. the patient appeared euvolemic on exam. cath report revealed normal left sided filling pressures. the patient was continued on lasix per outpatient dose. 3. sob. differential diagnosis included cardiac etiology/demand ischemia, copd exacerbation, chf, infectious causes particularly because the patient was on chronic prednisone therapy, pe. the patient was afebrile. leukocytosis was attributed to prednisone therapy. she patient was transferred from the osh on ceftazidime and levaquin which were started empirically to cover for pneumonia given a question of infiltrate on cxr. ceftazidime was discontinued and she was continued on levaquin for empiric treatment of cap. the had no evidence of decompensated chf on exam or by cath report. the patient was treated for copd exacerbation with slow steroid taper (started prednisone at 60 mg), levaquin, and she was continued on her nebulizers and inhalers. on the day of discharge she reported her breathing being at baseline on her outpatient level of oxygen at 2 liters per minute. 4. osteoporosis. the patient was a former smoker and also is on chronic steroids for her copd. the patient was continued on fosamax and calcium supplements. 5. chronic steroids. she was continued on a ppi. bactrim and folate were added for pcp . her finger sticks were monitored and covered with iss. medications on admission: outpatient meds: prednisone 20 mg daily aleve one lasix 60 mg daily kcl 20 meq norvasc 2.5 mg daily mucinex meds at transfer: protonix 40mg daily, mucinex 1200mg , norvasc 2.5mg daily, kcl 20meq , lasix 60mg daily, aleve 200 , solumedrol 40 , fosamax 70mg qweek, colace 100 , caltrate 600, ceftaz 1gm q8 hrs, levaquin 500 mg daily, flovent , duo nebs, verapamil 300mg daily, ecotrin 325, lescol, ntg patch 0.6mg, flordil inhaler . discharge medications: 1. 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* 2. alendronate sodium 70 mg tablet sig: one (1) tablet po qweek (). disp:*20 tablet(s)* refills:*2* 3. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day) as needed for constipation. disp:*30 capsule(s)* refills:*2* 4. calcium carbonate 500 mg tablet, chewable sig: one (1) tablet, chewable po bid (2 times a day). disp:*60 tablet, chewable(s)* refills:*2* 5. clopidogrel bisulfate 75 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 6. trimethoprim-sulfamethoxazole 160-800 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 7. furosemide 40 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 8. potassium chloride 10 meq capsule, sustained release sig: four (4) capsule, sustained release po daily (daily). disp:*120 capsule, sustained release(s)* refills:*2* 9. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 10. atorvastatin calcium 40 mg tablet sig: two (2) tablet po daily (daily). disp:*60 tablet(s)* refills:*2* 11. aspirin 325 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). disp:*30 tablet, delayed release (e.c.)(s)* refills:*2* 12. albuterol-ipratropium 103-18 mcg/actuation aerosol sig: puffs inhalation q6h (every 6 hours). disp:*1 inhaler* refills:*2* 13. guaifenesin 600 mg tablet sustained release sig: two (2) tablet sustained release po bid () as needed for cough. disp:*30 tablet sustained release(s)* refills:*0* 14. albuterol sulfate 0.083 % solution sig: one (1) neb treatment inhalation q6h (every 6 hours) as needed for shortness of breath or wheezing. 15. ipratropium bromide 0.02 % solution sig: one (1) nebulizer treatment inhalation q6h (every 6 hours) as needed for shortness of breath or wheezing. 16. lisinopril 5 mg tablet sig: 0.5 tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 17. fluticasone propionate 110 mcg/actuation aerosol sig: two (2) puff inhalation (2 times a day). disp:*1 inhaler* refills:*2* 18. verapamil hcl 300 mg cap, 24hr sust release pellets sig: one (1) cap, 24hr sust release pellets po q24h (every 24 hours). disp:*30 cap, 24hr sust release pellets(s)* refills:*2* 19. nitroglycerin 0.3 mg tablet, sublingual sig: one (1) tablet, sublingual sublingual prn (as needed) as needed for chest pain. disp:*15 tablet, sublingual(s)* refills:*0* 20. levofloxacin 250 mg tablet sig: one (1) tablet po q24h (every 24 hours) for 5 days. disp:*5 tablet(s)* refills:*0* 21. senna 8.6 mg tablet sig: one (1) tablet po hs (at bedtime) as needed for constipation. disp:*30 tablet(s)* refills:*0* 22. prednisone 10 mg tablet sig: tapered dose as below: po once a day for 16 days: take 4 tabs x 4days, then 3 tabs x 4days, then 2 tabs x 4days, then 1 tab x 4days, then off. disp:*40 tablet(s)* refills:*0* discharge disposition: home with service facility: nursing services discharge diagnosis: primary diagnoses: 1. coronary artery disease 2. intramyocardial hematoma 3. chronic obstructive pulmonary disease exacerbation 4. osteoporosis 5. chronic steroid use 6. hyperlipidemia secondary diagnoses: 1. osteoarthritis 2. gastroesophageal reflux disease discharge condition: shortness of breath at baseline on 2l of oxygen. vital signs and labs are stable. discharge instructions: please return to care immediately if you develop chest pain, worsening shortness of breath, nausea, dizziness, pain or numbness in groin or leg or other concerning symptoms. please take all medications as prescribed below and follow up with dr. . please note that we made several changes in your medications. below is the updated list. do not stop taking plavix until you are told to stop taking it by your cardiologist. please resume your usual activities gradually. do not exert yourself. avoid lifting more than 5 pounds or other strenous activity in the next 1-2 weeks. followup instructions: please call to schedule a follow up appointment with dr. within 3-4 days after discharge from the hospital. please call to schedule a follow up appointment with dr. in one month. procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more parenteral infusion of concentrated nutritional substances insertion of endotracheal tube atrial cardioversion transfusion of packed cells diagnoses: pneumonia, organism unspecified anemia, unspecified esophageal reflux acute kidney failure with lesion of tubular necrosis unspecified pleural effusion congestive heart failure, unspecified unspecified essential hypertension chronic airway obstruction, not elsewhere classified atrial flutter pulmonary collapse bacteremia cardiac catheterization as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure other complications due to other cardiac device, implant, and graft paralytic ileus staphylococcus infection in conditions classified elsewhere and of unspecified site, other staphylococcus chronic pancreatitis other and unspecified complications of medical care, not elsewhere classified diastolic heart failure, unspecified chronic vascular insufficiency of intestine mixed acid-base balance disorder other drugs and medicinal substances causing adverse effects in therapeutic use unspecified peritonitis 

Answer: The patient is high likely exposed to