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: aspirin attending: chief complaint: transfer for aspirin sensitization and cardiac catherization major surgical or invasive procedure: cardiac catheterization cardiac catheterization with rotoblator of lmca, mid lad, diagonal and ramus with cypher stents x 4 (lmca, mid lad, diagonal and ramus) history of present illness: 77 yo f with h/o schizophrenia, recent chf, htn, cad s/p medically managed mi 3 wks ago when she presented to and she was supposed to go to cath but declined as she said they "didn't explain things" to her and she was sent out with medical therapy. over the last week she has become progressively more sob with pnd, orthopnea, dyspnea at rest and on exertion and chest tightness. she went to on because of her worsening symptoms where her ecg showed lvh with strain pattern, cxr with pulmonary edema, echo w/ ef 40-45 % and as w/ 0.9 am, grad 25/12, bnp >5,000, flat cks and trop 0.5. she was monitored in the icu and started on asa, plavix, nitro gtt, lovenox, statin and iv lopressor. she was also found to have a uti and was treated with levofloxacin and transferred to for asa desensitization and cath. past medical history: htn cad s/p recent mi 2 weeks ago which was medically managed new chf schizophrenia - unclear when diagnosed or who made the diagnosis social history: lives alone has vna and house keeper for help. no smoking, etoh, drugs. family history: non-contributory physical exam: vitals: bp 137/46 hr 65 r 20 general: pleasant elederly woman lying in bed in nad. heent: perl, mmm, no carotid bruits, no lad, jvp 12 cm cv: normal s1s2, 2/6 systolic murmur radiating to apex pulm: crackles bilaterally anteriorly at the bases abd: normal bs, soft, nt/nd, no hepatospleomegaly ext: 2+ dp pulses, 2+ pitting edema lle, rle in brace as swan in place, no ooze, no hematoma, no femoral bruit neuro: aaox3 pertinent results: 03:05pm blood wbc-6.8 rbc-4.15* hgb-11.7* hct-35.2* mcv-85 mch-28.2 mchc-33.3 rdw-14.8 plt ct-189 07:20am blood wbc-7.3 rbc-3.69* hgb-10.5* hct-31.5* mcv-85 mch-28.4 mchc-33.3 rdw-15.0 plt ct-327 03:05pm blood neuts-74.1* lymphs-16.1* monos-6.7 eos-2.4 baso-0.6 03:05pm blood pt-13.9* ptt-25.8 inr(pt)-1.3 07:20am blood plt ct-327 06:00pm blood glucose-165* urean-22* creat-0.7 na-139 k-3.6 cl-94* hco3-32 angap-17 07:20am blood glucose-133* urean-20 creat-0.6 na-138 k-4.2 cl-94* hco3-35* angap-13 07:34pm blood ck(cpk)-18* 07:20am blood ck(cpk)-44 07:34pm blood ck-mb-notdone ctropnt-0.12* 07:20am blood ck-mb-notdone ctropnt-0.38* 07:34pm blood calcium-8.5 phos-3.8 mg-1.9 cholest-147 07:20am blood calcium-8.9 phos-2.9 mg-2.0 05:19am blood type-art po2-116* pco2-48* ph-7.46* calhco3-35* base xs-9 07:41pm blood freeca-1.08* 05:19am blood freeca-1.15 ekg: cardiac cath: 1. selective coronary angiography in this right dominant circulation demonstrated severe three vessel and left main coronary artery disease. the lmca had a calcified 80% stenosis present. the proximal and mid lad had diffuse disease with the mid lad having a complex 80% stenosis at the takeoff of the d1 followed by a 100% mid-lad stenosis. the distal lad filled via left to left collaterals. the d1 had diffuse disease and supplied collaterals to the distal lad. the lcx had a 90% proximal stenosis in the major om1. the om2 was a small vessel. the rca was a dominant vessel with diffuse disease in the proximal and mid vessel. a 99% complex stenosis was seen in the mid rca. the distal rca was supplied by left to right collaterals. 2. right and left heart catheterization demonstrated severely elevated right and left sided filling pressures rvedp=19mmhg, mean pwcp=42mmhg and lvedp=38mmhg. there was severe pulmonary hypertension (82/36). there was moderate systemic arterial hypertension (165/88). cardiac output and index were severely depressed at 2.7 l/min and 1.7 l/min/m2 respectively. mild aortic stenosis was seen with mean gradient of ~15mmhg and calculated of 1.4cm2. a mean mitral stenosis gradient of ~12mmhg was seen but is likely artifactual since a true pcwp tracing was unable to be obtained after multiple attempts as evidenced by low pwcp saturations (~66%). 3. no left ventriculogram was performed due to elevated left sided filling pressures. final diagnosis: 1. severe three vessel and left main coronary artery disease. 2. mild aortic stenosis. 3. severe biventricular diastolic dysfunction. 4. severely depressed cardiac output and cardiac index. 5. severe pulmonary hypertension. echocardiogram: 1. the left atrium is moderately dilated. 2.there is moderate symmetric left ventricular hypertrophy. there is severe global left ventricular hypokinesis. overall left ventricular systolic function is severely depressed. resting regional wall motion abnormalities include severe global hypokinesis with more marked inferior and mid and distal septal hypokinesis. 3.there is mild global right ventricular free wall hypokinesis. 4.the aortic valve leaflets are moderately thickened. there is minimal aortic valve stenosis. mild to moderate (+) aortic regurgitation is seen. 5.the mitral valve leaflets are moderately thickened. there is severe mitral annular calcification. moderate to severe (3+) mitral regurgitation is seen. 6. moderate tricuspid regurgitation is seen. there is moderate pulmonary artery systolic hypertension. 7.there is no pericardial effusion. 8. there is an echogenic density in the right atrium and ventricle consistent with a swan -ganz catheter. cxr:moderate congestive heart failure with moderate-to-large bilateral pleural effusions cxr: there is marked decrease in the pulmonary edema. there is a moderate right-sided pleural effusion and a small left-sided pleural effusion. there is mild cardiomegaly. comments: 1. selective coronary angiography of the left coronary circulation revealed severe diffuse disease in heavily calcified vessels. the lmca had a distal 80% stenosis at an area of severe focal calcification. the lad was totally occluded in its mid segment after giving off a large d1. the mid lad had an 80% stenosis at another area of severe focal calcification. the lcx was a small diffusely diseased, nondominant vessel. there was a large, tortuous, heavily calcified ramus which had a focal 99% proximal stenosis. 2. a 7 french 30 cc intraaortic balloon pump was inserted prophylactically via the lfa through an 8 french sheath with good augmentation and unloading with conterpulsation. 3. successful rotational atherectomy, ptca and stenting of the mid lad into d1 with overlapping 3.5 x 23 and 3.5 x 8 mm cypher des, with the proximal stent being postdilated with a 3.75 mm balloon in its mid lad segment. final angiography revealed no residual stenosis in the stented segment of the lad into d1, no apparent dissection, and normal flow (see ptca comments). 4. successful rotational atherectomy, ptca and stenting of the ramus with a 3.0 x 13 mm cypher des which was postdilated with a 3.5 mm balloon. final angiography revealed no residual stenosis in the stented segment, no apparent dissection, and normal flow (see ptca comments). 5. successful rotational atherectomy, ptca and stenting of the lmca with a 3.5 x 13 mm cypher des which was postdilated with a 3.75 mm balloon. final angiography revealed no residual stenosis, no apparent dissection, and normal flow (see ptca comments). 6. resting hemodynamics revealed elevated right and left sided filling pressures (mrap 8 mmhg, mpcw 28 mmhg). the cardic index on the balloon pump was low-normal at 2.5 l/min/m2. final diagnosis: 1. three vessel coronary artery disease. 2. elevated filling pressures. 3. successful rotational atherectomy, ptca, and placement of 2 drug-eluting stents in the lad. 4. successful rotational atherectomy, ptca, and placement of a durg-eluting stent in the ramus intermedius. 5. successful rotational atherectomy, ptca, and placement of a drug-eluting stent in the lmca. cxr:moderate-to-large bilateral pleural effusions are unchanged. upper lungs are clear. minimal edema is seen about areas of atelectasis at the lung bases. cardiac silhouette is obscured by adjacent pleural parenchymal abnormality. heavy calcification is seen in the mitral annulus. there is no pneumothorax. brief hospital course: 77 yo f with h/o schizophrenia, recent chf, htn, cad s/p medically managed mi 3 wks ago when she presented to and she was supposed to go to cath but declined as she said they "didn't explain things" to her and she was sent out with medical therapy. over the last week she has become progressively more sob with pnd, orthopnea, dyspnea at rest and on exertion and chest tightness. she went to on because of her worsening symptoms where her ecg showed lvh with strain pattern, cxr with pulmonary edema, echo w/ ef 40-45 % and as w/ 0.9 am, grad 25/12, bnp >5,000, flat cks and trop 0.5. she was monitored in the icu and started on asa, plavix, nitro gtt, lovenox, statin and iv lopressor. she was also found to have a uti and was treated with levofloxacin and transferred to for asa desensitization and cath. 1. aspirin desensitization: patient was desensitized to aspirin using the usual protocol with no complications prior to cardiac catheterization. 2. cad: patient had refused catheterization during a recent hospitalization of nstemi and the presented to with decompensated chf. she was vigorously diuresed and sent for cardiac catheterization which showed severe 3 vessel disease and severe valvular disease. she was evaluated by ct surgery, but was not a candidate for cabg. she had significant ectopy on telemetry and continued to have some shortness of breath. in addition, she had 2 episodes of cp with no changes on telemetry. it was finally decided that a high risk intervention was the only option remaining for treatment. the patient agreed to this and underwent successful rotational atherectomy, ptca, and placement of 2 drug-eluting stents in the lad, rotational atherectomy, ptca, and placement of a durg-eluting stent in the ramus intermedius and rotational atherectomy, ptca, and placement of a drug-eluting stent in the lmca. the course of her procedure was uncomplicated and she was transferred back to the floor for continued diuresis. she had no further episodes of chest pain and was continued on asa, statin, plavix, bb and ace-i. the importance of taking her medications was stressed and the patient agreed and understood the risks of not taking her medication including stent restenosis. she will follow up with dr. for outpatient cardiology care and also has follow up with her pcp . . 3. chf: patient was unable to breath comfortably unless she was seated in an upright position. she responded well to iv lasix, diuresing several liters. she was discharged on po lasix as well as asa, statin, bb, and ace-i. 4.uti: patient was found to have a uti at outside hospital. she completed a 7 day course of ciprofloxacin. 5. diarrhea: patient had 2 episodes of diarrhea which was sent for c. diff toxin assay, which came back positive. she was on her last day of ciprofloxacin which was discontinued. she was started on a 14 day course of flagyl and put on contact precautions. she had no further episodes of diarrhea and was discharged on flagyl. medications on admission: meds on admission: lasix 20 mg po qday mvi vit e 400 iu vit c 500 mg po qday atenolol 100 mg po qday zyprexa 5 mg qday tylenol prn mom prn meds from osh: levofloxacin 250 tylenol lopressor 26 mg po bid colace lovenox - declined by patient plavix zyprexa lipitor 40mg po qday discharge disposition: home with service facility: vna discharge diagnosis: 1. 3 vessel cad 2. chf 3. c. diff discharge condition: no chest pain, resolved shortness of breath, afebrile and stable discharge instructions: if you have any chest pain, shortness of breath, palpitations or any other concerning symptoms, call you doctor or go to the emergency room. you should weigh yourself every day. if you gain more than 3 lbs you should call your doctor. you must take all of your medications as directed!!! the following medications are for your heart and you have to take them every day: 1. plavix 75 mg once daily 2. lisinopril 20 mg once daily 3. metoprolol xl 100 mg once daily 4. aspirin 325 mg once daily 5. lipitor 80 mg once daily 6. lasix 80 mg twice per day 7. potassium chloride 40 once per day you are also on antibiotics for your diarrhea. it is important you finish your 14 day course: 1. flagyl 500mg three times per day followup instructions: you have a follow up appointment with your primary care doctor dr. () on , at 9 am to follow your blood pressure and monitor your new medications. you have a follow up appointment with a cardiologist dr. on thursday, at 4 pm. if you have any questions or if you need to reschedule your appointment you can call the office at . his office is located , , , . procedure: combined right and left heart cardiac catheterization combined right and left heart cardiac catheterization coronary arteriography using two catheters coronary arteriography using two catheters angiocardiography of left heart structures injection or infusion of platelet inhibitor implant of pulsation balloon angiocardiography of right heart structures insertion of drug-eluting coronary artery stent(s) diagnoses: subendocardial infarction, initial episode of care coronary atherosclerosis of native coronary artery urinary tract infection, site not specified unspecified essential hypertension other chronic pulmonary heart diseases rheumatic heart failure (congestive) intestinal infection due to clostridium difficile multiple involvement of mitral and aortic valves 

Answer: The patient is high likely exposed to