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: acute stroke major surgical or invasive procedure: cerebral angiogram intraarterial tpa history of present illness: pt is a 65 yo cantonese speaking female w/ pmhx sig for htn, gerd, ? ovarian cancer who presents as a transfer from after receiving iv tpa for code stroke. the patient was apparently at home taking care of her grandchildren when she fell to the floor. the time of onset from talking to family was between 12:00 - 4:00 pm. she was unable to speak but called her husband on the phone. eventually she was found and taken to where she was found to have right face weakness, flaccid right arm, and difficulty producing language. ct scan showed a l hyperdense mca sign. the patient was given iv tpa and transferred to . at the patient had a cta of the head that showed residual clot in the m2 segment of the l mca. she was taken to the angiography suite for intra-arterial tpa administration. she was deemed to have a near total occlusion of the l ica. 15 cc of intra-arterial tpa was administered to the carotid artery. the patient was then transferred to the icu for further management. past medical history: htn, gerd, osteoporosis, per family ovary or possibly uterus removed for cancer. social history: married. no etoh/tobacco family history: brother - stroke physical exam: t 97.0; bp 140/70; p 81; rr ; o2 sat 99% general: lying in bed, in c-collar heent: ncat neck: supple pulmonary: cta b/l cardiac: regular rate and rhythm, with no m/r/g carotids: no blood flow murmur abdomen: soft, nontender, non distended, normal bowel sounds extremities: no c/c/e. neurological exam: mental status: eyes open, attends to examiner, says "two" in cantonese when asked to identify two fingers. states ok to majority of things stated to her. cranial nerves: perrl 4->2, eomi, r lmn facial droop, tongue midline. motor/: rue flaccid, normal tone in all other extremities w/ movement to nailbed pressure. reflexes: bic t br pa ac right 2 2 2 2 2 left 2 2 2 2 2 r toe upgoing. pertinent results: 137 103 16 - - - - - - gluc 134 3.3 25 0.7 ck: 232 mb: 4 alt: 18 ap: 55 tbili: 0.4 alb: 3.9 ast: 31 : 114 lip: 72 wbc 14.2 hct 33.3 plt 238 n:90.1 band:0 l:7.9 m:1.7 e:0.2 bas:0.1 hypochr: 1+ anisocy: 1+ macrocy: 1+ microcy: 1+ polychr: pt: 12.2 ptt: 27.4 inr: 1.0 cta - + hyperdensity of l m2 segment of mca carotids: less than 40% right ica stenosis. near-occlusive lesion of the left mid cca. echo: no asd or pfo seen. normal global and regional biventricular systolic function. mild pulmonary hypertension. ef 55%. head : continued evolution of left mca infarct. no evidence of intracranial hemorrhage or mass effect. brief hospital course: pt is a 65 yo female w/ pmhx sig for htn, gerd, ? ovarian cancer p/w acute onset aphasia, r facial weakness, rue plegia found to have l mca occlusion now s/p iv and ia tpa. the patient appears to have a total left main carotid occlusion based on the angiogram. suspect that the patient had long standing carotid disease and released an artery to artery embolus. the patient had no complications of iv tpa and was transferred to the neurology floor. she was placed on heparin gtt for a presumed clot in the left common carotid artery, based on angiogram results, which suggested proximal occlusion. she was transitioned to coumadin, to remain on for 3 months, at which point she will get a repeat cta and be seen in stroke clinic. tte showed no source of embolism or thrombus. carotid u/s showed less than 40% right ica stenosis. near-occlusive lesion of the left mid cca. cta on admission showed "an abrupt cutoff at the location of hyperdense clot noted on noncontrast head ct within the m2 portion of the left middle cerebral artery, consistent with thrombus. remaining vessels and branches of the circle of appear unremarkable. there is a visible mismatch identified on perfusion imaging with increased mean transit time and decreased blood flow with perhaps slightly decreased blood volume noted within the distribution of the left mca consistent with an ischemic penumbra. evaluation of the internal carotid and vertebral circulation reveals a minimal amount of flow identified within the left internal carotid with retrograde and collateral filling of the distal segements consistent with a high-grade, more proximally situated stenosis. please refer to results from angiogram on same day for further detail. the right internal carotid and vertebral system do not display any evidence of flow limiting stenosis. there is no evidence of av malformation or aneursymal dilatation within the anterior and posterior circulations or the circle of " hospital course was complicated by orthostatic hypotension, treated well with midodrine. at discharge to rehab, she has persistent right face/arm/leg weakness, at least antigravity and tone is coming back. she will remain on coumadin and should have frequent inr checks. medications on admission: calcium, nifedipine, protonix discharge medications: 1. insulin regular human 100 unit/ml solution sig: one (1) injection asdir (as directed): sliding scale. 2. docusate sodium 50 mg/5 ml liquid sig: one (1) po bid (2 times a day). 3. midodrine 5 mg tablet sig: one (1) tablet po tid (3 times a day). 4. protonix 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po once a day. 5. warfarin 2.5 mg tablet sig: one (1) tablet po hs (at bedtime). 6. calcium 500+d 500-125 mg-unit tablet sig: one (1) tablet po twice a day. discharge disposition: extended care facility: discharge diagnosis: left middle cerebral artery stroke left common carotid occlusion orthostatic hypotension discharge condition: improved discharge instructions: you have been started on coumadin, a blood thinner. the level of this medication must be checked frequently at rehab and after discharge (goal inr ). please continue to take all medications as listed below. you should keep you return to ed with recurrent or new neurologic symptoms. followup instructions: 1. primary care - please call dr. office prior to discharge from rehab ( 2. clinic drs. & phone: date/time: wed 1:00pm. building md procedure: injection or infusion of thrombolytic agent arteriography of cerebral arteries diagnoses: esophageal reflux unspecified essential hypertension osteoporosis, unspecified cerebral embolism with cerebral infarction orthostatic hypotension occlusion and stenosis of carotid artery with cerebral infarction 

Answer: The patient is high likely exposed to