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: the patient is a year old female with a history of diabetes mellitus, hypertension, congestive heart failure who woke up 5 am on with 4 out of 10 substernal chest pain. she called emergency medical services two to three hours later. the pain in her chest awoke her from her sleep and radiated into her back. her electrocardiogram in the field showed some inferior st elevations and st depressions. she was treated with sublingual nitrogen, nitroglycerin and the pain was decreased on arrival to the outside emergency department. the patient did note some shortness of breath, nausea, and vomited times one in the emergency department. she was treated with heparin, aspirin, integrilin and plavix. on the morning of , the patient vomited bright red blood. the heparin and integrilin were stopped. at that point the patient's chest pain and electrocardiogram changes recurred. the patient was given a heparin bolus and then transferred to for emergent cardiac catheterization. the patient went to cardiac catheterization on arrival to the where she was found to have three vessel disease, and had three stents placed to her left anterior descending. in the catheterization laboratory the patient was transfused 1 unit of packed red blood cells and her breathing remained stable. past medical history: 1. type 2 diabetes, diet-controlled; 2. congestive heart failure with normal ejection fraction on an echocardiogram in ; 3. hypertension; 4. question of history of atrial fibrillation; 5. history of common bile duct stone; 6. diverticulitis; 7. peptic ulcer disease; 8. gastritis; 9. osteoarthritis; 10. history of pancreatitis. medications at home: zantac 50 q.d.; atenolol 25 q.d.; lasix 20 q.d.; 10 q.d. and mycolog cream prn. allergies: the patient is allergic to penicillin and developed gastritis with aspirin. social history: the patient is an independent year old woman who lives alone with nursing and aides that come in daily. her lawyer, mr. is her health care proxy. she is do-not-resuscitate, do-not-intubate and this is documented in the chart. physical examination: physical examination on admission to the ccu revealed vital signs with blood pressure of 116/64 with a mean arterial pressure of 86, oxygen saturation 96% on 5 liters. heartrate 88. in general the patient is alert and oriented, somewhat agitated, trying to sit up. head, eyes, ears, nose and throat, pupils are equally round and reactive to light and accommodation. extraocular movements intact. oropharynx with dry blood. nasogastric tube in place. neck, no jugulovenous distension appreciated. lungs, bibasilar crackles with no wheezes or rhonchi. cardiovascular, regular rate and rhythm, normal s1 and s2 with no murmurs, rubs or gallops. abdomen, soft, nontender, nondistended with positive bowel sounds. extremities, warm with 1+ dorsalis pedis bilaterally, right venous and arterial sheaths in place. no cyanosis, clubbing or edema. good capillary refill. neurologic examination, the patient is moving all extremities, speaking but not always making sense. laboratory data: nasogastric tube lavage was positive for bright red blood which did not clear with 250 cc. laboratory data on arrival to included a white count of 23.5, hematocrit of 36.5 and platelets of 340. sodium was 134, potassium 3.8, chloride 98, bicarbonate 18, bun 44, creatinine 1.1, glucose 187, magnesium 1.2, phosphorus 5.7. ck was 2219, mb 400, mb index of 18 and troponin greater than 50. an arterial blood gases in the catheterization laboratory was 7.37, 42 and 79. her urinalysis was negative. her cks from the outside hospital initially ck on , was 129, later on , ck was 1503 with an mb of 171 and mbi of 11.4. at 12 am on , cks 1736, mb 199, mbi 11.5. the patient had a troponin on the first of 11. results of the cardiac catheterization revealed a pulmonary capillary wedge pressure of 32, pa pressures of 63/29 and ra pressure of 15. cardiac index was 1.8. the patient had three vessel disease with 30% left main coronary artery lesion, and 80% mid left anterior descending lesion, approximately included the left circumflex that had three stents placed and an occluded right coronary artery. the patient was given dopamine in the catheterization laboratory for hypotension. electrocardiogram from the patient's baseline on has normal sinus, normal access. on , on arrival to the outside hospital she had st depressions in v1 through v3 which were about 1 mm in size. at 8 am on , her st depressions in v1 through v4 were increased to 2 mm and later on she had persistent st depressions in v2 to v5 of 2 mm. chest x-ray on admission, post catheterization shows congestive heart failure with interstitial edema but no frank pulmonary edema. swan tip was in place. nasogastric tube was in place and calcifications in coronaries were noted. hospital course: the patient is a year old female who is status post st elevation, inferior posterior myocardial infarction complicated by hematemesis while on anticoagulation. the patient is status post catheterization with three vd and three stents placed to the left circumflex. cardiovascular - ischemia, the patient is status post a inferior posterior myocardial infarction with cks peaked of 2219. she is status post three stents to her left circumflex. the patient was placed on plavix 75 q.d. and aspirin. initially beta blockers and ace inhibitors were held while blood pressure was unstable in the immediate post catheterization setting. beta blockers and ace inhibitors were eventually able to be started and these were titrated up such that at the time of discharge she was on lopressor 25 b.i.d. and captopril 12.5 t.i.d. the patient developed chest pain on the morning of which showed some exaggeration of her st depression, and pain was relieved with one sublingual nitroglycerin. it was discussed with the cardiology team and decided that the patient should not return to the catheterization laboratory at that time. she had no recurrence of chest pain. pump, the patient is status post inferior posterior myocardial infarction. echocardiogram on showed an ejection fraction of 25%, symmetric left ventricular hypertrophy, severe left ventricular systolic dysfunction and 2+ tricuspid regurgitation. the patient was put on ace inhibitor and beta blocker for her congestive heart failure as well as lasix titrated up to 40 b.i.d. at the time of discharge. she was also on potassium repletion. blood pressure, the patient had some hypotension in the catheterization laboratory but once arriving to the ccu and to the floor her blood pressure was stable. gastrointestinal - the patient is status post upper gastrointestinal bleed in the setting of integrilin and heparin. the patient was transfused a total of 2 units of packed red blood cells and her hematocrit stayed stable throughout her hospital stay. she had no further gastrointestinal bleeding and her nasogastric tube was removed. she was seen by gastroenterology who would not intervene at this time. she was tolerating p.o. diet at the time of discharge and still pacing some guaiac positive stools as expected. the patient needs to continue on plavix times one month and aspirin for life. heme - the patient's hematocrit despite the gastrointestinal bleed remained fairly stable. she received 3 units of packed red blood cells and remained hemodynamically stable. infectious disease - the patient was noted to have elevated white count, urine culture from grew out escherichia coli and proteus. the patient was started on levofloxacin on . of note, she also developed some green sputum on , and was treated for pneumonia, again with the levofloxacin. chest x-ray revealed a left lower lobe retrocardiac infiltrate. flagyl was added on for concerns that this infiltrate may have been secondary to aspirations during the time of her vomiting. she should complete a ten day course of each medication. renal - the patient developed some mild renal failure secondary to aggressive diuresis for congestive heart failure. her creatinine peaked at 1.9 on and was gradually decreasing at the time of discharge. the creatinine on the day of discharge is pending but it was 1.3 on . when she presented her creatinine was 1.1. her creatinine and potassium should be monitored as an operating table and her lasix and potassium doses should be adjusted as needed. discharge status: the patient will be discharged to rehabilitation and will need close follow up with cardiology. discharge medications: 1. k-dur 10 p.o. q.d. 2. colace 100 p.o. b.i.d. 3. dulcolax 10 p.o. q.d. prn 4. sliding scale insulin 5. atrovent 2 puffs q.i.d. 6. albuterol 1 to 2 q. 6 prn 7. lopressor 25 b.i.d. 8. amiodarone 400 mg p.o. q.d. 9. levofloxacin 250 p.o. q.d. until 10. tylenol prn 11. nitroglycerin .3 mg sublingual prn 12. protonix 40 p.o. q.d. 13. lipitor 10 p.o. q.d. 14. aspirin 35 p.o. q.d. 15. plavix 75 p.o. q.d. until 16. captopril 12.5 p.o. t.i.d. 17. lasix 40 p.o. b.i.d. 18. flagyl 500 p.o. t.i.d. until note: please note that on about , the patient developed rapid atrial flutter that was controlled with some intravenous lopressor. the patient was started on amiodarone at that time and has not had any further prolonged episodes of atrial flutter. her liver function tests, thyroid function tests, and pulmonary function tests will need to be followed. follow up: follow up will be arranged for the patient though is not available at the time of this discharge summary. , m.d. dictated by: medquist36 procedure: insertion of non-drug-eluting coronary artery stent(s) angiocardiography of left heart structures injection or infusion of platelet inhibitor left heart cardiac catheterization coronary arteriography using a single catheter diagnoses: coronary atherosclerosis of native coronary artery urinary tract infection, site not specified congestive heart failure, unspecified unspecified essential hypertension atrial flutter pneumonitis due to inhalation of food or vomitus cardiogenic shock hematemesis acute myocardial infarction of inferoposterior wall, initial episode of care 

Answer: The patient is high likely exposed to