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: sudden onset of dizziness and shortness of breath major surgical or invasive procedure: right heart catheterization history of present illness: ms. is a 64 yo female with a history of pulmonary artery hypertension (on a continous flolan infusion via hickman catheter and 6l of o2), diastolic chf, chronic afib, and htn. on the day of admission, the patient woke up at took her blood pressure and found it to be in the 80's/40's. this is significantly lower than her baseline blood pressure of 100/60. the patient then went to the bathroom and had a bm. after she got out of the bathroom, ms. suddenly became short of breath, dizzy (she felt as if she would pass out), diaphoretic, and felt her heart pounding. she did not have any chest pain, nausea, or vomiting. at this time, she sat on the floor but this did not improve her symptoms. there was no loss of consciousness and the patient did not hit her head. while sitting on the floor, the patient realized that she needed to change her flolan pump cassette and attempted to do so. however, this was a difficult task due to her dizziness and she forgot to clamp the hickman catheter and blood began to backflow out of the catheter onto the floor. the patient then managed to activate ems. ems found ms. on the floor, with cyanotic lips and breathless speech. the hickman catheter was clotted off and the flolan would not infuse. vitals signs were as follows: hr: 80-120, bp: 100/60, rr: 26-28. she was placed on 15l of o2 via nrb. the patient was taken to . at this time the patient felt much better and her vital signs normalized: hr: 73-76, bp: 99-123/54-83, 96-99% of 6l of o2 (here home dose.) on exam, she was alert and oriented, with crackles at the base of the lungs. ekg: showed a rate of around 78 and afib. there were normal qrs interval and normal axis. there was no st segment elevations or depressions. possible q waves in avr, v1, and v2. there was no hypertrophy and normal r wave progression. labs showed na-138, k-4.2, cl-105, hco3-22, bun 20, cr-1.1, glucose 108, inr 1.66, cpk 79,wbc-4.9, hct 29.3. in the ed, ms. hickman's cath was unclogged and flolan infusion resumed. . on review of symptoms, the patient does endorse a week history of sob on exertion and 1-pillow orthopnea. this sob did not improve with increases of flolan and her pulmonologist was concerned that her chf was that actual cause of the sob not her pah. in fact, it was planned for her to have a cardiac catheterization. she has a long history of peripheral edema due to her pulmonary artery hypertension which is unchanged in the recent weeks. she does not report paroxysmal nocturnal dyspnea, hyperlipidemia, or diabetes. she denies any prior history of stroke, tia, deep venous thrombosis, pulmonary embolism, bleeding at the time of surgery, myalgias, joint pains, cough, hemoptysis, black stools or red stools. she denies recent fevers, chills or rigors. she denies exertional buttock or calf pain. all of the other review of systems were negative. . past medical history: 1) severe pulmonary artery hypertension -initially presented in . the etiology of this pah is thought to be due to multiple factors including left-sided diastolic chf due to htn and interventricular septal dysplacement, emphysema, possible rhematologic condition (crest). she was admitted in , at which point an extensive work-up was done. 2) emphysema 3) raynaud's phenomenonlikely crest syndrome-positive with positive anticentromere antibodies. 4) congestive heart failue and diastolic dysfunction 5) alcoholic induced cardiomyopathy-improved when alcohol was discontinued. 5) chronic atrial fibrillation-failed attempts at cardioversion. now, rate controlled. anticoagulated with coumadin with goal of 6) hypertension 7) right upper lobe pulmonary nodule and mediastinal lad on ct in . 8) ventral hernia-no symptoms of bowel obstruction or abdominal pain. 9) cataracts-scheduled surgery 10) chronic anemia-baseline hct around 30. normal iron studies. . social history: ms. is an ex-nurse who lives alone in . she has two daughters whom live in the area. she smoked heavily in the past but stopped 30 yeasr ago. she also drank heavily but stopped 1 year ago. she never had any seizures or withdrawl symptoms. family history: the patient's father had a stroke at 65 years of age. her mother had lung cancer. physical exam: vs: t 99.1 , bp , hr 68 , rr 20, o2 % 97 on 6l nasal cannula gen: female in no distress. she is oriented to person, place, and time. mood, affect appropriate. pleasant. heent: ncat. sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. neck: supple. difficlut to assess jvp due to carotid pulse and large external jugular. cv: irregular rate with normal s1 and s2. there is a iii/vi systolic murmur loudest at the right sternal border. chest: patient is on nasal canula and breathing comfortably with no accessory muscle use. no cyanosis. no chest wall deformities, scoliosis or kyphosis. there where bilateral crackles. no wheezes. abd: soft, ntnd with large right sided hernia. ext: 1+ bilateral pedal edema skin: no stasis dermatitis, ulcers, scars, or xanthomas. pulses: right: carotid 2+; femoral 2+ without bruit; 2+ dp left: carotid 2+; femoral 2+ without bruit; 2+ dp . pertinent results: admission labs: 09:27pm wbc-4.5 hgb-9.4* hct-29.5* mcv-87 mch-27.8 mchc-31.8 09:27pm glucose-94 urea n-20 creat-0.9 sodium-137 potassium-3.6 chloride-104 total co2-22 anion gap-15 09:27pm ck(cpk)-74 ctropnt-0.02* 09:27pm pt-22.4* ptt-36.2* inr(pt)-2.2* . chest xray : heart size is markedly enlarged increased diameter compared to due to known pericardial effusion increased in size. the widespread bilateral interstitial abnormalities represent known micronodular centrilobular interstitial pattern which might be due to active inflammation or lymphoproliferative disorder in the chest. . tte : mild symmetric lvh with normal cavity size and systolic function (lvef >55%). moderately dilated rv with moderate global free wall hypokinesis and abnormal septal motion/position consistent with right ventricular pressure/volume overload. moderate to severe tricuspid regurgitation. moderate sized circumferential pericardial effusion without echocardiographic signs of tamponade. . right heart cath : elevated right-sided filling pressures with rvedp of 14 mm hg. severe pulmonary arterial systolic hypertension with pasp of 90 mm hg. the left sided filling pressures were mildly elevated with mean pcwp of 13 mm hg. the cardiac index was preserved at 2.8 l/min/m2. brief hospital course: ms. is a 64 yo female with a history of pulmonary artery hypertension, diastolic chf, and chronic a-fib, and htn who presented with an acute episode of sob, dizziness, and diaphoresis. this is in the setting of worsening sob on exertion for 3-4 weeks and a non-functioning flolan pump. #) pulmonary hypertension-- the etiology of her symptoms was best explained by acute worsening of her pulmonary hypertension due to lack of flolan, resulting in acute decompensated right-sided heart failure. right heart cath revealed severe pulmonary arterial systolic hypertension. while the patient reports dysfunction of the flolan infusion after symptoms started, it is possible that the pump was malfunctioning before the event. patients on flolan can be very dependent on the infusion for survival. the flolan pump was re-started and her rate was up-titrated as tolerated to a rate of 27. the patient responded well to this intervention. her sob improved and she returned to her usual baseline. she was consulted by pulmonary and rheumatology during this admission. her chest ct looked worse than prior and concern was brought up that she may have crest. a number of blood tests were sent for connective tissue disorder work-up, to be followed up as an outpatient. . #) diastolic chf-- she has known diastyolic dysfuntion due to lvh and interventricular septal displacement. flolan can worsen chf. patient did have crackles on exam but this may have beenb due to her known emphysema. her cxr was relatively dry. tte during this admission revealed moderately dilated rv cavity, moderate global rv free wall hypokinesis, and abnormal septal motion/position consistent with rv pressure/volume overload. lasix was held initially due to patient's hypotension, but she was then re-started on her home dose of lasix. she was also treated with lisinopril for afterload reduction. . #) afib-- she was continued on digoxin and coumadin for her afib. on admission her inr was therapeutic at 2.2 and her dose was titrated as necessary to maintain a therapeutic inr. . #) depression- her home does of citalopram was continued. . #) code- the patient was dnr/dni for this admission . medications on admission: allergies: nkda . 1) digoxin 0.125mg po daily 2) lasix 40mg po bid daily 3) lisinopril 5mg po daily 4) coumadin 2.5mg po daily 5) coumadin 5mg on wed,fri 6) flolan 83ml/24hrs with pump set at 25 7) 6l o2 via nasal cannula 8) celexa 20mg po daily . discharge medications: 1. citalopram 20 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 2. digoxin 125 mcg tablet sig: one (1) tablet po daily (daily). 3. epoprostenol 0.5 mg recon soln sig: one (1) recon soln intravenous infusion (continuous infusion): 27 nanograms/kg/ minute infusion. 4. lisinopril 5 mg tablet sig: one (1) tablet po once a day. 5. lasix 40 mg tablet sig: one (1) tablet po twice a day. disp:*60 tablet(s)* refills:*2* 6. warfarin 2.5 mg tablet sig: two (2) tablet po at bedtime for 2 days: take 2 tablets on and , then resume regular dosing. disp:*60 tablet(s)* refills:*2* discharge disposition: home with service facility: medical discharge diagnosis: pulmonary hypertension diastolic congestive heart failure atrial fibrillation connective tissue disease . discharge condition: stable, ambulating . discharge instructions: weigh yourself every morning, md if weight > 3 lbs. adhere to 2 gm sodium diet please continue your home medications. we have increased the dose of your flolan. you should take 5mg of coumadin on saturday and sunday and have your coumadin level checked on at the coumadin clinic in . . you will need to follow up with your pulmonologist, rheumatologist, and primary care physician. . you were admitted to the hospital for worsening of your pulmonary hypertension secondary to malfunctioning of your flolan pump. because of this, your heart was not able to pump blood effectively to your brain and the rest of your body, which resulted in your symptoms of shortness of breath and dizziness. we were able to correct this by re-starting your pump and increasing the flow rate. please return to the hospital if you experience worsening shortness of breath, chest pain, if you have malfunctioning of your flolan, or any other concerning symptoms. . followup instructions: please call dr. office to schedule an outpatient appointment as soon as possible. provider: , md (cardiology) phone: date/time: 1:40 please have your coumadin level checked on in . please schedule follow-up with rheumatology as previously instructed. . procedure: coronary arteriography using a single catheter right heart cardiac catheterization diagnoses: congestive heart failure, unspecified atrial fibrillation other chronic pulmonary heart diseases hypopotassemia other emphysema mechanical complication due to other implant and internal device, not elsewhere classified diseases of tricuspid valve raynaud's syndrome chronic diastolic heart failure systemic sclerosis 

Answer: The patient is high likely exposed to