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: history of present illness: this is a 60-year-old white female with a history of cad, status post inferior mi in , status post complex rca stent x3, status post catheterization in ptca of rca with 30% residual stenosis, status post cabg x3 in with svg to the lad, svg to the om, svg to the pda, who was recently discharged from on status post cabg, who represented to the emergency room on . she reported doing well until of ' when she developed dyspnea on exertion, was unable to climb a flight of stairs, or walk up an incline without dyspnea. the patient was evaluated and had a positive exercise ett mibi, went for catheterization on with left main 50% ostial lesion, left circumflex 60-70% lesion, rca with fractured stenosis 80%, 80% ostial lesion, 1+ mr, ef 46%. subsequently, the patient underwent three vessel cabg on . she denies symptoms preoperatively. she had no orthopnea or pnd. preoperative she had complained of episodes of palpitations which have resolved spontaneously in less than one hour. she reported an uneventful operative course except for difficulty with hallucinations after anesthesia and she had left arm and shoulder tingling. the patient was discharged home with one week course of lasix. since discharge post-cabg, the patient reports increasing dyspnea, and inability to lay flat secondary to the dyspnea. she had two-three pillow orthopnea. the last time she had taken lasix was . since that time, her weight had increased by 10 pounds. she had increasing lower extremity edema, increasing dyspnea with exertion, and chronic nonproductive cough. she had palpitations and increasing fatigue with minimal exertion. she presented to the emergency room on the 28th with the complaints of dyspnea and palpitations. she was felt to be in chf. she was started on oxygen and lasix with some improvement, and ekg at that time showed new onset afib. she was rate controlled with cardizem and lopressor. she was admitted for rule out mi. her enzymes were negative. the cardizem and lopressor were titrated up and the patient converted to normal sinus rhythm on the . an echocardiogram on the 29th showed no focal wall motion abnormalities, moderate pericardial effusion, no tamponade. the patient had been stable hemodynamically without pulsus paradoxus on the floor. due to the echocardiogram findings of a pericardial effusion, heparin drip which had been started on admission was discontinued, and diuresis was held. the patient was still quite short of breath. a repeat echocardiogram on showed an increasing effusion at this time, it was felt now to be moderate to large size. in addition, the patient had become hypoxic on the floor. a cta was ordered to rule out pulmonary embolus, however, the ct was held in light of the patient's enlarging effusion. she was transferred to the ccu for close observation and pericardial drain placement. physical examination: her vitals on admission to the ccu, her temperature was 98.4, her blood pressure was 108/60, heart rate was 88, respiratory rate 20, and her o2 sats were 98% on 4 liters. in general, she was a thin white female sitting upright in a chair on o2 nasal cannula breathing was labored at time. heent: perrla. sclerae are anicteric. oropharynx clear. mucous membranes are moist. neck is supple. her jugular venous pressure was about 15 cm. there were no carotid bruits. cardiovascular: regular, rate, and rhythm, normal s1, s2, no murmurs, rubs, or gallops. respiratory: she had decreased breath sounds at the bases bilaterally to of the way up her lung fields. there was no egophony. abdomen is soft, obese, nontender, and nondistended. bowel sounds are present. extremities: she had 2+ pitting edema just to up below the knees. she had 2+ dp and pt pulses bilaterally. laboratories: unremarkable. thyroid function tests were sent and were pending. an abg showed a ph of 7.45, pco2 of 40, po2 of 82 on 4 liters o2 nasal cannula. a chest x-ray on the 30th showed that the heart was within normal limits. slight interval increase of the bilateral pleural effusions, her left hemidiaphragm was not well visualized which is consistent with effusion or left lower lobe collapse or consolidation. the echocardiogram results were as previously noted. past medical history: 1. hodgkin's disease status post mantel radiation. 2. small basal cell carcinoma. 3. breast cancer status post right mastectomy and lymph node resection. 4. cad with a history of imi as noted in the history of present illness. medications on admission: 1. aspirin 325 mg p.o. q.d. 2. lopressor 50 mg p.o. q.d. 3. imdur 30 mg p.o. q.d. 4. zestril 10 mg p.o. q.d. 5. albuterol prn. 6. levothyroxine 112 mcg p.o. q.d. 7. triamcinolone. 8. lasix 40 mg p.o. q.d., which was discontinued on the 24th. allergies: 1. iodine. 2. dye. 3. bruises with plavix. medications at time of admission to the ccu: 1. indomethacin 25 mg p.o. t.i.d. 2. mucomyst 600 mg p.o. b.i.d. x2 days. 3. heparin subq. 4. metoprolol 50 mg p.o. t.i.d. 5. diltiazem 60 mg p.o. q.i.d. 6. lisinopril 2.5 mg p.o. q.d. 7. colace. 8. protonix. 9. tylenol. 10. albuterol 1-2 puffs q.6h. 11. levothyroxine 112 mcg q.d. ccu course: a pericardial drain was placed 250 cc of blood were drained initially. the pericardial pressure was 20 mm hg upon entering and three after the drain was placed. after the drain was placed, shortness of breath and cough resolved, and the patient was given 30 mg of iv lasix and she could lay flat at 30 degrees and rest without shortness of breath. her o2 requirement at this point fell. the drain was placed on . prior to the pericardial drainage, the patient was anxious and went into rapid afib with rates of 140-160, 5 mg of iv lopressor were given x2. her rate fell to 100 to 110, but her heart rate then increased again. diltiazem drip was started at 5 mg and her heart rate came down to 100, however, her systolic blood pressure fell to 80, so the diltiazem drip was held, a 250 cc bolus was given, and the patient's systolic blood pressure increased appropriately, and the diltiazem drip was restarted. endocrine wise, the patient's thyroid function tests: her tsh was 26, which was low. her t3 was 72 which is low and her t4 was 8.1, which was normal. her synthroid was increased, this was felt to be consistent with hypothyroidism and her synthroid was increased to 125 mcg a day. on the 3rd, the patient was started on a heparin drip. she was dig loaded. her diltiazem drip was changed to cardizem p.o. as she had spontaneously converted to normal sinus rhythm and her pericardial output from the drain had started to decrease. on the 4th, a bedside echocardiogram was done, which showed a very small pericardial effusion. the pericardial drain was pulled without complications. she denied chest pain or palpitations, no shortness of breath. the patient could now lie more comfortably, and her medicine regimen was continued. as her dyspnea was improving, her oxygen was gradually weaned off. physical therapy was consulted. patient was felt to be medically stable, so she was transferred to the floor on the 4th. it was decided that the patient would benefit from amiodarone therapy, so pulmonary function tests were ordered, which the results were fvc was 54% of predicted, her fev1 was 60% of predicted. her fev1:fvc ratio was 49%. it was felt at this time, that the fvc was likely underestimated due to patient had a strong gag reflux during spirometry maneuver with otherwise good test quality. her total lung capacity was 71% of predicted. her frc was 75% of predicted. despite the pulmonary function tests findings, it was felt that it would worthwhile to start the patient on amiodarone and have her follow up one month later to do repeat pulmonary function tests when she would likely be able to get better effort. on the 5th, the patient had an episode of 6 beat v-tach. her blood pressure remained stable. for the v-tach, the patient was to receive a holter monitor and of hearts monitor. on the 7th, metoprolol was increased to 75 mg b.i.d. for better rate control. ep was consulted, and they felt that the amiodarone load should be continued and the beta blocker should be increased to a goal resting heart rate of 60 as tolerated by her blood pressure and bradycardia. laboratories were ordered, which were within normal limits, but they resolved spontaneously. the primary team was notified. on the 6th, the patient was started on coumadin. urinalysis suggested a possible uti. the patient was discharged home in stable condition on the 7th. discharge instructions: she was to have vna follow her as an outpatient. she was to continue taking all medications as instructed. discharge diagnoses: 1. pericardial effusion. 2. coronary artery disease status post inferior myocardial infarction. 3. status post coronary artery bypass graft on . 4. hypothyroidism. 5. breast cancer status post mastectomy. 6. basal cell carcinoma. major surgical or invasive procedures: she had a pericardial drain placed and cardiac catheterization. discharge medications: 1. albuterol 1-2 puffs q.6h. prn. 2. protonix 40 mg p.o. q.d. 3. aspirin 325 mg p.o. q.d. 4. vitamin d one tablet p.o. q.d. 5. ............ 2.5 mg p.o. q.d. 6. fluvastatin four capsules p.o. q.h.s. 7. colace 100 mg p.o. b.i.d. 8. senna one tablet p.o. q.h.s. 9. calcitonin 200 units spray q week. 10. calcium carbonate 500 mg tablet chew t.i.d. 11. levothyroxine 125 mg p.o. q.d. 12. furosemide 40 mg p.o. q.d. 13. acetaminophen 325 mg p.o. q.4-6h. prn pain. 14. maalox 30 cc p.o. q.6h. prn. 15. metoprolol 75 mg p.o. b.i.d. 16. amiodarone 600 mg p.o. q.d. for a two week course, which would end on and she should start taking amiodarone 200 mg p.o. q.d. 17. coumadin one 5 mg tablet p.o. q.h.s. appointments and followups: she was to followup with her primary care physician weeks. she should have her inr checked on by the vna services. she is to followup with her primary cardiologist in weeks. she is to followup with dr. on . she was to followup with dr. on . treatments: cardiac was cardiac heart healthy diet. post discharge services was physical therapy. , m.d. dictated by: medquist36 procedure: pericardiocentesis right heart cardiac catheterization diagnoses: unspecified pleural effusion congestive heart failure, unspecified atrial fibrillation aortocoronary bypass status pulmonary collapse hypotension, unspecified hodgkin's disease, unspecified type, unspecified site, extranodal and solid organ sites hemopericardium postmyocardial infarction syndrome 

Answer: The patient is high likely exposed to