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: no known allergies / adverse drug reactions attending: chief complaint: abdominal pain and chest pain major surgical or invasive procedure: percutaneous cholecystostomy drainage history of present illness: 64 year old woman with pmh cad, dmii, htn who two night ago had some stomach pain and chest pain. she says that this pain was sharp, in the center of her chest, with radiation into her right arm. she says this pain is similar to the pain she experienced when she has had heart attacks in the past. she endorsed nausea, vomiting, as well as diaphoresis. movement worsened the pain, while staying still kept it stable. she vomited that night, in addition to having diarrhea. . she was seen in lgh emergency hospital at 4/20 at 11:30 pm, where she was found to have bp 99/72 hr 126, 18 98.9, and 100% on 2 l. her labs at that time were notable for tropi 5.5, cpk , wbc count of 13.5, hct 35.8, and bun/cr of 26/1.33, with a digoxin level of less than 0.02. ekg on admission at lgh showed tachycardia, twi in iii, and lfb and poor r wave progression. she was subsequently admitted to ccu at lgh with heparin gtt, lopressor, asa, plavix, kept npo for cath. they held liniopril and lasix. the patient was given morphine and nitrates prn for pain, and an abd u/s and echo were performed. the echo per reprot showed ef 20% with mdoerate mr. , it showed dilated lv lvef estimated to be 20%. anteroapical and septal hypokinesis, severe. inferior hypokinesis, severe. moderately severe global rv hypokinesis. structually normal mv. moderate to severe mitral regurgitation is present. mild tricuspin reguritation. mild ph, systolic 46 mmhg. left atrium mildly dilated. . cath report showed lad 100%, diagnoal open, lcx small 60-70%, open 2nd om, rca 70%. per discharge summary, the patient had a u/a and cxr which did not explain any infectious process. . on admission to ccu, the patient was noted to be tahcycardic to 121, with bp 110/69. . on review of systems, she endorses a history of stroke, but denies deep venous thrombosis, pulmonary embolism, bleeding at the time of surgery, myalgias, joint pains. she endorse a cough with dark brown sputum, with streaks of blood. she denies hemoptysis, or bloody stools, but does say that her stools have been black. she endorses recent fevers and chills. patient denies dysuria. bm x 2. she denies exertional buttock or calf pain. all of the other review of systems were negative. . cardiac review of systems is notable for the presence of abdominal pain, the lack of dyspnea on exertion, paroxysmal nocturnal dyspnea, orthopnea, but positive for ankle edema, palpitations, syncope and presyncope. . past medical history: 1. cardiac risk factors: (+)diabetes, (+) dyslipidemia, (+)hypertension 2. cardiac history: s/p mi in , , - cabg: - percutaneous coronary interventions: s/p cath with , unclear which time - pacing/icd: 3. other past medical history: - cad - dmii - hyperlipidemia - pad - htn - essential thrombocytopenia - chf: ef 35% on - stroke: right parietal in , saw neurologist ramsamy in the past - s/p fem/ on the left - chronic abdominal pain, first noted in , has had negative workup including egd x2, ct x3, last colonoscopy , pos fh of ca. social history: - tobacco history: none - etoh: none - illicit drugs: none family history: sister died of an mi at age 50. has 16 siblings; only 4 of them are currently alive, many of them have passed away from cardiac disease. sister with ca physical exam: on admission: vs: t 96.3 bp 122/70 hr 118 rr o2 99% on ra general: uncomfortable. mood, affect appropriate. heent: ncat. sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. no xanthalesma. mucous membranes were dry. neck: no jvd appreciated cardiac: pmi located in 5th intercostal space, midclavicular line. tachycardic, with a normal s1, s2. no m/r/g. no thrills, lifts. no s3 or s4. lungs: no chest wall deformities, scoliosis or kyphosis. resp were unlabored, but has crackles midway up the lung fields bilaterally. abdomen: diffusely ttp, but most so in the ruq. nbs. extremities: no c/c/e. no femoral bruits. skin: no stasis dermatitis, ulcers, scars, or xanthomas. pulses: right: carotid 2+ dp 2+ pt 2+ left: carotid 2+ 2+ dp 2+ pt 2+ on discharge: mildly tachycardic, improved lung sounds, decreased abdominal pain. pertinent results: on admission: 10:18pm blood wbc-11.5* rbc-3.59* hgb-11.4* hct-34.0* mcv-95 mch-31.9 mchc-33.7 rdw-13.7 plt ct-111* 10:18pm blood pt-13.0 ptt-21.8* inr(pt)-1.1 10:18pm blood glucose-135* urean-32* creat-1.2* na-143 k-3.7 cl-107 hco3-24 angap-16 10:18pm blood alt-81* ast-64* ld(ldh)-449* ck(cpk)-936* alkphos-77 totbili-0.9 10:18pm blood ck-mb-8 ctropnt-0.25* 10:18pm blood albumin-3.7 calcium-8.4 phos-3.7 mg-1.9 cholest-177 11:35pm blood %hba1c-8.2* eag-189* 10:18pm blood triglyc-127 hdl-63 chol/hd-2.8 ldlcalc-89 11:04pm blood lactate-1.2 cardiac enzymes 10:18pm blood ck-mb-8 ctropnt-0.25* 06:30am blood ck-mb-8 ctropnt-0.26* 12:12pm blood ck-mb-6 ctropnt-0.21* 10:42pm blood ck-mb-6 ctropnt-0.29* creatinine 06:30am blood creat-1.2* 08:25am blood creat-0.9 04:38pm blood creat-1.0 04:00am creat-1.0 05:36am creat-1.1 wbcs 06:30am blood wbc-11.2* 06:22am blood wbc-5.6 05:36am blood wbc-6.0 05:36am blood wbc-5.3 microbiology: h. pylori antibody - negative c. diff toxin - negative bile cx - no growth blood cx's - no growth to date urine cx - no growth (final) imaging: ruq ultrasound: impression: 1. partially distended gallbladder, with circumferential wall thickening that could be reactive. please correlate with liver function tests. if there is continued concern for acute cholecystitis, hida scan could be ordered. 2. prominent-appearing pancreatic duct, of uncertain etiology. please correlate with prior imaging, or ct/mrcp if necessary. ct abdomen/pelvis: impression: 1. no evidence of intraabdominal or intrapelvic abscess, as questioned. 2. small amount of pericholecystic fluid identified, compatible with findings seen on prior ultrasound exams. 3. probable patency of the cystic duct, as suggested by the normal caliber of the gallbladder on the ct scan in relation to the collapsed size of the gallbladder status post percutaneous aspiration performed on the same day. 4. small bilateral pleural effusions with evidence of interstitial volume overload. ekg: sinus tachycardia. consider inferior myocardial infarction. low limb lead voltage. late r wave progression with reversal in leads v2-v4. consider anterior myocardial infarction. since the previous tracing of the rate is faster. ventricular premature beat is not seen. othewise, no change. brief hospital course: 64 year old female with pmh cad s/p lad and rca stents, mi x 3, dmii, htn, pad presenting with cp x2 nights, seen at osh and treated as nstemi and depressed ef (30-35% to 15-20%) with unchanged coronary disease and significant abdominal pain, transferred to for further management. . # decompensated chf and coronary artery disease: the patient has known schf, but noted to have a depressed ef to 15-20% from 30-35% per previous report from a year ago. even though her cardiac enzymes were elevated, it seems unlikely to be an acute ischemic cardiomyopathy, given that her most recent catheterization findings were unchanged from those of previous catheterizations. she was diuresed effectively with iv furosemide, without any acute changes in hr or bp. she underwent a myocardial viability study using cardiac mr, showing findings consistent with low likelihood of functional recovery in the anterior and septal walls and distal inferior wall after mechanical revascularization. therefore, further surgical evaluation for cabg was deferred to the outpatient setting upon follow-up with cardiology. for medical management, she was continued on asa, b-blocker, ace-i, and her home dose of digoxin. her statin was held secondary to liver enzyme elevation and should be restarted at the discretion of her pcp. will also continue on anticoagulation for her hypokinetic ventricle. she was discharged on a lovenox bridge for continued warfarin therapy (which she should continue indefinitely for history of a parietal stroke), with inr checks by her pcp. should also be considered for an icd placement with her depressed ef on outpatient follow-up. . # abdominal pain: she was admitted with concerning abdominal pain. she was very tender to palpation in the ruq with an ultrasound show gallbladder wall thickening. given her persistent sinus tachycardia, hypotension, pain, and imaging studies concerning for sepsis, she was started on zosyn for broad antibiotic coverage. a percutaneous cholecystostomy was done, draining normal-appearing, non-purulent bile negative for microorganisms on culture. her pain was controlled with narcotics and eased down to her baseline abdominal pain, which she has had for a few years. h. pylori serologies were negative and ct abomen/pelvis was unremarkable for abscess or occult infection. no etiology for her pain was uncovered. her antibiotic was discontinued. we would advise an outpatient colonoscopy to further work up her abdominal pain. . inactive issues . # essential thrombocytopenia: platelets briefly trended below 100, but rebounded back to her baseline. we did not perform any intervention for this. . # dmii: she was continued on sliding scale insulin while in house, as well as her home dose of lantus. . transitional issues . # follow-up: she should follow-up with cardiology for 1) ?icd placement in future for low ef, 2) possible cabg, and 3) optimize medical management # healthcare maintenance: we would highly recommend a colonoscopy to complete her abdominal pain work-up. medications on admission: coumadin 5 mg daily lantus 25 units subq metformin 500 mg po bid lisinopril 40 mg po daily omeprazole 20 mg po daily simvastatin 80 mg po qhs colace 100 mg po bid prn constipation lasix 20 mg po daily metoprolol 50 mg po daily (toprol xl) gabapentin 300 mg po tid lorazepam 0.5 mg qid prn anxiety (? no script from pcp) celexa 20 mg po daily levaquin 500 mg po daily (start day ) bisacodyl 10 mg qhs prn mvi digoxin 0.125 mg daily lactulose 1tb tid ibuprofen daily compression stockings discharge medications: 1. citalopram 20 mg tablet sig: one (1) tablet po daily (daily). 2. insulin glargine 100 unit/ml solution sig: twenty five (25) units subcutaneous once a day. 3. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po once a day. 4. warfarin 5 mg tablet sig: one (1) tablet po once daily at 4 pm. 5. outpatient lab work please check inr on saturday with results to dr. ,kiame j. 6. metformin 500 mg tablet sig: one (1) tablet po twice a day. 7. lisinopril 10 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 8. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po daily (daily). 9. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 10. furosemide 20 mg tablet sig: one (1) tablet po once a day. 11. metoprolol succinate 100 mg tablet extended release 24 hr sig: one (1) tablet extended release 24 hr po once a day. disp:*30 tablet extended release 24 hr(s)* refills:*2* 12. gabapentin 300 mg capsule sig: one (1) capsule po tid (3 times a day). 13. bisacodyl 10 mg suppository sig: one (1) suppository rectal daily (daily) as needed for constipation. disp:*30 suppository(s)* refills:*0* 14. lactulose 10 gram/15 ml syrup sig: fifteen (15) ml po tid (3 times a day). 15. multivitamin tablet sig: one (1) tablet po once a day. 16. digoxin 125 mcg tablet sig: one (1) tablet po once a day. 17. enoxaparin 100 mg/ml syringe sig: one (1) syringe subcutaneous once a day. disp:*4 syringes* refills:*2* discharge disposition: home with service facility: multicultural vna discharge diagnosis: non st elevation myocardial infarction coronary artery disease acute on chronic systolic congestive heart failure . secondary diagnosis: diabetes mellitus type 2 hypertension discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you had chest pain and had a heart attack at hsopital. a cardiac catheterization was done there and you were transferred to to evaluate your heart arteries and decide on a plan for treatment. you had a cardiac mri which showed that there are areas of your heart that would not benefit from a bypass operation. therefore we have recommended to hold on cardiac surgery for now. when dr. and dr. review your tests together, they may contact you to have you come for an appt here. weigh yourself every morning, call dr. if weight goes up more than 3 lbs in 1 day or 5 pounds in 3 days. you also had pain in your abdomen that has resolved now. all of the tests that we performed did not show a cause for the abdominal pain. you should have a colonoscopy done soon to evaluate your for any problems. . we made the following changes to your medicines: 1. start taking lovenox once a day to prevent blood clots until your inr is more than 2 and dr. tells you to stop. your next inr check is on saturday . 2. decrease the lisinopril to 10 mg daily 3. increase the metoprolol to 100 mg daily 4. stop simvastatin because your liver tests are high, dr. will restart this medicine again followup instructions: name: ,kiame j address: , , phone: appt: at 3:40pm name: , b. md location: cardiology address: , , phone: appt: at 3pm md, procedure: coronary arteriography using a single catheter right heart cardiac catheterization percutaneous aspiration of gallbladder central venous catheter placement with guidance diagnoses: other primary cardiomyopathies subendocardial infarction, initial episode of care coronary atherosclerosis of native coronary artery congestive heart failure, unspecified unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled other and unspecified hyperlipidemia other specified cardiac dysrhythmias accidents occurring in other specified places unspecified accident injury to bladder and urethra, without mention of open wound into cavity acute on chronic systolic heart failure hematuria, unspecified cholecystitis, unspecified abdominal pain, periumbilic primary thrombocytopenia,unspecified 

Answer: The patient is high likely exposed to