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: dyspnea major surgical or invasive procedure: none history of present illness: ms. is a 79 yo f c pmh sig htn, gerd, pulm htn, cri, osa, copd, and diastolic chf who reports dyspnea at home. she called ems, and when they arrived the patient was hypoxic, 80%ra. on presentation to ed she was tachypneic with rr 28, and oxygen saturation 70%ra. according to the residents in the er, the patient denied chest pain. she had crackles on exam. she was given aspirin 325mg, sl nitro and lasix 40mg iv x1. she was placed on cpap. after awhile, she was taken off cpap and was breathing 90% on 4l nc, and was therefore placed back on cpap. her vitals prior to transfer to the icu were 110/47, 60, 20 98% on cpap . past medical history: #hypertension #diastolic congestive heart failure -estimated dry weight of 94kg -last tte ; lvef >55%; 3+ tricuspid regurg #atrial fibrillation -s/p cardioversion x 2 -previously on amiodarone, discontinued due to paced rhythm during hospitalization in -not anticoagulated due to history of hemorrhagic cva #pulmonary hypertension -rsvp 75 in -thought secondary to longstanding asd #copd -home o2 (5l nc) -baseline saturation high 80's-low 90's on 5l o2 #osa, -nonadherent to cpap therapy microcytic anemia #chronic renal insufficiency -baseline cr 2-2.5 #gerd #atrial septal defect - s/p repair - complicated by sinus arrest - with ppm placement. #hypothyroidism #hx of hemorrhagic cva on coumadin #hx of gallstone pancreatitis s/p ercp, sphincterotomy #frequent hospitalizations -admitted almost monthly since #surgeries -s/p appy -s/p chole () -s/p tah/bso ( for fibroids) social history: lives alone. daughter-in-law visits frequently and helps out around house and c groceries. vna comes once a week to set medications out in a pill box. no tob, etoh, ivdu. family history: nc physical exam: tmax: 37.7 ??????c (99.8 ??????f) tcurrent: 37.7 ??????c (99.8 ??????f) hr: 60 (60 - 64) bpm bp: 121/54(70) {121/54(70) - 126/61(78)} mmhg rr: 19 (19 - 20) insp/min spo2: 99% heart rhythm: sr (sinus rhythm) general appearance: overweight / obese eyes / conjunctiva: perrl head, ears, nose, throat: poor dentition, bipap cardiovascular: (s1: normal), (s2: normal), 3/6 systolic murmer at rusb, 3/6 systolic murmur over llsb peripheral vascular: (right radial pulse: present), (left radial pulse: present), (right dp pulse: not assessed), (left dp pulse: not assessed) respiratory / chest: (breath sounds: crackles : way up bilaterally.) abdominal: obese, erythema and pitting edema of pannus extremities: right: 2+, left: 2+, cyanosis, erythemetous, tender skin: not assessed neurologic: responds to: not assessed, movement: not assessed, tone: not assessed pertinent results: admission labs 02:00am neuts-66.7 lymphs-25.0 monos-5.1 eos-2.9 basos-0.4 02:00am wbc-5.2 rbc-3.71* hgb-10.9* hct-33.7* mcv-91 mch-29.6 mchc-32.5 rdw-16.0* 02:00am glucose-115* urea n-67* creat-1.9* sodium-142 potassium-4.3 chloride-98 total co2-39* anion gap-9 cardiac labs 02:00am ck-mb-notdone probnp-4510* 02:00am ctropnt-0.01 02:00am ck(cpk)-49 04:49pm ck-mb-notdone ctropnt-0.01 04:49pm ck(cpk)-37 abgs 07:53am blood type-art po2-86 pco2-86* ph-7.28* caltco2-42* base xs-10 03:36am blood type-art o2 flow-6 po2-60* pco2-60* ph-7.42 caltco2-40* base xs-11 intubat-not intubated ekg baseline artifact. atrial pacing with ventricular sensing. intraventricular conduction defect. extensive st-t wave changes, likely due to repolarization abnormality. compared to the previous tracing of ventricular paced beats are not seen on the current tracing. the other findings are similar. discharge labs- 07:41am blood wbc-4.6 rbc-3.39* hgb-10.2* hct-31.2* mcv-92 mch-30.0 mchc-32.5 rdw-15.6* plt ct-143* 07:41am blood plt ct-143* 07:40am blood pt-13.7* ptt-30.5 inr(pt)-1.2* 07:41am blood glucose-80 urean-42* creat-1.8* na-143 k-4.4 cl-98 hco3-36* angap-13 07:41am blood calcium-8.6 phos-3.6 mg-2.4 brief hospital course: in summary, ms is an 80yo woman with chronic diastolic chf (ef > 55%), pulm htn ( long-standing asd in past), copd (on 5l o2 by nc at home and non-compliant w bipap), osa, who presented with dyspnea was found to have acute chf exacerbation. . # dyspnea: likely acute exacerbation of chronic diastolic congestive heart failure. cxr demonstrated bilateral pulmonary infiltrates, crackles on exam, pitting edema of lower extremities and pannus. home o2 requirement is 5l, per previous discharge summaries. she was initially given a lasix bolus and diuresed ~1 l daily. bipap was started with improvement in co2; however, patient did not tolerate the bipap mask due to discomfort. she was thus transferred out of the icu on 5 l nasal cannula with o2 sats in the upper 80s and low 90s, which seemed to be similar to her baseline. her diuresis was continued until day of discharge, requiring 80iv at first and then transitioning to po doses. she was discharged on a lasix dose of 80mg po bid. . # le edema/pain: pt had extensive le edema and erythema, likely volume overload. legs were elevated and wrapped in ace bandages. wound consult was obtained, they recommended skin moisturizing and other supportive treatments which were implemented. there was low suspicion for dvt, but le doppler examination was attempted; however, patient did not tolerate this test. her pain improved by increasing her neurontin dose to 300mg in the am and 100mg in the pm. . #atrial fibrillation: not on coumadin hx of hemorrhagic cva. metoprolol and asa were continued. . #copd: ipratropium nebs were given instead of home tiotropium. . #hypothyroid: levothyroxine was continued at home dose. during her hospitalization, there was also a family meeting which concluded in the patient stating she is full code. she wants to return home after discharge. she was evaluated by pt and approved to go home. she will have vna to assist with her cardiopulmonary monitoring, home oxygen, and medications. she was discharged home with a f/u appointment with dr. . medications on admission: aspirin 81 mg qd gabapentin 100 mg qd paroxetine hcl 10 mg qd calcium acetate 667 mg tid metoprolol tartrate 12.5 mg ferrous sulfate 325 mg qd senna 8.6 mg tablet qd prn furosemide 80 mg qam, 50 mg qpm tiotropium 18 mcg capsule qd levothyroxine 100 mcg qd discharge medications: 1. metoprolol tartrate 25 mg tablet sig: 0.5 tablet po bid (2 times a day). 2. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 3. paroxetine hcl 10 mg tablet sig: one (1) tablet po daily (daily). 4. calcium acetate 667 mg capsule sig: one (1) capsule po tid w/meals (3 times a day with meals). 5. ferrous sulfate 325 mg (65 mg iron) tablet sig: one (1) tablet po daily (daily). 6. senna 8.6 mg tablet sig: one (1) tablet po once a day as needed. 7. levothyroxine 100 mcg tablet sig: one (1) tablet po daily (daily). 8. furosemide 80 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*30 tablet(s)* refills:*0* 9. tiotropium bromide 18 mcg capsule, w/inhalation device sig: one (1) capsule inhalation once a day. 10. gabapentin 100 mg tablet sig: 3 in the morning and 1 at night tablets po twice a day: please take 300mg (3 tablets) in the morning, and 100mg (1 tablet) at night. disp:*120 tablet(s)* refills:*2* discharge disposition: home with service facility: art of care vna discharge diagnosis: primary: acute exacerbation of chronic diastolic congestive heart failure secondary: hypertension, atrial fibrillation, pulmonary hypertension, chronic obstructive pulmonary disease, obstructive sleep apnea, chronic renal insufficiency, hypothyroidism discharge condition: stable, with 5 l oxygen requirement discharge instructions: you came to the hospital because your heart failure was worsening and you were having trouble breathing. you improved with medications to remove water from your body and with oxygen. it is very important that you use your oxygen all the time at home. medications that were changed while in the hospital: lasix was increased to 80 mg twice daily gabapentin was increased to 300 mg in the morning and 100mg at night weigh yourself every morning, md if weight > 3 lbs. adhere to 2 gm sodium diet fluid restriction: 1 liter please return to the emergency room if you have worsening trouble breathing or chest pain and seek medical attention if you have fevers and chills or other symptoms that are concerning to you. followup instructions: please follow up with dr. on at 10:45 a.m. please call if you need to change this appointment. procedure: non-invasive mechanical ventilation diagnoses: obstructive sleep apnea (adult)(pediatric) esophageal reflux congestive heart failure, unspecified unspecified acquired hypothyroidism chronic airway obstruction, not elsewhere classified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified atrial fibrillation acute on chronic diastolic heart failure other chronic pulmonary heart diseases chronic kidney disease, unspecified acute respiratory failure cardiac pacemaker in situ personal history of transient ischemic attack (tia), and cerebral infarction without residual deficits personal history of noncompliance with medical treatment, presenting hazards to health venous (peripheral) insufficiency, unspecified ulcer of calf 

Answer: The patient is high likely exposed to