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: sob, transfer for st elevations major surgical or invasive procedure: endotracheal intubation and extubation mechanical ventilation cardiac catheterization history of present illness: ms. is an 89 year old female with severe asthma, htn, hl, dm, and cad who was admitted to the micu due to acute sob and st elevations. she is now being transferred to the floor. she has frequent exacerbations of her asthma and was recently treated at for a copd/asthma exacerbation. she was discharged home and developed acute sob, diaphoresis, and htn in the ambulance. her ecg at the time showed st elevations in the lateral wall and she was given ntg, lasix, asa, and taken back to . she was found to be hypoxic and agitated and intubated for airway protection. she was then started on a nitro gtt and heparin gtt due to st elevations and transferred to . in the ed, she was found to be hypertensive to 225/118 and was admitted to the micu on versed and a heparin gtt (nitro gtt had been weaned off due to downtrending bps). in the micu, she was noted to have diffuse st elevations and a code stemi was called. she was taken to the cath lab and found to have no flow-limiting lesions but elevated filling pressures and was felt to have takotsubo's cardiomyopathy with an estimated ef 40%. she was diuresed in the micu with 40mg iv lasix and also given insulin and d50 for hyperkalemia. her course was also complicated by agitation and the patient pulling out her picc line and ej iv access. she was also hitting and scratching the nurses this morning and was given haldol 2mg im x 1 at 5:30am with excellent calming effect. she also had hypernatremia and was given 1l d5w yesterday. she currently has no iv access and has not had labs drawn since yesterday. she was switched from iv beta blocker to oral this morning. currently she states that she is mildly short of breath but feeling much better than previous. she has no other complaints, other than wanting to go home. review of systems: she denies any headaches, confusion, chest pain, palpitations, cough, abdominal pain, nausea, vomiting, diarrhea, constipation, or urinary symptoms. she has a foley catheter in place. past medical history: - hypertension - hyperlipidemia - diabetes - s/p thyroid surgery - h/o severe asthma, no pfts in our system, recently on steroid taper - h/o cri - h/o blood clot in the leg several years ago social history: states she smoked 1ppd x most of her life, cannot give quit date history (once she said , once she said 1 month ago). denies etoh use. denies other drug use. lives alone in , ma and has a sister in nc. had one daughter who passed away recently from asthma exacerbation. family history: osh transfer note states that she has a family history of premature cad and that both her parents are deceased. she states that parents died of old age and "a natural death." she has 2 sisters who are in nc but she doesn't know about their health. physical exam: vitals: 98.1 84 148/79 23 98%ra general: disheveled african-american elderly female in nad. eyelids with slight drooping bilaterally and eyes with haziness diffusely. heent: sclera anicteric, mmm, oropharynx clear but with poor dentition neck: supple with jvp 9-10cm lungs: decreased air movement throughout with low-pitched expiratory wheezes bilaterally and faintly. cv: regular rate with marked ectopy, normal s1 + s2, no murmurs, rubs, gallops abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly. does have extra skin hanging on abdomen suggestive of previous weight loss. ext: warm, well perfused, no clubbing, cyanosis. rue edema just below the elbow. pertinent results: admission labs: 04:40am wbc-13.9*# rbc-3.38* hgb-10.2* hct-32.9* mcv-97 mch-30.3 mchc-31.1 rdw-16.2* 04:40am neuts-93.9* lymphs-3.9* monos-1.3* eos-0.8 basos-0.1 04:40am plt count-224 04:40am pt-11.7 ptt-32.0 inr(pt)-1.0 04:40am alt(sgpt)-25 ast(sgot)-42* ck(cpk)-61 alk phos-99 tot bili-0.5 04:40am glucose-124* urea n-34* creat-1.5* sodium-142 potassium-5.4* chloride-110* total co2-24 anion gap-13 04:40am ctropnt-0.20* 04:40am ck-mb-5 03:31pm lactate-1.0 k+-5.5* discharge labs: 05:15am blood wbc-8.3 rbc-3.46* hgb-10.3* hct-32.2* mcv-93 mch-29.7 mchc-31.9 rdw-15.8* plt ct-182 05:15am blood pt-11.5 ptt-27.0 inr(pt)-1.0 05:15am blood glucose-89 urean-50* creat-1.6* na-142 k-3.8 cl-103 hco3-32 angap-11 04:31pm blood ck-mb-5 ctropnt-0.55* 05:15am blood calcium-10.6* phos-2.3* mg-2.1 studies: ct head : no acute intracranial hemorrhage or mass effect. cxr :as compared to the previous examination, there is no relevant change. due to projection effect, the cardiac silhouette appears slightly larger than before. however, no evidence of pulmonary edema is seen. moderate tortuosity of the thoracic aorta. no newly occurred focal parenchymal opacity suggesting pneumonia. no pleural effusions, no pneumothorax. tte : the left atrium is elongated. no atrial septal defect is seen by 2d or color doppler. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. there is mild regional left ventricular systolic dysfunction suggested with distal septal and apical hypokinesis. there is no ventricular septal defect. right ventricular chamber size and free wall motion are normal. the aortic valve leaflets are moderately thickened. there is mild aortic valve stenosis (valve area 1.2-1.9cm2). mild (1+) aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. mild (1+) mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. moderate tricuspid regurgitation is seen. there is mild pulmonary artery systolic hypertension. there is no pericardial effusion. compared with the prior study (images reviewed) of , a mild regional wall motion abnormality is now seen suggestive of cad. cardiac cath : 1. coronary angiography of this right dominant system revealed no significant coronary artery disease. the lmca appeared normal. the lad, lcx, and rca had minor luminal irregularities with marked tortuosity. 2. limited resting hemodynamics demonstrated low-normal systemic arterial blood pressure (sbp 109 mm hg). there was no gradient upon pullback of the catheter from the lv into the aorta. 3. left ventriculography revealed marked distal anterior, apical, and distal inferoapical severe hypokinesis/ akinesis with contraction of the basal segments, with an estimated lvef of 40%. there was no mitral regurgitation. final diagnosis: 1. no significant angiographically apparent coronary artery disease. 2. marked lv apical dysfunction consistent with takotsubo cardiomyopathy. rue ultrasound : no evidence of dvt of the right upper extremity. brief hospital course: 89 year old female with dchf, htn and severe asthma requiring recurrent ed visits currently on prednisone taper, transferred from osh with respiratory distress intubated for airway protection and ecg changes now s/p clean cardiac catheterization. #. respiratory distress: patient has had recurrent exacerbations of copd vs asthma requiring repeated treatment with steroids. she carries diagnosis of asthma and smoked 1 pack per week in past and has been on spiriva. she improved rapidly with steroids iv which were transitioned to oral. there was no documentation of hypercapnia or hypoxia prior to intubation so unclear if she actually had respiratory failure or was just intubated for airway protection given ecg changes. wheezing and air movement improved with nebulizers and steroids and she extubated without difficulty on . given elevated bp requiring nitro gtt prior to intubation, may have had some component of flash pulmonary edema as well but cxr was clear without evidence of volume overload or pneumonia. she was also given lasix 40 iv x 1 and then 20 po x 1 for some mild component of volume overlaod but was satting well on room air prior to trasnfer to floor. she is being discharged on a prednisone taper as well as standing nebulizer treatments. #. ecg changes/takotsubo's cardiomyopathy: ecg with st elevations in v2-6 and positive troponins which peaked at 0.58 then trended down. cardiology was consulted and code stemi was called on arrival to the micu and she was taken for cardiac catheteterization. she was also initially started on heparin gtt and integrillin drip. there were no flow limiting lesions so heparin and integrillin stopped. ecg changes and positive troponin felt to be due to takotsubo's cardiomyopathy. she was started on asa 325 daily, metoprolol, and an ace-inhibitor. she should have an repeat tte in weeks. #. htn: was initially hypertensive on nitro gtt prior to trasnfer which was quickly weaned off in ed and bp remained improved and normalized back on home regimen hctz, imdur and amlodipine. she was also started on an ace-inhibitor and beta blocker, which can be uptitrated after discharge as needed. #. chronic diastolic chf: known diastolic dysfunction with ef >55% in the past and ef now depressed 40% on lv gram done in cath lab but repeat formal tte with improved ef. bb and ace were started. #. : cr 1.7 from baseline 1.2-1.3 which improved slightly with gentle diuresis. feurea 34%. it was felt that her renal function was likely worsened by dye load but stable at time of transfer. she was given nac after her contrast load. #. hyperkalemia: k 6.8 increased from 5.4 on admission. possibly related to worsening renal function vs acidemia from progressive hypercarbia. improved with insulin/d50, lasix, bicarb and calcium gluconate. #. anemia: hematocrit remained at baseline 32. #. delirium: was combative and agitated post-extubation which responded well to 2mg im haldol and she was alert oriented and cooperative at time of floor transfer and subsequently thereafter. #. code status: she was full code during this hospitalization medications on admission: mdur 60mg po daily amlodipine 10mg po daily folic acid 1mg po daily albuterol nebs q4 hours prn hctz 12.5mg po daily spiriva 1 cap ih daily colace 100mg po bid prednisone 10mg po taper (currently 20mg dose (taper ) discharge medications: 1. isosorbide mononitrate 60 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po daily (daily). 2. amlodipine 10 mg tablet sig: one (1) tablet po once a day. 3. folic acid 1 mg tablet sig: one (1) tablet po once a day. 4. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) nebulization inhalation q6h (every 6 hours). 5. hydrochlorothiazide 12.5 mg capsule sig: one (1) capsule po daily (daily). 6. docusate sodium 100 mg tablet sig: one (1) tablet po twice a day. 7. prednisone 20 mg tablet sig: three (3) tablet po once a day for 1 days: take 3 tablets (60mg) daily for 1 day, then take 2 tablets (40mg) daily for 3 days, then take 1 tablet (20mg) daily for 3 days, then take 10mg daily for 3 days. 8. lisinopril 5 mg tablet sig: 0.5 tablet po daily (daily). 9. metoprolol tartrate 25 mg tablet sig: 0.5 tablet po bid (2 times a day). 10. ipratropium bromide 0.02 % solution sig: one (1) nebulization inhalation q6h (every 6 hours). 11. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 12. insulin lispro 100 unit/ml solution sig: per sliding scale subcutaneous asdir (as directed). discharge disposition: extended care facility: & rehab center - discharge diagnosis: primary diagnoses: - chronic obstructive pulmonary disease exacerbation - takotsubo's cardiomyopathy - hyperkalemia - delirium - anemia - acute kidney injury secondary diagnoses: - hypertension - type 2 diabetes mellitus - hyperlipidemia - chronic kidney disease, stage 3 - h/o blood clot in the leg several years ago discharge condition: mental status: confused - sometimes. level of consciousness: alert and interactive. activity status: ambulatory - requires assistance or aid (walker or cane). discharge instructions: you were admitted to the hospital with shortness of breath. you were intubated and placed on a ventilator for a few days. you underwent a cardiac catheterization which showed that you did not have a heart attack and you do not have significant coronary artery disease. you were also treated for an exacerbation of your copd. changes to your medications: added albuterol nebulizers every 4 hours added ipratropium nebulizers every 4 hours added lisinopril 2.5mg by mouth daily added metoprolol tartrate 12.5mg by mouth twice daily stop spiriva (you should restart this medication when you stop taking ipratropium nebulizers) added aspirin 325mg by mouth daily start insulin sliding scale while at rehab followup instructions: you are being discharged to a rehabilitation facility. you should be followed by the physician at your rehab facility while you are there. you should have your electrolytes checked in one week and creatinine checked in one week. you should have follow-up echocardiogram in 1 week. when you are discharged, please call your primary care provider, . , to schedule a follow-up appointment at . procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours left heart cardiac catheterization coronary arteriography using a single catheter diagnoses: hyperpotassemia anemia in chronic kidney disease congestive heart failure, unspecified diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute kidney failure, unspecified other and unspecified hyperlipidemia chronic kidney disease, stage iii (moderate) chronic obstructive asthma with (acute) exacerbation hyperosmolality and/or hypernatremia delirium due to conditions classified elsewhere chronic diastolic heart failure hypertensive chronic kidney disease, benign, with chronic kidney disease stage i through stage iv, or unspecified takotsubo syndrome 

Answer: The patient is high likely exposed to