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: demerol attending: chief complaint: chest pain major surgical or invasive procedure: left heart catheterization history of present illness: 82 yr old female with history of fractured hip, hypothroidism no cardiac hx who presented to er this am with chest pain. reports onset of pain at 7:45 am when walking, severe crushing substernal pain. associated nausea and bilateral arm pain. stuttering pain, with no resolution to ed. anterior st elevations, which improved during ed course. troponin 0.71, ck 155, mb 11. heparin and nitro drip, morphine 2 mg, asa, bb, plavix load 600 mg total, sent for cath. vitals stable. catheterization revealed small hazy lad lesion possibly consistent with plaque rupture and question aortic dilatation. perhaps plaque lysed or with heparin. pt reports pressure sensation at this time, with no associated nausea, diaphoresis, or arm pain. . ros: (+) pressure sensation on chest (-) denies fever, chills, night sweats, recent weight loss or gain. denies headache, sinus tenderness, rhinorrhea or congestion. denied cough, shortness of breath. palpitations. denied nausea, vomiting, diarrhea, constipation or abdominal pain. no recent change in bowel or bladder habits. no dysuria. denied arthralgias or myalgias. past medical history: hypothyroidism hip fracture x 2 social history: lives with husband, he is ill and she reports caring for him. children present and active in the care of parents. denies alcohol or smoking. primary care giver for husband with dementia. family history: father expired from mi age 73. physical exam: vitals: t: 97.5 p: 60 bp: 108/60 r: 18 sao2: 94% ra general: awake, alert, nad. heent: nc/at, perrl, eomi, no scleral icterus noted, mmm, no lesions noted in op neck: supple, no jvd or carotid bruits appreciated pulmonary: few crackles in bases bilaterally cardiac: rrr, nl. s1s2, no m/r/g noted abdomen: soft, nt/nd, normoactive bowel sounds, no masses or organomegaly noted. extremities: no c/c/e bilaterally, feet cool but 2+ radial and dp pulses. pertinent results: 10:20pm wbc-5.7 rbc-3.77* hgb-12.2 hct-35.3* mcv-94 mch-32.4* mchc-34.7 rdw-12.6 10:20pm magnesium-2.0 10:20pm ck-mb-13* mb indx-7.4* ctropnt-0.65* 10:20pm ck(cpk)-176* 10:20pm estgfr-using this 10:20pm glucose-101 urea n-6 creat-0.5 sodium-142 potassium-3.6 chloride-110* total co2-22 anion gap-14 . sinus rhythm, low qrs voltages in limb leads. st segment elevation in lead v2 with t wave inversion in leads v1-v2, flat t waves in leads v3-v4 . cardiac cath 1. selective coronary angiography revealed a right dominant system with patent lmca. lad had a proximal 20-30% non-hemodynamically significant lesion and was otherwise free of angiographically apparent disease. lcx was small. the rca had no angiographically apparent disease. 2. left ventriculography showed ef of 40-45% with hypokinetic anterior wall and hyperdynamic base. 3. limited hemodynamic assessment showed normal systemic pressures and mildy elevated lvedp. 4. ascending aorta was dilated. there was no evidence of dissection. final diagnosis: 1. coronary arteries are normal. 2. moderate systolic and diastolic ventricular dysfunction. . cta chest w&w/o c&recons, non-; cta abd w&w/o c & recons cta: there is aneurysmal dilatation of the ascending aorta, which measures 4.2 cm in diameter at the level of the pulmonary vein confluence (series 4, image 31). the aortic arch and descending thoracic aorta are of normal caliber. there is an aberrant right subclavian artery arising from a diverticulum of kommerell off the aortic arch. there is caliber narrowing at the origin of the celiac with post- stenotic dilatation noted. the superior mesenteric, both renal arteries, and inferior mesenteric arteries are patent. the common iliac, external and internal iliac, and both femoral arteries are patent. no abdominal aortic aneurysm is identified. there are no filling defects in the pulmonary arterial vasculature. no pulmonary embolism is identified. . ct chest with contrast: calcified nodule with associated linear atelectasis is seen on series 4, image 37 in the right lower lobe measuring approximately 6 mm in diameter. there is biapical scarring noted. small opacity is seen in the lingula which could reflect atelectasis. there is a small amount of bibasilar atelectasis present. no lung masses are present. no pericardial or pleural effusion is present. the airways are patent to the level of the segmental bronchi bilaterally. small fat-containing axillary lymph nodes are present bilaterally. no enlarged mediastinal or hilar nodes are present. . ct abdomen: there are multiple nonobstructing stones within the collecting systems of both kidneys. in the left upper pole, there is a 3.5-mm stone. in the left mid pole, there is a 2-mm nonobstructing stone. there is an additional 5- mm nonobstructing stone in the mid pole of the left kidney. in the left lower pole, there is a 4-mm nonobstructing stone. in the upper pole of the right kidney, there is a 5.5-mm nonobstructing stone, and in the interpolar region of the right kidney, there is a 3-mm nonobstructing stone present. there is a simple cyst in the interpolar region of the right kidney measuring 13 mm in diameter. the adrenal glands, spleen, pancreas, are normal in appearance. the caliber of the loops of small and large bowel is normal in appearance. patient is status post cholecystectomy. there are numerous low attenuation lesions throughout both lobes of the liver, the largest of these is in the left lobe measuring approximately 3.9 x 2.7 cm and is a simple cyst. lesions smaller than 5 mm are too small to characterize. near the dome of the liver, there is a 5-mm area of low attenuation that is incompletely characterized on this study due to size (series 2, image 50), of relative low attenuation. there is no ascites. . ct pelvis: there is diverticulosis of the sigmoid colon without diverticulitis. there is a foley catheter in the bladder. patient has a prosthetic right hip screw fixation device which creates significant artifact in this region. there are phleboliths seen in the pelvis. there is no free fluid in the pelvis. no enlarged inguinal or pelvic lymph nodes are seen. there is ectasia of the abdominal aorta. bone windows: no suspicious lytic or blastic lesion. degenerative changes are seen at l1-2 and l5-s1 consistent with disc space narrowing. lucent lesions are seen in the iliac bones bilaterally adjacent to the sacroiliac joint, likely related to cystic degenrative change. . conclusions: the left atrium is normal in size. left ventricular wall thickness, cavity size, and systolic function are normal (lvef>55%). there is mild regional left ventricular systolic dysfunction with focal hypokinesis of the mid to distal anterior septum and anterior wall. the remaining segments contract well. right ventricular chamber size and free wall motion are normal. the aortic root is moderately dilated at the sinus level. the ascending aorta is moderately dilated. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion. there is no aortic valve stenosis. mild (1+) aortic regurgitation is seen. the mitral valve appears structurally normal with trivial mitral regurgitation. there is no mitral valve prolapse. the estimated pulmonary artery systolic pressure is normal. there is an anterior space which most likely represents a fat pad. impression: regional left ventricular dysfunction consistent with single vessel coronary artery disease. mild aortic regurgitation. moderately dilated aortic root and ascending aorta. . chest (pa & lat) 3:37 pm chest pa and lateral: the heart size, mediastinal and hilar contours are unremarkable. the lungs are clear. there are no pleural effusions. the pulmonary vasculature is normal. small hiatal hernia is present. aorta is tortuous. mild left apical pleural thickening noted. brief hospital course: 82 yr old female with no known cad, good functional capacity with hx of chest pain x 10 yrs, presenting with severe chest pain, elevated enzymes, with cardiomyopathy. chest pain: at the osh ed, she was found to have an ekg with st elevations in the anterior leads. her troponin was positive: troponin 0.71, ck 155, mb 11. she was started on heparin and nitro drips, and given morphine 2 mg, asa, bb, plavix load 600 mg total. she was transferred to with stable vitals. at cath , she was found to have normal coronary arteries but apical ballooning consistent with possible -tsubo's cardiomyopathy. aortic aneurysmal dilatation, followed up by cta no evidence of dissection, worsening diameter. on the first day after cath, she again complained of substernal chest pain which was not associated with exertion. she was started on a nitro gtt on the floor, causing her sbp to fall to 70. she had st elevations on ekg but decision was made not to cath her, given previous cath with clean coronaries. cath reviewed, no missed lesion. she was transferred to the ccu for management of her hypotension related to nitro. in the ccu, she received nitro boluses for pain control, taken off nitro given chest pain free. her bp improved, in the high 90s. chest pain free 2 days prior to admission, but decreased to 80's systolic day prior to admission. patient had been started on isosorbide and captopril in the ccu. meds dc'd and patient was hydrated with return of bp to baseline systolic 90's. considered chest pain and resultant st elevations in anterior and precordial leads, elevated enzymes, but clean cath, all due to stress induced cardiomyopathy stress. no evidence of precipitating uri, or major stressor change, though patient does report increased stress related to ailing husband as she is the primary care giver. pt discharged on low dose ace, sl nitro and asa, to follow up with primary care physician . . cystitis: day prior to discharge patient had temp to 101.1. complaining of dysuria and incontinence. ua + for uti. discharged on cipro x 3 days. foley had been placed for procedures likely instigator. cultures pending, blood and urine. cxr with no evidence if infiltrate. to follow up with pcp cx urine cx medications on admission: synthroid 100 mcg discharge medications: 1. acetaminophen 325 mg tablet sig: one (1) tablet po q4-6h (every 4 to 6 hours) as needed for pain. 2. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 3. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day) as needed for constipation. 4. levothyroxine 100 mcg tablet sig: one (1) tablet po daily (daily). 5. trazodone 50 mg tablet sig: 0.5 tablet po hs (at bedtime) as needed for insomnia. 6. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 7. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 8. nitroglycerin 0.3 mg tablet, sublingual sig: one (1) tablet, sublingual sublingual prn (as needed) as needed for chest pain: every 5 minutes not more than 2 times, if still not pain free, call 911. disp:*30 tablet, sublingual(s)* refills:*0* 9. lisinopril 2.5 mg tablet sig: one (1) tablet po at bedtime. disp:*30 tablet(s)* refills:*0* 10. ciprofloxacin 250 mg tablet sig: one (1) tablet po twice a day for 3 days. disp:*6 tablet(s)* refills:*0* 11. amlodipine 5 mg tablet sig: 0.5 tablet po qam (once a day (in the morning)). disp:*30 tablet(s)* refills:*2* discharge disposition: home with service facility: homecare discharge diagnosis: primary: ?takotsubo's cardiomyopathy hypotension . secondary: hypothyroidism discharge condition: stable, chest pain free discharge instructions: you were admitted with chest pain and elevated enzymes. you underwent a cardiac catheterization which demonstrated clean coronaries. you had a second episode of chest pain with a drop in blood pressure from nitrates and were observed in the cardiac care unit. you are stable and chest pain free now, with a diagnosis of likely stress induced cardiomyopathy which should resolve within one to 4 weeks. you also developed a urinary tract infection and were given antibiotics. please take all medications as prescribed to you. please follow up with your primary care physician . in . you should be on an ace i, as your blood pressure allows, please follow up with your pcp. return to the hospital if you are experiencing severe chest pain. shortness of breath, fainting, or any other symptoms concerning to you. followup instructions: please follow up with your primary care physician . in the upcoming week. please call to make an appointment, if on vacation, please make appoitment with coverage. please call ( to schedule an echocardiogram for weeks before your cardiology appointment. you need to follow-up with a cardiologist. please call on monday to make an appointment after your echo. procedure: angiocardiography of left heart structures left heart cardiac catheterization coronary arteriography using a single catheter diagnoses: other iatrogenic hypotension urinary tract infection, site not specified unspecified acquired hypothyroidism thoracic aneurysm without mention of rupture infection and inflammatory reaction due to indwelling urinary catheter takotsubo syndrome coronary vasodilators causing adverse effects in therapeutic use 

Answer: The patient is high likely exposed to