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: penicillins / ambien attending: chief complaint: thoracic and abdominal aortic atheroma with history of embolic disease to the left foot, as well as the spleen major surgical or invasive procedure: : 1. thoracic and abdominal aortic atherectomy using right heart bypass. 2. epiaortic duplex scan. 3. left femoral artery reconstruction. . : 1. endarterectomy of thoracic and abdominal aorta. 2. epiaortic duplex. 3. repair of left femoral vessels. history of present illness: the patient is a 43 year-old female transferred from hospital c infarct to spleen secondary to thrombus in descending aorta diagnosed by ct scan. she presented to hospital with abdominal pain, nausea, vomiting, and diarrhea thought to initially have been caused by acute gastritis. a ct scan was performed in the workup and she was transferred to dr. for further evaluation. past medical history: hypertension depression social history: currently a smoker. denies etoh or illicit drug usage. family history: noncontributory physical exam: on discharge: vitals; 98.0 82 132/74 18 94% room air nad a&o x 3 rrr ctab soft, nd, apporpriately ttp, nabs incision clean, dry, intact, steristrips present. no cyanosis, cords, or edema pertinent results: on admission: 05:00pm blood wbc-17.0* rbc-5.12 hgb-10.4* hct-32.3* mcv-63* mch-20.2* mchc-32.1 rdw-17.3* plt ct-487* 05:00pm blood pt-13.4* ptt-24.8 inr(pt)-1.2* 05:00pm blood glucose-90 urean-8 creat-1.0 na-139 k-3.5 cl-106 hco3-24 angap-13 05:00pm blood calcium-9.5 phos-1.7* mg-2.4 . on discharge: 05:50am blood wbc-13.4* rbc-4.13* hgb-9.5* hct-29.0* mcv-70* mch-22.9* mchc-32.7 rdw-22.7* plt ct-750* 05:50am blood pt-14.1* ptt-25.0 inr(pt)-1.2* 12:39pm blood fibrino-406*# 05:50am blood glucose-94 urean-16 creat-0.8 na-141 k-3.9 cl-103 hco3-30 angap-12 05:50am blood calcium-9.3 phos-4.5 mg-2.1 . radiology final report cta abd w&w/o c & recons 3:08 pm cta chest w&w/o c&recons, non-; cta abd w&w/o c & recons reason: please evaluate from chin to mid thigh / include neck, arch contrast: medical condition: 43 year old woman with thrombus in aorta reason for this examination: please evaluate from chin to mid thigh / include neck, arch vessels to external iliacs contraindications for iv contrast: none. examination: cta of the torso dated . comparison: none. indication: 43-year-old female with thrombus in aorta. please evaluate. technique: axial imaging was obtained through the chest without iv contrast. then after the bolus intravenous administration of 130 cc of nonionic contrast, imaging was obtained through the chest, abdomen, and pelvis. images were reformatted three dimensionally as well as in the coronal and sagittal planes. findings for cta of the chest: bilateral breast implants are demonstrated. the heart is mildly enlarged. there is suggestion of left ventricular hypertrophy. the ascending aorta is at the upper limits of normal for size measuring 3.5 cm in maximum dimension.the aortic valve appears tricuspid there is no pericardial effusion. there is a tiny left pleural effusion. there is bibasilar atelectasis. emphysematous changes are demonstrated involving the upper lobes bilaterally. there is no mediastinal, hilar, or axillary lymphadenopathy. multiple low-density lesions are demonstrated within both hepatic lobes, likely cysts. layering high density is demonstrated within the gallbladder, likely sludge. the pancreas, adrenal glands, and left kidney are unremarkable. at the upper pole of the right kidney, there is a 2.3 cm low- density lesion with a suggestion of enhancing septations within it, further evaluation with mri is recommended. there is no hydronephrosis. there is a large region of wedge shaped low density within the spleen consistent with known splenic infarction. there is no ascites, lymphadenopathy, or free intraperitoneal gas. the bowel is normal in caliber. the thyroid gland is heterogeneous and demonstrates multiple low-density regions, correlation with ultrasound is recommended. ct of the pelvis: the uterus is enlarged and the uterine contour is lobulated with multiple enhancing lesions consistent with uterine fibroids. there is no ascites, lymphadenopathy, or free intraperitoneal gas. no adnexal lesions are demonstrated. the bowel within the pelvis is normal in caliber. bone windows: there are no suspicious lytic or blastic lesions. cta: there is no evidence of pulmonary embolism. there is no evidence of thoracic aortic dissection. multiple foci of adherent thrombus are demonstrated within the lower thoracic aorta and upper abdominal aorta above the level of the renal arteries consistent with known thrombus. the celiac axis, sma, and are widely patent. there are single bilateral renal arteries, which are widely patent. no thrombus is demonstrated in the infrarenal aorta down to the bifurcation. there is no evidence of thrombus within the iliac arteries or femoral arteries bilaterally to the level of the mid sfas. impression: 1. multiple foci of adherent thrombus in the lower thoracic aorta and the suprarenal abdominal aorta as described. 2. large splenic infarction. 3. emphysema. 4. tiny left pleural effusion. 5. suggestion of left ventricular hypertrophy and ascending aorta at the upper limits of normal in size, correlation with echocardiography to evaluate for valvular disease may be helpful. 6. 2.3 cm low-density lesion within the right kidney, which does not appear as a simple cyst, correlation with mri is recommended 7. multiple large uterine fibroids. 8. heterogeneous thyroid, correlation with ultrasound is recommended. . radiology final report chest (pre-op pa & lat) 2:43 pm chest (pre-op pa & lat) reason: descending thoracic aorta thrombus medical condition: 43 year old womanneeds possible endovascular surgery reason for this examination: pre-op history: possible endovascular surgery, pre-op evaluation for aaa repair. no prior comparison exams are available. pa and lateral chest radiograph findings the lungs are clear. cardiac silhouette may displace mild prominence of the right atrium but is within normal limits. the aorta is slightly unfolded. hilar contours are unremarkable. there are small bilateral pleural effusions (left greater than right). no evidence of pneumothorax or pulmonary edema. impression: probable small bilateral pleural effusions, otherwise no acute cardiopulmonary process. . exercise mibi reason: 43 yr old woman with aortic atheroma showering emboli assess cardiac function pre-op for aortic resection radiopharmeceutical data: 9.8 mci tc-m sestamibi rest (); 30.8 mci tc-99m sestamibi stress (); history: chest tightness and sob. summary of data from the exercise lab: exercise protocol: modified . resting heart rate: 82 bpm resting blood pressure: 110/80 exercise duration: 7 min peak heart rate: 133 bpm percent maximum predicted heart rate obtained: 75 % peak blood pressure: 156/74 symptoms during exercise: none reason exercise terminated: fatigue ecg findings: 0.5 mm st segment depression in v4-6 at peak exercise, which progressed to biphasic t waves in early recovery and returned to baseline by minute 10 of recovery method: resting perfusion images were obtained with tc-99m sestamibi. tracer was injected approximately one hour prior to obtaining the resting images. at peak exercise, approximately three times the resting dose of tc-99m sestamibi was administered iv. stress images were obtained approximately one hour following tracer injection. imaging protocol: gated spect this study was interpreted using the 17-segment myocardial perfusion model. interpretation: the image quality is good. left ventricular cavity size is normal. resting and stress perfusion images reveal uniform tracer uptake throughout the left ventricular myocardium. gated images were not performed secondary to technical difficulties caused by the patient's irregular heart rate. impression: at the level of exercise achieved, normal myocardial perfusion study. gated images and lvef not calculated secondary to technical difficulties. . radiology final report chest (portable ap) 7:14 pm chest (portable ap) reason: f/u medical condition: 43 year old woman s/p endarterectomy of desc. thoracic and abd. aorta. reason for this examination: f/u indication: status post endarterectomy of descending thoracic and abdominal aorta. portable chest: comparison to a day prior reveals that the patient has been extubated and pulmonary artery catheter has been removed with right internal jugular vascular sheath persisting and terminating over the upper superior vena cava. two left-sided chest tubes are unchanged in position. ng tube has been removed. cardiomediastinal silhouette demonstrates no short interval change with moderate layering pleural effusions, bilaterally, as well as retrocardiac opacity. there is no evidence of pneumothorax. impression: 1)new moderate bilateral layering pleural effusions 2)retrocardiac opacity likely reperesents atelectasis but in the appropriate clinical setting could represent airspace consolidation. . radiology final report chest (portable ap) 4:08 pm chest (portable ap) reason: s/p ct d/c medical condition: 43 year old woman s/p endarterectomy of desc. thoracic and abd. aorta. reason for this examination: s/p ct d/c examination: ap chest. indication: status post chest tube removal. single ap view of the chest was obtained at 16:00 hours and is compared with the prior day's radiograph. again is seen evidence of bilateral pleural effusions which appear likely to be unchanged on the left side and improved on the right side. left-sided chest tube has been removed. there does appear to be a tiny left apical pneumothorax. of concern on the current examination is a patchy opacity developing in the right mid lung field, likely in the anterior portion of the right upper lobe which may be secondary to aspiration/pneumonia. no other changes noted since the prior examination. impression: 1) air space opacity developing in the right chest as described which requires follow up. 2) possible tiny apical pneumothorax. 3) bilateral pleural effusions. . radiology final report chest (portable ap) 11:36 am chest (portable ap) reason: r/o inf, eff medical condition: 43 year old woman s/p endarterectomy of desc. thoracic and abd. aorta. reason for this examination: r/o inf, eff addendum: these findings were discussed with dr. . reason for examination: evaluation after endartectomy of descending thoracic and abdominal aorta. portable ap chest radiograph compared to . there is worsening in bibasal consolidations and increased bilateral pleural effusion. although there is no evidence of overt pulmonary edema, the increased interstitial perihilar haziness may represent volume overload or mild congestive heart failure. the heart size is mildly enlarged but stable. there is no change in mediastinal contours. the right internal jugular line tip terminates in mid svc. brief hospital course: the patient was admitted to dr. service on . she underwent pre-operative workup and underwent a left thoracotomy on with the following: (1) thoracic and abdominal aortic atherectomy using right heart bypass (2) epiaortic duplex scan (3) left femoral artery reconstruction (4) endarterectomy of thoracic and abdominal aorta (5) epiaortic duplex and (6) repair of left femoral vessels. for details of the operation, please refer to the operative reports. her post-operativel course was uncomplicated. she was extubated postoperatively and stable in the csru. on pod 1, she was afebrile and her pain was well-controlled with a dilaudid pca. she remained on nitro drip, which were weaned by pod 3. her diet was advanced as tolerated without complications. her chest tube and spinal drain was continued. on pod 2, she continued to remain afebrile and tolerating a regular diet. she continued to be on a low dose nitro drip which continued to be weaned. her chest tubes and spinal drains were discontinued without complications and her pain remained well-controlled. . on pod 3, she was stable for transfer to the floor. she remained afebrile and tolerating a regular diet. physical therapy continued to workup with her. . on pod , she continued to do well on the floor. her central line was dicsontinued and she continued to ambulate without difficulty. chest physcial therapy was continued. she remained afebrile and tolerating a regular diet. . on pod 6, she was deemed stable for discharge home. she remained afebrile, tolerating a regulardiet and ambulating well. she will follow-up with dr. and , as well as her primary care physician. medications on admission: hctz, celexa, motrin discharge medications: 1. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4-6h (every 4 to 6 hours) as needed for pain: do not take with tylenol. disp:*45 tablet(s)* refills:*0* 2. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*2* 3. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). disp:*30 tablet, delayed release (e.c.)(s)* refills:*0* 4. metoprolol tartrate 25 mg tablet sig: three (3) tablet po tid (3 times a day). disp:*270 tablet(s)* refills:*0* 5. atorvastatin 80 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 6. captopril 12.5 mg tablet sig: 0.5 tablet po tid (3 times a day). disp:*45 tablet(s)* refills:*0* 7. protonix 20 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po once a day as needed for heartburn. disp:*30 tablet, delayed release (e.c.)(s)* refills:*0* 8. previous home medications please resume your previous home medications except for the hydrochlorothiazide. discharge disposition: home with service discharge diagnosis: thoracic and abdominal aortic atheroma with history of embolic disease to the left foot, as well as the spleen discharge condition: stable discharge instructions: please call your doctor or return to the emergency room for the following: - chest pain - shortness-of-breath - pain not relieved by prescribed pain medication - inability to tolerate food - increased redness or purulent drainage from your incision - or other concerns . please take pain medication and stool softener as prescribed. do not operate heavy machinary while taking prescription medications. . please follow-up as directed. . you may shower, but no baths for 4-6 weeks. pat your incision dry. please leave small pieces of tape until they fall-off on their own. followup instructions: please call dr. at ( to schedule a follow-up appointment in weeks. . please call dr. at ( to schedule a follow-up appointment in weeks. . please follow-up with your primary care phsyician in weeks. you will need a mri to evaluate the 2.3 cm low-density lesion within the right kidney on your ct scan. you will also need a thyroid ultrasound to evaluate your heterogeneous thyroid seen on ct scan. you will also need to have him adjust your blood pressure medications. procedure: extracorporeal circulation auxiliary to open heart surgery other repair of vessel endarterectomy, aorta continuous intra-arterial blood gas monitoring procedure on single vessel diagnoses: tobacco use disorder unspecified essential hypertension embolism and thrombosis of thoracic aorta 

Answer: The patient is high likely exposed to