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: admit for pericardiocentesis major surgical or invasive procedure: pericardiocentesis history of present illness: pt is a 84 yom with dm2, cad recent hx of pe early discharged on coumadin. pt went for routine echo with cardiologist and found to have a new pericardial effusion and was referred and admitted to . pt did not have any signs of temponade and did not have any complaints and was discharged home without pericardiocentesis. pt discharged home on coumadin . . he states that he has been experienceing mild dyspnea on exertion and fatigue since the pe and has felt moderate fatigue. on follow up appointment pt noted to have increasing size of effusion and pt scheduled for tap. he states that he hasn't had any chest pain or increase in his baseline dyspnea since the last admission. denies any other complaints of caugh/fevers/chills. past medical history: -cad -r-cea -dm ii -prostate cancer -gout -hypercholesterolemia -cva -htn social history: -pt lives with wife and son -positive hx: smoked cigars and pipes 6pipes/day x 20 years, quit 20 years ago -no etoh, cocaine or other drug use . family history: f: died of "enlarged heart" m: died of ?cva in 80s brother: died of mi at 51, another brother with mi in 70s . physical exam: t: 98.8 bp: 140/73 hr:66 rr 20 o2sat 95%ra pe: gen: pt is a elderly male s/p tap earlier now in no appearent acute distress heent: mmm, perrl, jvp not assessed as pt lying flat post cath. chest: ctab anteriorly and laterally. pericardial tap site - dressing intact, no drainage. cvr: rrr, nl s1, s2, no r/m/g appreciated abdomen: soft, nontender and nondistended with normal bowel sounds ext: no edema. wound: r groin site no hematoma, drssing c/d/i. pertinent results: 04:47pm other body fluid tot prot-4.5 glucose-123 ld(ldh)-1472 amylase-28 albumin-2.5 04:47pm other body fluid wbc-* rbc-* polys-32* lymphs-57* monos-9* macrophag-2* 11:30am inr(pt)-1.5. . ecg: sr at about 60, nl axis, rbbb, prolonged pr(0.13). . echo conclusions: 1. the left atrium is mildly dilated. 2.there is mild symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. overall left ventricular systolic function is normal (lvef>55%). 3. right ventricular chamber size and free wall motion are normal. 4.there is a large pericardial effusion. there appears to be an echodense material adjacent to the myocardium which is probably fat but can not rule out the presence of a thrombus. there are no echocardiographic signs of tamponade. of note the size of the efusion at 45degrees elevation is 1.75 cm apically. . cath 10/26/105 prelim. comments: 1. right heart catheterization revealed slightly elevated left and right heart filling pressures. there was no evidence of tamponade physiology. 2. difficult tapping of a loculated pericardial effusion. the mean pericardial pressure was 5mm hg, decreasing to 2mm hg with drainage of 360ml of bloody fluid. 3. a removable ivc filter was placed so thta coumadin could be witheld for 3-4 weeks as the effusion was bloody. if the decision to restart coumadin is made, consider removing the filter. . echo left ventricular wall thickness, cavity size, and 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 aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic regurgitation. there is a small to moderate sized loculated echo dense pericardial effusion extending anteriorly in the interventricular groove from the mid wall to the apex c/w a hematoma. there is no evidence of right ventricular diastolic collapse. compared with the prior study (tape reviewed) of , the findings are similar. the loculated echo dense pericardial effusion was also present on review of the prior study. brief hospital course: impression and plan - pt. is a 84 yom with dm, cad with pericardial effusion on anticogualation for recent pe. refferred for drain after increase in size. . pericardial effusion - drain in place will continue to monitor overnight. previous work up for the effusion included normal tsh 0.3 and psa of 0.1 . ddx for pleural effusion is wide however given the cell count with numerous rbc, this is likely hemorrhagic pericardial effusion. likely etiology include malignancy ?????? 26%, percutaneous interventional procedures ?????? 18%, postpericardiotomy syndrome ?????? 13%, complications of myocardial infarction (free wall rupture, thrombolysis) ?????? 11%, idiopathic ?????? 10% uremic ?????? 7%, aortic dissection ?????? 4%, trauma ?????? 3%, and other ?????? 8 percent according to a recent study in chest ;116(6):1564-9. in conjunction with the history the three most likely are to be melignancy, idiopathic or likely due to anticogulation. - f/u cytology to evaluate for possible malignancy. - pt was treated with warfarin for pe recently and this can certainly have atributed to the effusion. . cardiac ischemia - history of cad per records however no records of cath here. continue asa 81, plavix 75, atenolol 12.5, lipitor 20, quinapril 10 and imdur. no episodes of chest pain or shortness of breath and monitored on tele. . pump - ef >55% on echo done . repeat echo showed preserved lvef, full report in results section. . rhythm - sr with rbbb . pulmonary - history of pe - given recent pe early concerning for repeat event, however given hemorrhagic effusion and ivc filter which was placed today at cath, held anticogulation with coumadin immediately post procedure. - given hemorrhagic pericardial effusion, pt discharged off coumadin. will f/u with dr. . . dm- on home insulin 70/30, 15u qam, 13u qpm + riss. prostate cancer - continue casodex. htn - continue outpt meds, adjust accordingly. code - full dispo - to home. pt will f/u with cardiologist dr. . medications on admission: asa81 vit e 400 atenelol 12.5, slntg prn, lipitor 20, plavix 75 iso mn 15, amoxicillin sbe prophylaxis. accupirl 10, folic acid, casodex 50 qd. discharge medications: 1. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 2. multivitamin capsule sig: one (1) cap po daily (daily). 3. atorvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 4. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). 5. quinapril 5 mg tablet sig: two (2) tablet po daily (daily). 6. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 7. bicalutamide 50 mg tablet sig: one (1) tablet po qd (). 8. isosorbide mononitrate 30 mg tablet sustained release 24hr sig: one (1) tablet sustained release 24hr po daily (daily). 9. pyridoxine 50 mg tablet sig: one (1) tablet po daily (daily). 10. atenolol 25 mg tablet sig: 0.5 tablet po daily (daily). discharge disposition: home discharge diagnosis: pericardial effusion coronary artery disease insulin dependent diabetes mellitus discharge condition: good- patient afebrile and hemodynamically stable, minimal pain. discharge instructions: please continue to take all of your medications every day as instructed. please call your doctor or return to the hospital if you experience chest pain, shortness of breath, fever, or chills. followup instructions: you have an appointment scheduled with dr. on monday, , at 11:00 am. you should also follow up with your pcp 1-2 weeks, call the number above for an appointment. procedure: interruption of the vena cava pericardiocentesis diagnoses: coronary atherosclerosis of native coronary artery pure hypercholesterolemia unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled gout, unspecified unspecified disease of pericardium personal history of other diseases of circulatory system long-term (current) use of insulin malignant neoplasm of prostate personal history of venous thrombosis and embolism 

Answer: The patient is high likely exposed to