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: pea arrest major surgical or invasive procedure: cardiac catheterization intubation and extubation ngt placement history of present illness: ms. is a 55 yo f with significant obesity who had a pea arrest in the pilgrim garage. there the patient was coded and taken to the er. given the arrest, the patient was taken urgently to the cardiac cath lab. . cath lab findings included no coronary artery disease, cardiac index of 2.0 and a lvedp and wedge of 25. pa diastolics were elevated. additionally echocardiogram showed diastolic dysfunction and biventricular systolic dysfunction. while in the cardiac cath lab, the patient was hypoxic with elevated airway pressures. after albuterol administration, the patient improved. . on review of systems, not available as patient is intubated and sedated. family reports that the patient did not have chest pain. . family states that she was dx with asthma 1 month ago, no prior hx. states the cold air caused sob in the garage with tightness of her chest. also currently c/o leg cramp in right calf. not a smoker per pt/family, and was on albuterol and advair for her asthma. denies hx of heart disease, but had "murmur" as child. reports remote hx of lasix use in past. in the ed, initial vitals were not recorded past medical history: asthma gastric bypass sugery bowel obstuctions in past per family morbid obesity hypertension social history: never smoked, divorced. has mother, son and sister who are aware of current care. son has severe epilepsy. partner is pt wants to have info shared with her in addition to family family history: no family history of early mi, otherwise non-contributory. physical exam: on admission- bp- 127/63, hr- 69, rr-18, 98% on ventilator at fio2 of 50%, cmv/assist, vt of 600, resp set at 14, peep 5 eyes: (conjunctiva and lids: wnl) ears, nose, mouth and throat: (oral mucosa: wnl), (teeth, gums and palette: intubated) neck: (jugular veins: not visible) back / musculoskeletal: (chest wall structure: large area of ecchymoses on chest wall, tenderness parasternally respiratory: (auscultation: wnl cardiac: (rhythm: regular), (palpation / pmi: wnl), (auscultation: s1: wnl) femoral artery: (right femoral artery: no bruit), (left femoral artery: no bruit), left femoral artery with venous catheter and arterial sheath, small amount of bleeding around the area without significant hematoma ext: no edema, dp 2+ bilaterally, cool extremities, hematoma of the right antecubital fossa. marked stable pertinent results: labs on admission: . hematology: 02:20pm blood wbc-17.7* rbc-4.81 hgb-14.1 hct-46.3 mcv-96 mch-29.3 mchc-30.4* rdw-13.8 plt ct-158 03:43am blood neuts-81* bands-12* lymphs-2* monos-4 eos-0 baso-0 atyps-1* metas-0 myelos-0 complete blood count wbc rbc hgb hct mcv mch mchc rdw plt ct 12:50pm 9.6 3.02* 9.7* 27.8* 92 32.3* 35.1* 14.4 462* . 11:31pm blood wbc-27.5* hct-33.7* 03:43am blood wbc-23.6* hct-32.7* 09:46am blood hct-29.2* . 02:20pm blood pt-13.9* ptt-33.7 inr(pt)-1.2* . chemistry: 06:48pm blood glucose-257* urean-20 creat-1.0 na-135 k-4.6 cl-108 hco3-17* angap-15 06:48pm blood alt-70* ast-78* ld(ldh)-425* ck(cpk)-114 alkphos-119* totbili-0.6 06:48pm blood albumin-3.4 calcium-8.5 phos-4.0 mg-1.7 na k hco3 07:00am 140 4.7 30 . 02:20pm blood ck(cpk)-131 ctropnt-<0.01 06:48pm blood ck(cpk)-114 11:31pm blood ck(cpk)-93 . 03:43am blood triglyc-58 hdl-58 chol/hd-2.5 ldlcalc-73 . 02:20pm blood asa-neg ethanol-neg acetmnp-neg bnzodzp-neg barbitr-neg tricycl-neg . 02:27pm blood lactate-8.7* 04:50am blood lactate-2.6* . microbiology: bl cx - pending urine legionella - pending sputum cx - pending . cardiology: admission echo there is severe global left ventricular hypokinesis (lvef = 20 %). the right ventricular free wall is hypertrophied. right ventricular chamber size is normal. with normal free wall contractility. the mitral valve leaflets are mildly thickened. there is no pericardial effusion. there is an anterior space which most likely represents a fat pad. impression: severe left ventricular global systolic dysfunction. right ventricular hypertrophy with normal function. . echo after extubation the left atrium is normal in size. left ventricular wall thickness, cavity size, and global systolic function are normal (lvef>55%). due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. right ventricular chamber size and free wall motion are normal. the descending thoracic aorta is mildly dilated. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion. there is mild aortic valve stenosis (area 1.2-1.9cm2). mild to moderate (+) aortic regurgitation is seen. the mitral valve leaflets are structurally normal. there is no mitral valve prolapse. mild (1+) mitral regurgitation is seen. the estimated pulmonary artery systolic pressure is normal. there is no pericardial effusion. there are no echocardiographic signs of tamponade. compared with the prior study (images reviewed) of , the aortic regurgitation is new (though prior study only had one color doppler aortic valve clip, there does not appear to be any ar). the left ventricular systolic function is better viewed on the current study, but was underestimated on review of the prior study. aortic stenosis is now identified. is there a history to suggest a primary aortic (e.g, dissection) or aortic valve pathology (e.g., endocarditis . cadiac cath comments: 1. selective coronary angiography demonstrated single vessel coronary artery disease. the lmca was without flow limiting disease. the lad and lcx were without flow limiting disease. the rca had 30% stenosis at the proximal segment and 40-50% stenosis at the origin of the pda. there was no evidence of acute thrombosis. . radiology: cxr (): impression: 1. endotracheal tube tip positioned 6.1 cm above the carina. tube could be advanced for more optimal positioning. 2. diffuse bilateral parenchymal opacification. differential considerations include pulmonary edema, multifocal pneumonia, or other etiologies such as pulmonary hemorrhage or ards. . ct torso impression: 1. no evidence of retroperitoneal hematoma. small right inguinal hematoma near insertion of central venous catheter. the catheter closely approaches and indents the wall of the common femoral artery adjacent to its course into the common femoral vein, likely simply due to proximity, but reassessment with ultrasound is recommended after catheter removal or if hematoma appears to be enlarging clinically. 2. 4 mm subpleural right middle lobe pulmonary nodule requires no further workup if there is no history of malignancy or significant risk factors for malignancy (i.e., smoking). if such history or risk factors exist, consider a one-year followup chest ct to evaluate for stability. . kub findings: there are air-filled loops of colon, without ileus or obstruction. there is no massive free air. there is degenerative change in the lumbar spine. impression: no ileus, obstruction, or massive free air. . cxr after extubation impression: overall, interval improvement of congestion of congestive heart failure with persistent mild congestion. interval removal of endotracheal tube and nasogastric tube. no pneumothorax or pneumonia. the study and the report were reviewed by the staff radiologist. . doppler of les - impression: limited study, no evidence of dvt in the left lower extremity brief hospital course: in summary, ms is a 61f with obesity (s/p gastric bypass surgery) and asthma, who was admitted s/p pea arrest. . # pea arrest: the cause was unclear. lbbb on ekg (and no prior for comparison), the patient went to the cardiac cath lab, where she was found to have no obstructive lesions but elevated lvedp/pcwp. given that she was hypoxemic responsive to nebulizer treatments, status asthmaticus was a possible cause. she was given methylprednisolone and treated with albuterol and ipratropium initially and was intubated. . # hypoxia/ pulmonary: the patient had a recent diagnosis of adult-onset asthma one month and was intubated during the arrest. she was found to have significant improvement in 02 sats and airway pressures after albuterol, so she was initially treated with methylprednisolone. cxr also was suspicious for pneumonia, possibly secondary to aspiration, so she initially received azithromycin and zosyn, narrowed after 1 day to levofloxacin. she will complete abx on . she was promptly extubated the day after admission, without difficulty. she required 2l nc of oxygen when lying flat and asleep and was suspected to have sleep apnea. she was seen by pulmonary and had pfts that showed a restrictive pattern (pt with rib fxs). she was recommended to use her albuterol before going into the cold. she was restarted on her home advair 250/50. she has a sleep clinic appointment and pulmonary f/u appointment with repeat pfts. . # pump: initial echo during the cath showed significant cardiac dysfunction with ef of 20%, elevated pcwp. repeat study showed ef 55% but new aortic insufficiency not visualized on the first study. her pcp was and records of an echo obtained, demonstrating only trace ai. thus, ct with contrast was done to evaluate for the possibility of aortic dissection. ct showed no dissection. . # rhythm: she remained in sinus with lbbb. . # leukocytosis: likely secondary to steroids and pneumonia in the setting of acute stress. also, thought to have pna likely from aspiration. was treated with levo with improvement. will complete at 9 day course. . # hct drop: mild decrease. likely secondary to blood loss during the procedure and multiple hematomas in the chest wall from cpr. however, had a ct to rule out an rp bleed. also had hematoma on right arm from er placed line, that appeared to have been into the brachial artery. hematoma in arm was stable. hct stabilized. . # rib fractures: seen on ct, likely from cpr. caused severe pain with movement and respirations. pt had pain consult. was treated with tylenol, toradol for 3 days, oxycontin, and oxycodone. as well, as lidocaine patches. changed to ibuprofen 800mg tid before discharge. continued on oxycontin and oxycodone, as well as, tylenol. will remain on omeprazole while on high dose nsaids. . # impaired fasting glucose: several elevated fasting glucose levels, however, was in setting of acute illness. pt is at risk for diabetes due to morbid obesity. will need f/u fasting glucose to test for diabetes. . # weakness: pt was weak after arrest. pt recommended acute care rehab. pt. pt was offered and refused to go to rehab center for short term acute rehab. will be discharged with home. . # constipation: hx of constipation. required multiple medications for bm since on pain medications. will likely need bowel regimen for duration of tx with pain medications. discharged with senna, colace, and lactulose. -partner - (okay per pt to share info with her) -sister will be discharge to her daughter's home with pcp, , and pulmonary f/u. medications on admission: vit d 50,000 units weekly proair hfa zolpidem 3 mg qhs (obtained from pharmacy ) advair 250/50 diovan 80mg discharge medications: 1. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 2. albuterol 90 mcg/actuation aerosol sig: 1-2 puffs inhalation q4h (every 4 hours) as needed for wheezing: use before going out in the cold. disp:*1 inhaler* refills:*2* 3. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for pain. 4. valsartan 80 mg tablet sig: two (2) tablet po daily (daily). disp:*60 tablet(s)* refills:*2* 5. zolpidem 5 mg tablet sig: two (2) tablet po hs (at bedtime) as needed for insomnia. 6. advair diskus 250-50 mcg/dose disk with device sig: one (1) inhalation twice a day. 7. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. disp:*60 tablet(s)* refills:*2* 8. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day) as needed for constipation. disp:*60 capsule(s)* refills:*2* 9. nystatin 100,000 unit/g ointment sig: one (1) appl topical qid (4 times a day) as needed: for rash under breasts. disp:*1 tube* refills:*2* 10. lactulose 10 gram packet sig: one (1) po once a day as needed for constipation: use once a day as needed for constipation. disp:*30 packets* refills:*0* 11. ibuprofen 400 mg tablet sig: two (2) tablet po q8h (every 8 hours) as needed for pain: take with food, stop if causing stomach pain. disp:*180 tablet(s)* refills:*0* 12. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po once a day: take while on the ibuprofen. disp:*30 capsule, delayed release(e.c.)(s)* refills:*2* 13. tylenol 325 mg tablet sig: two (2) tablet po every 6-8 hours as needed for pain: do not take more than 4000 mg per day. 14. oxycodone 10 mg tablet sustained release 12 hr sig: one (1) tablet sustained release 12 hr po q12h (every 12 hours) as needed for pain: long acting pain medication, do not crush or chew; do not combine with alcohol or drive while taking this medication, do not take if sleepy. disp:*30 tablet sustained release 12 hr(s)* refills:*0* 15. oxycodone 5 mg tablet sig: one (1) tablet po every 6-8 hours as needed for pain for 15 days: short acting pain medication, do not combine with alcohol, or drive while on this medication; do not take if sleepy. disp:*45 tablet(s)* refills:*0* 16. levofloxacin 750 mg tablet sig: one (1) tablet po daily (daily) for 2 days. disp:*2 tablet(s)* refills:*0* discharge disposition: home with service facility: discharge diagnosis: pea arrest s/p resuscitation hypoxia secondary to bronchoconstriction non-obstuctive coronary artery disease aspiration pneumonia multiple rib fractures discharge condition: hemodynamically stable, afebrile discharge instructions: you were admitted to due to a cardiac arrest in the parking lot, you received cpr and your heart restarted. you initally also required intubation to help you breath. it is believed that this event occured secondary to constriction of your airways. you had a cardiac catheterization which showed no heart attack, but some early coronary artery disease. you have an aspiration pneumonia for which you are on anitibiotics. you were given medications for your lungs. you have multiple rib fractures from the cpr. you will need to see a pulmonoligist after discharge. you will also need pulmonary function tests to better understand your lung condition. you also need a sleep study to assess if you have sleep apnea, which may have put you at risk for this event. please take your medications as instructed. please use your albuterol inhaler before going into the cold to prevent constriction of your airways. if you have shortness of breath, worsening chest pain, swelling in your groin or in your arm were your ivs were, fainting, or other concering symptom please seek medical attention. followup instructions: pulmonology appt- provider: function lab phone: date/time: 2:40 provider: ,interpret w/lab no check-in intepretation billing date/time: 3:00 provider: . / dr. phone: date/time: 3:00 cardiology appt- please call ( for an appointment, you can ask to see dr. on a thursday afternoon, he works that day of the week with dr. , the fellow, who took care of you will need a follow up echo in the future to monitor aortic regurgitation and mitral regurgitation pcp dr. , please call to make an appointment, once you leave the rehab center sleep clinic- , 9am, , ( procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours coronary arteriography using two catheters left heart cardiac catheterization diagnoses: coronary atherosclerosis of native coronary artery asthma, unspecified type, unspecified other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure pneumonitis due to inhalation of food or vomitus cardiac arrest other constipation hypoxemia leukocytosis, unspecified closed fracture of multiple ribs, unspecified long-term (current) use of aspirin bariatric surgery status acute bronchospasm 

Answer: The patient is high likely exposed to