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 / codeine / nsaids / levaquin attending: chief complaint: shortness of breath. major surgical or invasive procedure: right and left heart catheterization. endomyocardial biopsy. history of present illness: mrs. is a 34 year old woman with a history of hypertrophic cardiomyopathy, hypertension, svt, s/p pea arrest x3, s/p pericardial effusion/window who was transferred to from hospital for chf exacerbation and work up for constrictive pericarditis. she reports she developed bilateral back pain with inspiration about 2 days ago that is consistent with her prior chf exacerbation. she also reports that she noticed that her face and lips became cyanotic with exertion at home. of note, she reports she has a baseline variable 02 requirement at home from 0-2l. she otherwise denies f/c/change in appetite, cp/palp/sob/+dyspnea, -abd pain/n/v/d/c/melena/brbpr, paresthesias/weakness. . at hospital, she underwent ct angiogram that was negative for pe. she was treated for chf exacerbation with diuresis. she was noted to be bradycardic to the 40's and amiodarone briefly dc'd. she had a ct scan of the chest showing hilar and mediastinal adenopathy. rhc showed question of constrictive pericarditis with equalization of diastolic pressures in all four (rap 27, rvp 25, wedge 27). . during this hospitalization at the , she had multiple bursts of svt to hr 150s-160s. most recently this morning she had several minutes of svt to 160s x 3. during these episodes, she was noted to have undopplerable blood pressure per report. she was treated with carotid massage and converted to her native rhythm. she was also given 1 l of ivf with sbp 100. . cardiac review of systems is notable for absence of chest pain, +dyspnea on exertion, paroxysmal nocturnal dyspnea, +orthopnea chronic 2 pillows, -ankle edema, -palpitations, -syncope or presyncope. past medical history: past medical history: . cardiac risk factors: diabetes, dyslipidemia, + hypertension . percutaneous coronary intervention: none . pacemaker/icd: none . cardiac history, compiled from omr: taken from last discharge summary. age: 12: initial presentation with syncope 13: seen at for history of syncope, chest pain and progressive exercise intolerance; diagnosed with hypertrophic cardiomyopathy, and underwent catheterization in which lvedp was found to be 20. started on ongoing verapamil therapy. 16: cardiac arrest secondary to complex tachycardia, successfully resuscitated. repeat catheterization showed left ventricular end diastolic pressure of 36-40 without outflow tract obstruction. ep showed inducible atrial flutter with a rapid ventricular blood pressure; dx'ed w/rapid antegrade conduction and possible pre-excitation. started on norpace (dysopyramide); kept on verapamil and norpace for many years. had occasional palpitations, chest pain and light headedness. 25: appendicitis during pregnancy, with post-op course complicated by congestive heart failure, intubated and then eventually extubated without difficulty; delivered son at 25 weeks. recent history: * : atrial arrythmias (mat diagnosed at , afib/flutter seen at osh), started on amiodarone. * : admitted from hosp w palpitations, diagnosed as avnrt, discharged with increased dose of verapamil, made long-acting. * : pulmonary vein isolation procedure. post-procedure atrial tachycardia w/multiple morphologies-->cardioversion. respiratory distress and post-procedure re-intubation<--pulmonary edema and possible contribution of pan-sensitive klebsiella pna. ongoing fevers, ?pe treated with heparin. discharged on amiodarone 200 mg tid. * : dyspnea, chest pain, possible pneumomediastinum; diagnosed with large pericardial effusion; pericardial window done; post-op atrial tachycardia. during post-op course, had difficult-to-assess fluid status and was taken to the cath lab; in holding area had pea arrest, coded for 1 hour; intubated for 6 days and put on cvvh after cath confirmed volume overload; extubated; and then reintubated 2 days later for aspiration and hypoxia, then had pneumothorax as complication of intubation; ultimately extubated again, treated for pneumonia. admission also notable for arf and pancreatitis. * : admitted from rehab with dyspnea and chest pain, anemia and mild chf symptoms; having atrial tachycardia with varying 2:1 and 3:1 conduction. discharged . * : admit for shortness of breath, coded for 30 minutes while being evaluated in ed: pea w wide-complex near-sine-wave tachycardia hyperkalemia; regained pulse in 30 minutes, after which she had nsr w rbbb; then had wide complex tachy and bp drop; defibrillated x1 200j, briefly on dopamine gtt. admission notable for ongoing fluid overload and weakness/apparent deconditioning. source of hyperkalemia was never clear. pt discharged on to home after refusing placement to rehab. pt had been at home until her most recent admission to . social history: lives at home with her husband and 15y/o son. -tobacco history:quit (former 2ppdx20yrs). -etoh:denies -illicit drugs:denies family history: no family history of early mi, otherwise non-contributory. physical exam: physical exam at admission: vs: t97.7, b p 100/67, hr 105, rr 16, sat 96% on 2l pulsus: difficult to assess due to faint pulses ~8 general: nad. oriented x3. mood, affect appropriate. able to speak in full sentencnes. heent: ncat. sclera anicteric. perrl, eomi. conjunctiva pink, no pallor or cyanosis of the oral mucosa. no xanthalesma. neck: jvp ~8 cms cardiac: pmi located in 5th intercostal space, midclavicular line. rr, normal s1, s2, +s4, diastolic murmur loudest rusb. lungs: no chest wall deformities, scoliosis or kyphosis. resp were slightly labored, no accessory muscle use. crackles bases to mid lung fields b/l. abdomen: soft, ntnd. no hsm or tenderness. abd aorta not enlarged by palpation. no abdominial bruits. extremities: no c/c/e. no femoral bruits. skin: no stasis dermatitis, ulcers, scars, or xanthomas. pulses: right: carotid 2+ femoral 2+ popliteal 1+ dp 1+ pt 1+ left: carotid 2+ femoral 2+ popliteal 1+ dp 1+ pt 1+ .. physical exam at discharge: pertinent results: ekg () demonstrated atrial tachycardia to 164, left axis deviation, rbbb, biatrial enlargement. .. cxr pa and lat (): findings: two views of the chest are compared to . there are bilateral small-to-moderate pleural effusions (right greater than left), but much improved from . there is a cephalization of engorged pulmonary vasculature, but no overt pulmonary edema. there is no new superimposed consolidative process identified. cardiomegaly and mediastinal contours are stable. impression: bilateral loculated pleural effusions, improved from . mild pulmonary overload, but no overt interstitial edema. .. cardiac mri (): impression: 1. the pericardium demonstrates patchy late gadolinium enhancement and maybe tethered to the myocardium; the pericardial thickness is normal. abnormal septal motion was not seen. together, these findings are consistent with but not diagnostic of constrictive pericarditis. 2. moderate asymmetric hypertrophy with mildly depressed biventricular function due to septal akinesis. 3. the indexed diameters of the ascending and descending thoracic aorta were normal. the main pulmonary artery diameter index was normal. 4. moderate to severe biatrial enlargement. 5. moderate bilateral pleural effusion. patchy opacity is noted in the right middle lobe. correlation with other chest imaging studies is advised. .. endomyocardial biopsy (): diagnosis: heart, intraventricular septum, biopsy (a): cardiomyocyte disarray, hypertrophy and increased amount of interstitial fibrosis consistent with hypertrophic cardiomyopathy. thickening of the endocardium present. all findings could account for clinical picture. no evidence of amyloid or inflammation. masson trichrome done. .. coronary cath (): comments: 1. coronary angiography of this right dominant system demonstrated no angiographically apparent coronary artery disease. the lmca, lad, lcx, and rca were free of apparent flow-limiting lesions. 2. resting hemodyamics revealed moderately elevated right and left sided filling pressures (ra mean and rvedp both 28 mm hg, and pcwp mean 40 mm hg, lvedp 33 mm hg, respectively). there were prominent x and y descents and concordance of left and right ventricular pressures with respiration, consistent with restriction. pulmonary pressures were moderately elevated (pasp 59 mm hg). cardiac index was mildly depressed at 1.6 l/min/m2. systemic and pulmonary vascular resistance were normal (svr 1368 dynes-sec/cm5, pvr 52 dynes-sec/cm5). there was no gradient upon pullback of the catheter from the lv into the aorta. 3. left ventriculography was deferred. 4. endomyocardial biopsy was performed (2 samples) from the rv interventricular septum. rv contraction appeared normal, there was no pulmonic outflow obstruction, and prominent trabeculation was evident. final diagnosis: 1. no angiographically apparent coronary artery disease. 2. elevated right and left heart pressures consistent with diastolic dysfunction. 3. possible restrictive cardiomyopathy. 4. mildly depressed cardiac index. 5. successful endomyocardial biopsy. .. echocardiogram (): the atria are moderately dilated. there is moderate symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. overall left ventricular systolic function is normal (lvef>55%). the right ventricular free wall is hypertrophied and rv cavity is mildly dilated, with mild global free wall hypokinesis. the number of aortic valve leaflets cannot be determined. there is no aortic valve stenosis. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. trivial mitral regurgitation is seen. there is mild pulmonary artery systolic hypertension. there is no pericardial effusion or pericardial thickening. there is no evidence of pericardial constriction. brief hospital course: in summary, this is a 34-year old female with a history of hypertrophic cardiomyopathy, svt, hypertension, copd s/p multiple pea arrests who is admitted with chf exacerbation and work up for constrictive pericarditis versus restrictive cardiomyopathy. she is transferred to the ccu due to runs of atrial tachycardia to the 160s and associated hypotension. .. # rhythm: she has a history of multiple svts including atrial fibrillation, atrial tachycardia, mat and avnrt. she was transferred to the ccu after bursts of what appeared to be mat. due to her hemodynamic compromise in this rhythm, she was reloaded with amiodorone at a dose of 400 mg . she was then loaded with digoxin and had a subsequent decrease in her ventricular rate to 70s with 2:1-3:1 atrioventricular conduction. her metoprolol was uptitrated as blood pressure would tolerate. . plan for av nodal ablation and permanent pacemaker placement was delayed by symptomatic candidal uti being tx with 2 week course. however, at time of discharge her rate was well controlled on the combination of amiodorone, digoxin, and metoprolol. pt will return for elective procedure in 1 to 2 weeks after repeat ua is clear. .. # pump: she has a history of hypertrophic cardiomyopathy with preserved ef and moderate symmetric lvh. right heart catheterization at hospital prior to transfer showed equalization of pressures concerning for constrictive pericarditis. however, right and left heart catheterization at showed prominent x and y descents and concordance of left and right ventricular pressures with respiration, all consistent with a restrictive cardiomyopathy. endomyocardial biopsy was performed and pathology was consistent with hypertrophic cardiomyopathy. cardiac mr was done with full report above. . on physical exam and chest x-ray, it was clear that she was volume-overloaded and her symptoms of shortness of breath, fatigue were consistent with her usual heart failure exacerbations. she was therefore started on a lasix drip with goal diuresis 1 to 1.5 l per day. at time of discharge, her net diuresis is negative. her oxygen requirements are 2l. . # cad: there was no evidence of coronary disease on cardiac catheterization during this or previous hospitalizations. blood pressure and heart rate control were achieved with metoprolol, amio, and digoxin for primary prevention. . # urinary tract infection: during the hospital course, she started complaining of burning with urination. a urine culture grew out yeast, 100,000 colonies, and because she was symptomatic we decided to treat with a 14 day course of fluconazole. a renal ultrasound was performed to look for perinephric abscess; this showed no hydronephrosis or perinephric abcess, it did show a small left pleural effusion. her symptoms resolved on fluconazole and is to have a repeat ua in weeks. patient can have ablation once uti resolves. . # copd: we continued her outpatient regimen of xopenex, montelukast, and ipratropium. . # depression / anxiety: we continued her outpatient regimen of bupropion, clonazepam, sertraline. . she was maintained on a heparin drip due to her underlying atrial dysrrhythmia; this was switched to lovenox instead of coumadin at time of discharge because there was concern fo interactions with digoxin and amiodarone. she had a cardiac heart-healthy diet. there was no indication for gi prophylaxis. medications on admission: medications at time of transfer from : lopressor 12.5mg amiodarone 100mg daily lasix 80mg iv bid aldactone 25mg singular 10mg daily trazadone 100mg daily zoloft 50mg tid wellbutrin 75mg daily iv dilaudid q4hprn percocet 5/325 prn potassium chloride 40meq folic acid 1mg daily iron 300mg daily klonapin 1mg qid tylenol. .. medications at time of transfer from floor: albuterol prn amiodarone 200 metoprolol tartrate 37.5 tid wellbutrin 75 monteleukast clonazepam iron folic acid lasix 40 iv bid dilaudid prn discharge disposition: home with service facility: vna discharge diagnosis: atrial tachycardia atrial fibrillation/atrial flutter hypertrophic obstructive cardiomyopathy asthma depression anxiety fungal urinary tract infection with right flank pain discharge condition: stable right groin with tiny tender nodule under puncture site, no bruising swelling or erythema. discharge instructions: you had an episode of congestive heart failure with high pressures within your heart at hospital. we increased the amount of fluid medicine (spironolactone) to take with the furosemide. we also started you on digoxin and increased your metoprolol to control your heart rate. you have a urinary tract infection and we started you on fluconazole for a total of 14 days. you will need an av node ablation and pacemaker after your urinary tract infection is cleared. stop taking your warfarin for now, you will give yourself lovenox twice daily until the nurse who arranges the pacemaker tells you to stop taking it. we started lisinopril to control your blood pressure better and help your heart pump. we also started spiriva to help with your breathing. . weigh yourself every morning, md if weight > 3 lbs. adhere to 2 gm sodium diet fluid restriction: cc . congratulations on quitting smoking. information was given to you on admission regarding smoking cessation and preventing relapses. followup instructions: cardiology: dr. phone: ( date/time: monday at 3:30pm. . primary care: healthcare , ma , md wednesday at 10 am please do ekg at this time and e-mail , md results. . pt will need av ablation and pacemaker after urine culture is clear. this will be done by . md, procedure: combined right and left heart cardiac catheterization coronary arteriography using two catheters angiocardiography of right heart structures biopsy of heart diagnoses: congestive heart failure, unspecified unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled candidiasis of other urogenital sites atrial fibrillation acute on chronic diastolic heart failure atrial flutter dysthymic disorder other and unspecified hyperlipidemia other specified cardiac dysrhythmias other emphysema 

Answer: The patient is high likely exposed to