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: history of present illness: ms. is an 83-year-old female with a history of hypertension, aortic stenosis, hyperlipidemia, and mild congestive obstructive pulmonary complaining of dizziness after a breath, or palpitations. the etiology of the fall and the dizziness was unclear to her primary care physician . the patient was sent home and did well until the day of presentation when after lunch while lying on her bed, she diaphoresis. this sensation did not radiate. it was not associated with any shortness of breath, nausea, vomiting, or she tried standing during this episode. the pain lasted roughly 30-45 minutes unabated. she then called 911, and was transferred to the emergency room. in the emergency room, the patient was found to be in atrial fibrillation with a rapid ventricular rate to the 150s with blood pressure systolic in the 60s. the patient was unsuccessfully cardioverted x2 at 200 joules, and given lopressor 2.5 mg iv x2 without any improvement in her rate or blood pressure. the patient however, mentated throughout the entire treatment in the emergency room without any chest pain or shortness of breath. following the unsuccessful second cardioversion, the patient was transferred to the cardiac intensive care unit. at that time, she was still found to be in atrial fibrillation with a rapid ventricular rate into the 120s. then she had an arterial line placed in her right arm during which the patient spontaneously converted to sinus bradycardia with occasional premature atrial complexes. her heart rate dropped to 50s to 80s, and her blood pressure rose to 120/30s. she was then admitted to ccu for further observation and workup of the atrial fibrillation and evaluation of her aortic stenosis. past medical history: 1. hypertension. 2. aortic stenosis. catheterization in showed an area of aortic valve at 1.04 cm squared, a gradient of 0.23. an echocardiogram in showed an ejection fraction of 55%, previous echocardiogram in showed a left atrium 4.4 cm in size and valve area of 0.9 cm squared. 3. hyperlipidemia. 4. gastroesophageal reflux disease. 5. mild congestive obstructive pulmonary disease. 6. rotator cuff injuries bilaterally status post left rotator cuff repair six weeks ago. 7. cholecystectomy. 8. status post appendectomy. 9. c section x3. medications: 1. triamterene 37.5 mg po q day. 2. hydrochlorothiazide 25 mg po q day. 3. zantac 150 mg po bid. 4. celebrex 200 mg po bid. 5. lipitor 20 mg po q hs. 6. enteric coated aspirin 81 mg po q day. 7. colace 100 mg po bid. 8. os-cal 1000 mg po q day. 9. tylenol #3 1-2 tablets po prn shoulder pain. 10. rhinocort intranasal 32 mcg . 11. flexeril 10 mg po q hs. allergies: sulfa drugs unknown reaction and sublingual nitroglycerin results in hypotension. social history: lives by herself in elevator apartment. she has a son and a daughter who live in , and another daughter who lives in . review of systems: the patient denies any recent illnesses, but since her shoulder surgery six weeks ago she had decreased po intake secondary to cup holding difficulties. she denies any paroxysmal nocturnal dyspnea, orthopnea, or edema. she does note that she has had dizziness for several weeks that was worked up by her primary care physician, has remained of uncertain etiology. physical examination: upon arrival on the cardiac care unit post arterial line placement, the patient was found to have a temperature of 97.4, blood pressure 124/56, heart rate 88, breathing at 19, and sating 99% on two liters nasal cannula. general: she is lying in bed, sitting up in no acute distress. heent: normocephalic, atraumatic. oropharynx is clear and slightly dry mucous membranes, left surgical pupil. neck: supple, carotid upstrokes and no jugular venous distention. cardiovascular: irregularly, irregular, normal s1, s2, 4/6 systolic murmur at the right upper sternal border and left lower sternal border radiating both to the neck and to the axilla. it is a crescendo-decrescendo murmur. there were no rubs or gallops. lungs: there is sparse crackles at the bases, no wheezes or rhonchi. abdomen: soft, nontender, nondistended, normal bowel sounds. extremities: there is no clubbing, cyanosis, or edema. neurologic: she is alert and oriented times three. cranial nerves ii through xii are grossly intact and moves all extremities symmetrically and sensation is intact. her left leg was generally held in extension, but had full passive and active range of motion without pain. laboratories and studies: on admission, the patient had the following complete blood count: white count of 14.2, hematocrit of 34.1, platelet count of 234. mcv was 91, 82% polys, 0% bands, 12% lymphocytes, and 4% monocytes. urinalysis showed 15 ketones, white cells, rare bacteria. urine culture and blood cultures were negative throughout this hospital stay. chemistry-7 was as follows: sodium 140, potassium 3.6, chloride 103, bicarb 26, bun 26, creatinine 0.8, and glucose 109, calcium 9.0, magnesium 1.7, phosphorus 3.4. she had a tsh at 1.2. her arterial blood gas at the cardiac intensive care unit on a 100% nrb mask was the following: 7.39, 42, 400, and 98%. her cks through the hospital stay were as follows: the first one was 59. the second one was 107 with a mb of 12. third one of 148 and mb of 10, 152 with a mb of 5, and 202 with a mb of 4 on the day of discharge. her chest x-ray on admission showed mild cardiomegaly, no congestive heart failure, or pneumonia were present. of note, a cardiac catheterization in showed only a 30% occlusion in the first diagonal branch, no other coronary artery disease. she had electrocardiogram done revealed normal sinus rhythm in the 50s. there were no st-t wave changes indicating acute ischemia. an echocardiogram done on showed the following: her left atrium had increased in size from 4.4 enlarged to 5.6 now. her a-v valve area was 0.6 cm squared. her ejection fraction remained high with a left ventricular ejection fraction of 70-80. her tr gradient had increased from 14 to 33. the ra was mildly dilated with no septal defect. she had mild symmetrical left ventricular hypertrophy. her right free wall was hypertrophied. she had severe as, she had severe mitral annular calcification with no stenosis, moderate mitral regurgitation, mild pulmonary systolic hypertension, but no pericardial effusion. on the day of discharge, her laboratories are as follows: complete blood count: white count of 12.5, hematocrit of 32.3, platelet count of 203. pt 12.5, ptt 24.3, and inr of 1.0. chemistry 7 showed a sodium of 143, potassium 4.0, chloride 108, bicarb 37, bun 21, creatinine 0.6, calcium 8.3, magnesium 1.8, and phosphorus 2.0. during her hospital stay, she also had the following studies: she had a ultrasound of her left groin which showed a 10.5 x 12.5 x 5.8 cm hematoma in the left groin. flow was good in the femoral arteries and veins with no pseudoaneurysm. she had ct scan of her abdomen and pelvis on the which showed no retroperitoneal hematoma, extensive diverticular disease, and two cysts in her right kidney, and an abdominal hernia. summary of hospital course: 1. cardiovascular: a. pump: following her conversion to normal sinus rhythm spontaneously in the cardiac intensive care unit, the patient's blood pressure was still 120-130/56. she has remained in that range throughout the remainder of her hospitalization. she was given total of roughly 7 liters of fluids during her hospital stay, and became fluid overloaded. she was subsequently diuresed over several days, and was euvolemic on the day of discharge. in addition, she had the echocardiogram previously mentioned. this demonstrated a progression of her aortic stenosis with a valve area of now 0.6. this is likely in some way contributing to both of her spells of dizziness and possibly her fall, and also possibly her atrial fibrillation. b. rhythm: the patient as previously mentioned, presented in atrial fibrillation with a rapid ventricular rate in the 160s with chest discomfort following her conversion to normal sinus rhythm. she subsequently went in and out of atrial fibrillation, and was started on amiodarone. by the morning following admission she was consistently in sr, and remained in sr throughout the remainder of her hospital stay. she was initially heparinized for her af, but heparin was subsequently discontinued due to bleeding complications described below. c. coronary artery disease: the patient had chest discomfort in the settings of her tachycardia, but based on the catheterization in , it is deemed not likely that the chest pain is not due to coronary artery disease, more likely to demand ischemia. the patient was chest pain free when her heart rate was below 100 and blood pressures greater than 120-130. she was treated with lipitor and initially aspirin. 2. hematologic: the patient had a good drop in her hematocrit from 34 on admission to 25 the second day of her hospital stay. it was then noted that she had a large hematoma in her left groin as described on previous ultrasound report. it was also determined that she had been stuck several times in her left groin for blood in the emergency department, after which she had been subsequently heparinized for her atrial fibrillation. upon detection of the hematoma, and the hematocrit drop, heparin was discontinued. the aspirin was discontinued, and anticoagulation was held. the patient was transfused a total of 4 units of packed red blood cells with appropriate increase in her hematocrit to 37 which had stabilized to roughly 33 on the day of discharge. there was no additional signs of active bleed and the hematoma regressed in size. the issue of anticoagulation for her paroxysmal atrial fibrillation will need to be addressed further as an outpatient once her hematocrit stabilized and the hematoma is resolved. she will be currently discharged without any anticoagulation. however, she in normal sinus rhythm, and was in af for a total of less than 12 hours. 3. gastrointestinal: the patient complained of constipation upon presentation, and was given a dose of colace and senna without relief during her first hops day. on hospital day #2, she was given a single dose of lactulose and subsequently had diarrhea. she complained of crampy abdominal pain with continued loose stools on the morning of discharge. however, she remained afebrile and the pain was intermittent, crampy, and deemed likely secondary to this residual result of lactulose. 4. musculoskeletal: the patient has had bilateral rotator cuff injuries and complained of dull shoulder pain both sides during her hospital stay. she did not require any pain medication at this time. discharge medications: 1. protonix 40 mg po q day. 2. lipitor 20 mg po q day. 3. acetaminophen 650 mg q6h prn pain. 4. amiodarone likely 200 mg po q day, however, the final dosage is to be determined and will be added as a discharge summary addendum. 5. ambien 5 mg po q hs prn insomnia. follow up plans: the patient is to call dr. , cardiologist for an appointment in three days of discharge of rehabilitation, and she is to call her primary care doctor, dr. , a follow-up appointment within a week of her discharge from the rehabilitation facility. , m.d. dictated by: medquist36 d: 08:47 t: 08:56 job#: procedure: combined right and left heart cardiac catheterization coronary arteriography using two catheters angiocardiography of left heart structures other electric countershock of heart arterial catheterization diagnoses: esophageal reflux urinary tract infection, site not specified unspecified essential hypertension chronic airway obstruction, not elsewhere classified atrial fibrillation hematoma complicating a procedure aortic valve disorders blood sampling as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure 

Answer: The patient is high likely exposed to