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: cats attending: chief complaint: chest pain major surgical or invasive procedure: 1. emergent mediastinal re-exploration. 2. drainage of pericardial effusion. 3. cardiac catheterization 4. iabp placement 5. swan catheter placement history of present illness: (all information obtained via omr and patients chart. she is intubated and sedated) 79 year old female who presented to emergency room with the complaints of nausea,vomitting, unsteady gait and feeling disoriented. upon arrival to emergency room she was able to answer yes and no questions and then suddenly became unresponsive. she was intubated, and appeared to be in shock according to ekg. she continued to have signs of shock, with low blood pressure, requiring dopamine and levophed. on bedside ultrasound she had poor wall motion, no clear effusion. she was transferred to for cardiac catheterization. past medical history: hypertension atrial fibrillation cad (exercise stress test/stress echo wnl) hypercholesterolemia osa on cpap c-scope (-wnl) ckd - presumed htn(baseline cr: 1.5) hx scc l chest wall rx with topical agents () lcis() lumbar stenosis idiopathic b/l le numbness syncopal episodes (since teen years), breast cancer social history: lives alone - widowed . retired credit analyst. denies tobacco, etoh, recreational drugs family history: non-contributory physical exam: general: pt intubated. heent: ncat. sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. no xanthalesma. neck: supple, collar in place. cardiac: pmi located in 5th intercostal space, midclavicular line. rr, 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, no accessory muscle use. ctab, no crackles, wheezes or rhonchi. abdomen: soft, ntnd. no hsm or tenderness. abd aorta not enlarged by palpation. no abdominial bruits. extremities: no c/c/e. no femoral bruits. skin: no stasis dermatitis, ulcers, scars, or xanthomas. pertinent results: : cardiac cath: 1.delayed presentation of posterior wall stemi 2.cardiogenic shock 3.lateral wall myocardial rupture 4.successful recanalization of the left circumflex with balloon angioplasty 5.emergency surgery for myocardial rupture echo: the left atrium is normal in size. there is mild symmetric left ventricular hypertrophy with normal cavity size. there is mild regional left ventricular systolic dysfunction with severe hypo/akinesis of the basal inferolateral wall with a discontuity and the basal wall at the annulus level with apparent communication with the pericardial space. color flow doppler is inadequate to define flow. the remaining segments contract normally (lvef = 45-50 %). right ventricular chamber size is normal. the free wall is not well seen. the aortic valve leaflets are mildly thickened (?#). there is no aortic valve stenosis. there is a moderate sized circumferential pericardial effusion. tamponade could not be assessed. echo: there is mild symmetric left ventricular hypertrophy with normal cavity size. there is mild regional left ventricular systolic dysfunction with akinesis of the basal inferolateral wall. there appears to be a rupture of the basal inferolateral wall immediately apical to the mitral annulus with color flow doppler through this area in to the pericardial space. the remaining segments contract normally (lvef = 55 %). there is a moderate sized circumferential pericardial effusion. no right ventricular diastolic collapse is seen. compared with the prior study (images reviewed) of earlier in the day of , the pericardial effusion is slightly larger and flow from the left ventricle into the pericardial space is now more clearly defined. ekg: sinus rhythm. left atrial abnormality. a-v conduction delay. diminished voltage as compared to the previous tracing of and increase in rate. there is st segment elevation in leads i and avl with biphasic t waves in leads i and avl. right precordial st segment depression. these findings are new as compared to the previous tracing of and are consistent with active posterolateral ischemic process, rule out myocardial infarction. there is q-t interval prolongation. clinical correlation is suggested echo: pre-cpb:the patient was brought to the operating room on iabp with infusions of norepinephrine and dopamine. 1. no spontaneous echo contrast is seen in the left atrial appendage. no thrombus is seen in the left atrial appendage. 2. no atrial septal defect is seen by 2d or color doppler. 3. there is moderate symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. overall left ventricular systolic function is mildly depressed (lvef= 50 %). there is evidence of a lateral free wall rupture and contained hematoma. 4. right ventricular chamber size and free wall motion are normal. 5. the ascending, transverse and descending thoracic aorta are normal in diameter and free of atherosclerotic plaque. the iabp is in good positoipn 3 cm below the lsca. 6. there are three aortic valve leaflets. there is no aortic valve stenosis. no aortic regurgitation is seen. 7. the mitral valve appears structurally normal with trivial mitral regurgitation. there is no mitral doppler evidence for mitral stenosis. 8. there is a moderate sized pericardial effusion. the effusion appears loculated. there is left atrial diastolic collapse. drs. and notified in person of the results. post cpb: on infusion of epinephrine. reduced size of pericardial effusion with significant compression of left atrium. the lateral free wall has a smaller rupture than pre bypass. lvef = 60%. aortic contour is normal post decannulation. cxr: the et tube tip is approximately 4.3 cm above the carina. the intra-aortic balloon pump is very low, at least 8 cm below the roof of the aortic arch. mediastinal drains are in place. the swan-ganz catheter inserted through the right internal jugular approach terminates at the level of the low right ventricle. right chest tube is in place. mediastinal drains are in place. heart size and mediastinum are grossly stable. left pleural effusion and left lower lung consolidation is noted. echo: left ventricular wall thicknesses and cavity size are normal. there is mild regional left ventricular systolic dysfunction with severe hypokinesis of the basal inferolateral wall. the remaining segments contract normally (lvef >50 %). the mitral valve leaflets are not well seen. there is no definite pericardial effusion. no definite extravasation of blood is identified. impression: suboptimal image quality. regional left ventricular systolic dysfunction c/w cad. no definite pericardial effusion identified. cxr: in comparison with the earlier study of this date, the endotracheal tube has been removed. the swan-ganz catheter has been removed and replaced with a jugular shunt. nasogastric tube remains in place. iabp has been removed. there are still hazy opacifications bilaterally, more prominent on the right, consistent with bilateral pleural effusions and pulmonary vascular congestion. no evidence of acute pneumonia. cxr: an et tube is present, tip approximately 5.9 cm above the carina. ng tube is present, tip extends beneath the diaphragm, off the film. a right ij sheath is present, tip overlying lower ij above the level of the clavicle. the patient is status post sternotomy, with a prominent cardiomediastinal silhouette. there is upper zone redistribution and diffuse vascular blurring, asymmetrically more pronounced on the right. there is obscuration of the right inferior lung likely reflecting combination of pleural fluid and underlying collapse and/or consolidation. there is increased retrocardiac density, consistent with left lower lobe collapse and/or consolidation, likely with a small amount of pleural fluid. some subcutaneous emphysema is noted over the right greater than left chest. the possibility of a small right apical pneumothorax cannot be excluded. linear lucency traversing the right posterior third rib may represent artifact due to subcutaneous emphysema, but the differential diagnosis would include a non-displaced rib fracture. compared with at 8:27 a.m., lung findings are similar. right apical pneumothorax and possible right posterior third rib fracture, if real, are new. 01:45pm blood wbc-17.5*# rbc-3.59* hgb-11.7* hct-35.1* mcv-98 mch-32.5* mchc-33.3 rdw-13.4 plt ct-170 02:45am blood wbc-9.2 rbc-3.42*# hgb-10.7*# hct-31.1* mcv-91 mch-31.3 mchc-34.4 rdw-15.2 plt ct-88* 04:48am blood wbc-11.4* rbc-3.34* hgb-10.4* hct-29.8* mcv-89 mch-31.0 mchc-34.7 rdw-15.4 plt ct-77* 05:28am blood wbc-14.8* rbc-3.34* hgb-10.3* hct-30.5* mcv-91 mch-30.9 mchc-33.8 rdw-15.6* plt ct-55* 03:53am blood wbc-17.9* rbc-3.42* hgb-10.5* hct-31.2* mcv-91 mch-30.8 mchc-33.8 rdw-15.2 plt ct-66* 02:46am blood wbc-18.9* rbc-3.24* hgb-10.3* hct-30.2* mcv-93 mch-31.7 mchc-34.0 rdw-15.2 plt ct-73* 05:12am blood wbc-29.2*# rbc-3.24* hgb-10.0* hct-30.1* mcv-93 mch-30.9 mchc-33.3 rdw-15.9* plt ct-150# 03:48pm blood fibrino-195 05:28am blood fibrino-165* 01:45pm blood glucose-200* urean-51* creat-2.8* na-139 k-5.5* cl-103 hco3-14* angap-28* 02:45am blood glucose-140* urean-49* creat-2.8* na-144 k-5.0 cl-110* hco3-20* angap-19 03:21am blood glucose-99 urean-52* creat-3.0* na-141 k-4.1 cl-110* hco3-21* angap-14 05:28am blood glucose-128* urean-70* creat-4.0* na-137 k-4.2 cl-104 hco3-21* angap-16 03:53am blood glucose-118* urean-92* creat-4.9* na-138 k-3.8 cl-103 hco3-22 angap-17 02:46am blood glucose-350* urean-100* creat-5.2* na-134 k-3.4 cl-94* hco3-21* angap-22* 05:12am blood glucose-137* urean-120* creat-5.5* na-142 k-4.0 cl-102 hco3-23 angap-21* 01:45pm blood alt-1025* ast-808* ck(cpk)-739* alkphos-49 amylase-52 totbili-0.8 dirbili-0.4* indbili-0.4 02:45am blood alt-3259* ast-4504* alkphos-37 amylase-101* totbili-0.7 03:53am blood alt-41* ast-298* ld(ldh)-747* alkphos-53 totbili-1.9* 05:12am blood alt-26 ast-94* ld(ldh)-720* alkphos-57 totbili-1.5 12:46pm blood glucose-243* lactate-7.8* k-5.2* 01:54pm blood lactate-10.0* 04:22pm blood glucose-137* lactate-9.2* na-139 k-5.0 cl-108 09:23pm blood lactate-5.2* k-4.8 04:02pm blood glucose-126* lactate-2.6* k-4.8 12:09pm blood lactate-1.6 02:08am blood lactate-1.9 brief hospital course: 80yo f presented to on w/ n/v, ataxia, and disorientation several days following a suspected mi. she collapsed and was found to be in shock. after reperfusing an occluded circumflex in cathlab she remained in cardiogenic shock. a tee revealed a left ventricular free wall rupture. in cardiothoracic or she underwent clot evacuation without any identifiable bleeding source, surmising a contained rupture. she was post-operatively managed on ccu for the following problems: #delayed presentation of posterior wall stemi: the patient had endorsed several days of pain radiation to the jaw. she initally presented to an osh where she was found to be in cardiogenic shock. she was intubated and placed on pressors and transfered to where she was taken to the cardiac cath lab where she was found to have a fully occuled lcx artery and a free wall rupture of the lv. she was taken to the or by ct surgery who performed an emergent mediastinal re-exploration and drainage of pericardial effusion. they discovered a clot that tampanaded the free wall rupture. she was taken to the icu following surgery where the patient sbps were initially in the 80s and continued to require pressor support. she had an iabp that had been placed at time of cardiac cath and she was maintained on pressor support and iabp. she developed shock liver and her renal function deteriorated. her cardiac output initially worsened but were stabilized with the addition of inotropic support. in this setting she was able to be weaned off the iabp. following the removal she became hypertensive and became less reactive to stimuli. there was growing concern for a septic component to shock as wbc count bumped and temp persisted. sputum culture notable for gram neg rods and wbc increased to 19 so pt started on renally dosed cefepime and vancomycin. on after a family meeting and in keeping with the patients wishes and given the clinical status of the patient the decision was made to make her cmo. she was extubated and given fentanyl and morphine. the family was present and the patient passed peacefully on . # ventricular rupture. good hemostasis achieved in or, w/ct placement then removed . repeat echo confirmed effusion-free and good hemostasis. clopidogrel held due to rebleeding risk. cxr showed vascular congestion. patient diuresed furosemide and metolazone. after several liters removed, diuretics were scaled back with target net negative .5l daily. a repeat echo on showed continued hemostasis with no new effusion. there was no observed pulsus paradoxis. he recovery was complicated by the above issues issues. # coronaries: lca and occlusions reperfused with angioplasty. stenting was not indicated given the clinical situation and extensive coronary disease. echo showed akinesis in distribution of infarct with relatively well preserved ef . she was started on asa but clopidogel was held in setting of high bleeding risk. bb, acei, and statin were held in setting of acute comorbidities(hypotension, , transaminitis, respectively) # afib: pre-admission history of sinus bradycardia with apparently new af this admission. bursts of return to sinus beginning on . rates in 120s, so given amiodarone 150 bolus and then ggt started. drip stopped after pt found to be in sinus for several hrs. however, she continued to flip in and out of afib over next several days. amio was kept on at .5mg/min. rate was controlled with iv metoprolol to prevent further heart strain. #fever:uncertain etiolgy at this time. thought to be secondary to inflammation at site of ventricular rupture given persistence through broad spectrum antibiotics. abx were stopped as wbc was normal and cultures negative. on , wbc trended up to 19 and gram neg rods were isolated in sputum culture. cefepime and vancomycin was restarted for vap coverage. a repeat cxr did not show any consolidation or new infiltrate wbc not significantly elevated. # acute on chronic renal insufficiency. appears baseline cr prior to transfer was transfer 3.2 most likely secondary to cardiogenic shock and poor profusion with secondary atn. feurea was >40% indicating an intrarenal component. no eos seen on ua decreasing the likelihood for ain. renal was consulted and diuresis was achieved with lasix and metolazone. #thrombocytopenia: plt dropped from admission 170->66 presumed due to iabp. no bleeding. hit suspicion low, due to plt drop within 3 days of heparin. ttp considered re: ams and renal failure, though stable hct and no schistocytes seen on smear. dic considered, though marginally low fibrinogen (165) thought consistent with traumatic hx. smear was normal and hct and platlets remained stable following balloon removal. medications on admission: diltiazem er cap spironolactone atenolol valsartan 80 mg tab lovastatin 10 mg aspirin 81 mg discharge medications: expired discharge disposition: expired discharge diagnosis: st-elevated myocardial infarction with left ventricular free wall rupture discharge condition: expired discharge instructions: expired followup instructions: expired procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more extracorporeal circulation auxiliary to open heart surgery implant of pulsation balloon pericardiotomy excision of lingual thyroid percutaneous transluminal coronary angioplasty [ptca] procedure on single vessel diagnoses: acidosis obstructive sleep apnea (adult)(pediatric) pure hypercholesterolemia acute kidney failure with lesion of tubular necrosis acute and subacute necrosis of liver hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified atrial fibrillation chronic kidney disease, unspecified true posterior wall infarction, initial episode of care cardiogenic shock encounter for palliative care systemic inflammatory response syndrome due to noninfectious process with acute organ dysfunction acute myocardial infarction of other lateral wall, initial episode of care cardiac tamponade fever presenting with conditions classified elsewhere other secondary thrombocytopenia 

Answer: The patient is high likely exposed to