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: thoracentesis history of present illness: 55 year old female with history of metastatic breast cancer with mets to cervical spine, right hip and history of malignant pericardial and pleural effusions. pt underwent pericardial window on for pericardial effusion with improvement in symptoms of dyspnea. subsequently developed a left > right pleural effusion, which was managed with thoracentesis and placement of a pleurex catheter in . since that time pt has noted persistent weakness and dyspnea on exertion, now worsened to the point where the patient has difficulty with dressing, transfer and is unable to walk between rooms. she reports having worsening right hip pain recently, was found on mri to have evidence of bony mets and earlier today had cycle of radiation to this area with her radiation oncologist dr. . she noted that whereas she us usually able to walk from her car to the lobby for these appointments she was unable to do so today and required a wheelchair. called ems, was noted to by hypoxic to 87% on ra. . otherwise on notable history pt notes chronic cough x years, mildly worse lately with clear to yellow sputum production. weight loss (was 200lbs, now 128) with decreased appetite, weakness. had one episode of n/v over the weekend with low grade temp to 100.3. has since resolved. . on ros denies headache, vision changes, neck pain/stiffness, nausea, vomiting. has mild chest discomfort with coughing and dyspnea as above. no palpitations, abd pain. no diarrhea. + occasional constipation. no le edema. no rashes. . in the ed, 02 sat increased from 88% on ra to 93% on 2l. had cxr which showed bibasilar pleural effusions l>r and lll infiltrate. bedside tte showed suggestion of pericardial effusion. f/u formal tte showed lvef 35-40% with increased echo-dense loculated pericardial effusion and some evidence of increased pericardial pressure. inital vs: 97.4 123 161/92 24 93% 2l (88% ra). she was given 1l ns, vanc and cefepime for the pneumonia. had an elevated wbc with left shift. admitted to the ccu for monitoring of pericardial effusion with concern for evolving tamponade. upon arrival to ccu pt underwent thoracentesis with interventional pulmonology, with removal of 200cc cloudy fluid, pt reported interval symptom improvement. past medical history: 1) metastatic breast adenocarcinoma: breast cancer diagnosis in s/p mastectomy and ca chemotherapy. recurrence in neck in with xrt. in known metastatic disease to spine, supraclavicular node, and right hip. she has tried and failed multiple chemotherapy regimens, now cycle 1, day 16 of herceptin/xeloda 2) anxiety 3) hypertension (has been on lisinopril but stopped on own) 4) s/p appendectomy 5) hypothyroidism . social history: social history is significant for no tobacco since . the patient drinks socially and quite infrequently with no history of alcohol abuse. family history: there is no family history of premature coronary artery disease or sudden death. her father died of a aaa rupture. there is a history of cancer in multiple family members. physical exam: vs: hr 115 bp 139/82 93% 2l 18 general: middle aged - elderly woman, older than stated aged. tachypneic, anxious. heent: alopecia, multiple scabs. neck: extensive radiation changes, difficult to appreciate neck veins, no distention noted. cardiac: pmi located in 5th intercostal space, midclavicular line. rr. nl s1/s2. tachycardic. unable to take pulsus (s/p axillary ln dissection on r and picc on l) evidence of venous distention of l superfical thoracic wall veins. lungs: s/p r mastectomy and ln dissection, swelling r breast, chronic. s/p l thoracentesis. decreased bs r>l, poor air movement. abdomen: soft, ntnd. + bs extremities: slight pitting edema l breast, b/l elbows. s/p left picc line placement. s/p removal of l port-a-cath. some surrounding erythema, nothing expressible, not warm. skin: multiple scabs on shins, hands, scalp, per pt self inflicted. pertinent results: 10:00am blood wbc-16.0*# rbc-4.27 hgb-10.7* hct-33.8* mcv-79* mch-25.0* mchc-31.6 rdw-20.5* plt ct-451* 10:00am blood neuts-87.0* lymphs-3.2* monos-9.4 eos-0.3 baso-0.1 10:00am blood pt-16.9* ptt-32.2 inr(pt)-1.5* 10:00am blood glucose-149* urean-13 creat-0.5 na-138 k-4.2 cl-95* hco3-33* angap-14 05:18am blood alt-9 ast-19 ld(ldh)-245 ck(cpk)-17* alkphos-92 totbili-0.4 10:00am blood ck-mb-notdone ctropnt-0.03* 05:33am blood albumin-3.7 calcium-9.2 phos-4.0 mg-2.1 05:33am blood tsh-3.6 07:26am blood type-art po2-98 pco2-109* ph-7.12* caltco2-38* base xs-2 10:14am blood lactate-1.8 07:26am blood o2 sat-95 . ekg - sinus tachycardia. left atrial abnormality. low limb lead voltage. probable prior anterior myocardial infarction. compared to the previous tracing of the rate has increased. otherwise, no diagnostic interim change. . echo - left ventricular wall thicknesses and cavity size are normal. there is moderate global left ventricular hypokinesis (lvef = 35-40 %). right ventricular chamber size and free wall motion are normal. the aortic root is mildly dilated at the sinus level. there is a moderate sized partially echo filled loculated pericardial effusion most prominent anterior to the right ventricle (1.8cm) and anterolateral to the left ventricle (1.8) with minimal (1.1cm) inferior to the left ventricle and minimal around the lateral left ventricle and apex. the effusion is echo dense, consistent with blood, inflammation or other cellular elements. there is mild intermittent right ventricular diastolic collapse but no exacerbation of transmitral doppler inflow. . compared with the prior study (images reviewed) of , the effusion is larger and increased pericardial pressure is suggested. a prominent pleural effusion is also now present. left ventricular systolic dysfunction is also now present. brief hospital course: patient was admitted to the ccu in respiratory distress. patient was placed on bipap. family and patient decided that patient was to be dnr/dni and only wanted nasal cannula for oyxgen withoute bipap. the following day patient and family decided to make patiet comfort measures only. patient expired with husband present. medications on admission: clonazepam 0.5mg prn compazine 10mg po q6 prn nausea fentanyl patch 25mcg q 72 hours levothyroxine 150mcg daily metoprolol tartrate 25mg oxycodone 5mg po q4 prn vitamin d 400 units daily zometa 4mg iv q 3 months herceptin q 3 weeks adriamycin discharge medications: na discharge disposition: expired discharge diagnosis: metastatic breast cancer discharge condition: expired discharge instructions: na followup instructions: na procedure: thoracentesis diagnoses: pneumonia, organism unspecified congestive heart failure, unspecified unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled unspecified acquired hypothyroidism personal history of malignant neoplasm of breast other and unspecified hyperlipidemia acute respiratory failure encounter for palliative care other specified diseases of pericardium empyema without mention of fistula secondary malignant neoplasm of bone and bone marrow cardiac tamponade malignant pleural effusion 

Answer: The patient is high likely exposed to