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: chest pain and dyspnea on exertion . major surgical or invasive procedure: ivc filter placement . history of present illness: mr. is a 60 year-old male with no significant past medical history who presents with exertional chest pain since yesterday. he first noted chest discomfort while running up 2 flights of stairs 2 days ago. he developed sob, chest discomfort that felt like a "cramp" or a "bruise" (unable to quantify), and had to stop to catch his breath. the chest discomfort is mid-chest and non-radiating. normally he can run up the steps without difficulty. yesterday, he developed the same symptoms while loading up the car for a trip to . when he arrived in , he again had the same symptoms while unloading suitcases from his car. he reports that the shortness of breath and chest discomfort last for minutes and resolves with rest. he had associated diaphoresis. per his wife, he was clutching his chest and looked "ashen". no lightheadedness, dizziness, pre-syncopal sensation. no palpitations. he also notes pain in his left calf since yesterday. initially it felt like a sprained muscle and he took 2 alleve with some relief. the pain has since migrated to the back of his knee. . he travels twice per week to for work, which is a 50 minute train ride. he has also been on 2 long plane flights recently-- to in early and to on . no personal or family history of cancer. no history of pe. . of note, the patient had one episode of similar symptoms back in early . he was on a vacation in , and developed a "cramp"-like sensation associated with sob while carrying bags to his hotel room. at the time he attributed this to the high altitude. also, around he had an episode of syncope. he reports that he was walking downstairs in his house and all of a sudden he passed out and fell against the wall. he denies any pre- or post-syncopal symptoms. no lh, palpitations, incontinence, or post-ictal confusion. he did not have any work-up of these events. the patient did put himself on the treadmill around new year's and was able to run 5 miles without chest discomfort or sob. . he did not have any further symptoms this morning. he took 325mg of asa x 4. the patient called his pcp who recommended that he come to the ed. he reports he had another similar episode this afternoon, however, while walking from his car to triage. . in the ed, t 97.9, bp 139/94, hr 97, rr 18, sao2 97% on ra. ekg revealed st depressions in the inferolateral leads and there was concern for unstable angina. he received metoprolol 5mg iv x 1 and 25mg po x 1. he was also started on a heparin drip. cxr was negative. evaluated by cardiology fellow in the ed who recommended admission to for further evaluation. on his way up to the floor, he had lenis done which revealed lle dvt. on arrival to the floor, he has no complaints. denies chest pain, shortness of breath, lightheadedness. denies f/c, cough recently. . past medical history: none social history: he lives in with his wife. travels to 2x/week by train (50 min) for work. social history is significant for the absence of current tobacco use. he drinks an occasional glass of wine. family history: his father had type 1 diabetes from the age of 20 and developed heart problems in his 60s; died of "complications from his diabetes" at 74. his mother is alive, age 80, with osteoporosis. there is no family history of premature coronary artery disease or sudden death. no known family history of cancer. physical exam: vs - t 97.9 bp 153/99 hr 76 rr 18 o2sat 98% on 2l --> 97% on ra gen: wdwn middle aged male in nad. oriented x3. mood, affect appropriate. heent: ncat. sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. no xanthalesma. neck: supple with jvp at the clavicle. cv: pmi located in 5th intercostal space, midclavicular line. rr, normal s1, s2. no m/r/g. no thrills, lifts. no s3 or s4. chest: no chest wall deformities, scoliosis or kyphosis. resp were unlabored, no accessory muscle use. ctab, no crackles, wheezes or rhonchi. abd: soft, ntnd. no hsm or tenderness. abd aorta not enlarged by palpation. no abdominial bruits. ext: left leg is swollen and erythematous, no cord palpated, no calf tenderness, negative sign. no femoral bruits. skin: no stasis dermatitis, ulcers, scars, or xanthomas. . pulses: right: carotid 2+ femoral 2+ popliteal 2+ dp 2+ pt 2+ left: carotid 2+ femoral 2+ popliteal 2+ dp 2+ pt 2+ . pertinent results: pertinent labs: wbc-9.1 hgb-15.2 hct-41.1 mcv-91 plt ct-187 glucose-106* urean-19 creat-1.0 na-142 k-3.7 cl-105 hco3-26 12:20pm ck(cpk)-128 ck-mb-4 ctropnt-<0.01 07:29pm ck(cpk)-113 ck-mb-4 ctropnt-<0.01 06:42am ck(cpk)-85 ctropnt-<0.01 03:49pm ck(cpk)-75 ctropnt-<0.01 11:14pm ck-mb-3 ctropnt-<0.01 psa-0.9 . studies: cxr: no acute cardiopulmonary process. age indeterminant right ninth rib fracture, likely chronic given morphology. correlate with site of pain. . lle ultrasound: acute deep venous thrombosis involving the left popliteal and tibial veins. . cta chest: 1. extensive bilateral pulmonary emboli, predominantly within the lower lobes with a classic thin "saddle embolism" across the right and left main pulmonary arteries. 2. likely right heart strain given large right ventricle and leftward deviation of the intraventricular septum. . lle ultrasound: interval extension of deep venous thrombosis from the left popliteal and tibial veins to the mid and distal left superficial femoral vein. . tte: limited study. there is mild symmetric left ventricular hypertrophy with normal cavity size and overall systolic function (lvef>55%). due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. the rv is not well seen. the ascending aorta is mildly dilated. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion. there is no aortic valve stenosis. no aortic regurgitation is seen. the mitral valve appears structurally normal with trivial mitral regurgitation. there is no pericardial effusion. . lle ultrasound: left popliteal and the mid-to-distal femoral vein deep venous thrombosis. the level of clot has not changed significantly since . . tte: the left atrium is mildly dilated. left ventricular wall thicknesses are normal. the left ventricular cavity size is normal. overall left ventricular systolic function is normal (lvef>55%). tissue doppler imaging suggests a normal left ventricular filling pressure (pcwp<12mmhg). the right ventricular cavity is mildly dilated with mild global free wall hypokinesis. the aortic valve leaflets (3) are mildly thickened. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. the tricuspid valve leaflets are mildly thickened. there is mild pulmonary artery systolic hypertension. there is no pericardial effusion. brief hospital course: mr. is a 60 year-old male with no past medical history who presents with exertional chest pain, shortness of breath, and l calf pain for the past 2 days. he was found to have bilateral pulmonary embolism and a saddle embolism on cta along with dvt in his left tibial/popliteal vein. he was started on heparin gtt. an echocardiogram was performed to evaluate for right heart strain; it was a poor study. cardiac enzymes were negative x 3. he was transferred to the icu for closer monitoring. in the icu, he was closely monitored for any signs of hemodynamic compromise. overnight during his first night in the icu, he developed additional thigh pain (his previous leg pain was in his left popliteal fossa which correlated to the site of his dvt); a repeat ultrasound of his leg demonstrated extension of the dvt. it was thought to have extended prior to therapeutic heparin levels. the morning of , after discussion between interventional radiology and the icu team, an ivc filter was placed. his heparin drip was continued and he was transitioned to lovenox on prior to being called out from the unit. he remained hemodynamically stable on the floor without any significant events. an ambulatory sat was checked and ranged 95-98% on room air. . etiology of the dvt and pe was unclear. has no personal or family history of clotting. he did note 2 recent plane flights in the past 2 months and frequent commuter train travel. a hypercoagulable workup (including apc and antiphospholipin antibodies) were sent and were pending at the time of discharge; these should be followed up by his pcp. is otherwise up to date on his age-appropriate malignancy screening. . he will follow-up with radiology on for repeat ultrasound of his left leg to assess for any interval change in his dvt. he will follow-up with vascular surgery on to have his ivc filter removed. he was discharged on lovenox. he can discuss with his pcp switching to coumadin once the filter has been removed. . medications on admission: allergies: nkda . home medications: aspirin 81mg daily, most days alleve prn . discharge medications: 1. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 2. enoxaparin 80 mg/0.8 ml syringe sig: one (1) subcutaneous q12h (every 12 hours). disp:*30 syringes* refills:*2* . discharge disposition: home discharge diagnosis: bilateral and saddle pulmonary emboli . discharge condition: vital signs stable. satting well on ra. chest pain free. . discharge instructions: you were admitted to the hospital with chest pain and shortness of breath and found to have multiple large blood clots in your lungs (also known as pulmonary emboli). you were started on a medication called lovenox which will stabilize the clots and keep them from getting bigger. . during your hospital admission, you had an ivc filter placed to keep blood clots from your leg from migrating to your lungs. this filter will be removed in 2 weeks. you will need to take lovenox until the filter is removed. you should talk to dr. about starting coumadin after your filter has been removed. you should defer having any dental procedures performed while on lovenox or coumadin until you talk to your doctor. being on either of these medications will increase your risk of bleeding. . if you develop chest pain, shortness of breath, dizziness or lightheadedness, or the feeling like you will pass out, you should return to the emergency room. . followup instructions: please come to radiology on , at 9:30am for an ultrasound of your leg. in clinical center radiology. call . you will have your ivc filter removed on , . please come to the building and ask for directions to the care center'. you need to arrive by 10:30 am. dr. will perform the procedure. he also placed your filter. please do not take lovenox for 24 hours before the procedure (last dose should be saturday evening). dr. will instruct you when to re-start lovenox after the procedure. also, you cannot have anything to eat or drink after midnight on sunday night. telephone number is . . you should follow-up with dr. of pulmonary medicine. please call his clinic to schedule the appointment. . you should also follow-up with dr. in the next 7-10 days. you can further discuss getting a stress test at that time. . procedure: interruption of the vena cava diagnoses: acute venous embolism and thrombosis of deep vessels of proximal lower extremity other pulmonary embolism and infarction acute venous embolism and thrombosis of deep vessels of distal lower extremity 

Answer: The patient is high likely exposed to