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: amoxicillin attending: chief complaint: doe major surgical or invasive procedure: cardiac catheterization s/t stent placement to ramus and lima anastamosis swan catheter placement history of present illness: 73yo male with hx cad s/p cabg with redo , chf with ef 30%, afib, dm, cri, pvd who has recent stay last month for decompensated heart failure and arf that required ccu stay for tailored therapy and cvvh presents today with worsening doe. pt reports that he has been working with clinic to try to manage his weight gain of 11 lbs since being discharged on . his metolazone has been tepered off and his lasix was increased to 120mg qam/ 80mg qpm (from 80mg ). he reports increased doe today during his work as an at . this worsened to the point that he got sob walking across a room. he had some transient chest tightness that was relieved with rest but no ongoing chest pain. he has chronic non-productive cough, no fever. he has marked increase in his le edema in past weeks, l>r per baseline. he had a stress test just 4 days ago that showed defects and is aware that cath is planned for him in the near future. he has no ongoing sob currently. he notes easy fatiguability but - n/v, abd pain. dizziness, lh. -pnd, -orthopnea. he uses 2 pillows at night. past medical history: cad (cabg and ) chf w/ ef 30%, diastolic dysfx - recent admit with ccu transfer for tailored therapy . the patient had a swan line placed and initially was maintained on dopamine and vasopressin. his wedge was 33, pap 63/29, cardiac output 4.4, cardiac index 2.07. numbers improved when placed on milrinone. he ultimately required cvvh due to severe volume overload. he was stabilized and transferred back to a floor where he was maintained on lasix and metolazone with good urine output and faily stable renal function. af (dating back to ) dm (hba1c = 7.5) cri gerd pud gout claudication s/p ccy s/p cataract s/p back surgery social history: pt is a retired electrial engineer for ratheon. currently works as at . lives w/ wife, daughter and granddaughter in . quit tobacco >15 years ago; 50 pk-yr history. social etoh (2 drinks/week), no illicits. wife is hcp. daughter is cardiac nurse. family history: noncontributory. physical exam: gen: pleasant, comfortable, mild sob vs: 98.0 67 94/31 17 100% heent: eomi, anicteric, mild sclerae injection, mmm neck: supple, jvp at 11-12, no lad lungs: left basilar rales otherwise cta bilaterally heart: irregular, hsm across precordium greatest at lsb abd; soft nt nd -h/s megaly, midline hernia with scar ext: 3+ edema bilaterally but l>r (pt states chronic) neuro: cn intact, a&ox3 pertinent results: 11:00pm ck(cpk)-81 11:00pm ck-mb-notdone ctropnt-0.44* 04:19pm ck(cpk)-106 04:19pm ck-mb-12* mb indx-11.3* ctropnt-0.52* 04:19pm pt-21.2* ptt-37.4* inr(pt)-2.1* 02:00pm pt-42.4* ptt-44.4* inr(pt)-4.8* 01:20pm ck(cpk)-117 01:20pm ck-mb-15* mb indx-12.8* ctropnt-0.48* 01:20pm pt-40.1* ptt-39.8* inr(pt)-4.5* 08:50am glucose-137* urea n-115* creat-2.7* sodium-137 potassium-3.2* chloride-96 total co2-26 anion gap-18 08:50am ck(cpk)-120 08:50am ck-mb-16* mb indx-13.3* ctropnt-0.40* 08:50am plt count-104* 08:50am pt-45.6* ptt-40.8* inr(pt)-5.3* 07:01am urine hours-random urea n-521 creat-69 sodium-63 albumin-2.9 alb/crea-42.0* 07:01am urine osmolal-373 07:01am urine color-straw appear-clear sp -1.010 07:01am urine blood-neg nitrite-neg protein-neg glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-5.0 leuk-neg 10:15pm glucose-274* urea n-119* creat-3.0* sodium-134 potassium-4.3 chloride-92* total co2-28 anion gap-18 10:15pm alt(sgpt)-24 ast(sgot)-22 ld(ldh)-208 ck(cpk)-93 alk phos-144* tot bili-0.4 10:15pm ctropnt-0.08* 10:15pm ck-mb-notdone probnp-5593* 10:15pm albumin-3.8 10:15pm digoxin-1.5 10:15pm wbc-7.5 rbc-3.18* hgb-10.5* hct-30.9* mcv-97 mch-32.9* mchc-33.9 rdw-15.8* 10:15pm neuts-82.5* lymphs-10.5* monos-5.6 eos-0.8 basos-0.5 10:15pm macrocyt-1+ 10:15pm plt count-114* 10:15pm pt-49.7* ptt-41.4* inr(pt)-5.9* 01:15pm urea n-108* creat-2.8* sodium-137 potassium-3.8 chloride-93* total co2-29 anion gap-19 01:15pm magnesium-2.0 01:15pm digoxin-1.7 01:15pm wbc-7.5 rbc-3.18* hgb-10.5* hct-31.0* mcv-97 mch-33.0* mchc-33.9 rdw-16.0* 01:15pm plt count-134* 01:15pm pt-43.2* inr(pt)-4.9* . cxr: 1. mild pulmonary edema. 2. left lower lobe patchy atelectasis versus pneumonia. . ekg atrial fibrillation with a controlled ventricular response. since the previous tracing of the rate has decreased. st-t wave abnormalities are more marked. clinical correlation is suggested . brief history: 73 year old male with ischemic cardiomyopathy (ef 20%) referred for cardiac catheterization for non-st elevation mi. hi last catheterization was on that showed left dominant system with patent lmca and ramus only, otherwise occluded lad, lcx, and rca. the lima-lad, svg-om, and svg-pda were all patent. indications for catheterization: coronary artery disease, canadian heart class ii, stable. prior cabg & . procedure: right heart catheterization: was performed by percutaneous entry of the right femoral vein, using a 7 french pulmonary wedge pressure catheter, advanced to the pcw position through an 8 french introducing sheath. cardiac output was measured by the fick method. left heart catheterization: was performed by percutaneous entry of the right femoral artery, using a 5 french angled pigtail catheter, advanced to the left ventricle through a 5 french introducing sheath. coronary angiography: was performed in multiple projections using a 5 french jl4 and a 5 french jr4 catheter, with manual contrast injections. graft angiography: of 2 saphenous vein bypass grafts was performed using a 5 french right catheter, with manual contrast injections. arterial conduit angiography: of a left internal mammary artery graft was performed using a preformed catheter, with manual contrast injections. percutaneous coronary revascularization was performed using placement of drug-eluting stent(s). percutaneous coronary revascularization of an additional vessel was performed using placement of drug-eluting stent(s). conscious sedation: was provided with appropriate monitoring performed by a member of the nursing staff. hemodynamics results body surface area: 2.02 m2 hemoglobin: 10.2 gms % fick **pressures right atrium {a/v/m} 22/24/21 right ventricle {s/ed} 67/22 pulmonary artery {s/d/m} 64/30/40 pulmonary wedge {a/v/m} 33/36/30 aorta {s/d/m} 119/50/64 **cardiac output heart rate {beats/min} 53 rhythm sinus o2 cons. ind {ml/min/m2} 125 a-v o2 difference {ml/ltr} 55 card. op/ind fick {l/mn/m2} 4.6/2.3 **resistances systemic vasc. resistance 748 pulmonary vasc. resistance 174 **% saturation data (nl) pa main 58 ao 98 **arteriography results morphology % stenosis collat. from **right coronary 1) proximal rca discrete 70 2) mid rca discrete 70 2a) acute marginal normal 3) distal rca normal **arteriography results morphology % stenosis collat. from **left coronary 5) left main normal 6) proximal lad discrete 100 11) intermedius discrete 90 12) proximal cx discrete 100 **arteriography results to segments morphology % stenosis location **bypass graft 28) svbg #1 17 normal 29) svbg #2 14 discrete 100 32) lima 7 normal comments: 1. selective coronary angiogrraphy of this left dominant system revealed severe native three vessel coronary artery disease. the lmca was patent. the lad, lcx, and rca all had proximal occlusion. the ramus intermedius was the only remaining native vessel supplying the left ventricle with proximal 80% stenosis. 2. selective vein graft angiography demonstrated patent svg-pda with 80% stenosis in jump segment to the posterolateral branch. svg to om was not visualized and presumed to be occluded. 3. selective arterial conduit angiography revealed patent lima-lad with 90% distal anastomosis stenosis. final diagnosis: 1. three vessel coronary artery disease. 2. patent lima-lad. 3. patent svg-pda. . cxr indication: swan-ganz catheter placement. a swan-ganz catheter is present, with the tip making an abrupt rightward turn in the expected location of the junction of the main pulmonary artery and its bifurcation into the left and right pulmonary arteries. the acuity of the angle of the turn is greater than expected and the catheter could potentially be slightly coiled on itself at the tip. there is no pneumothorax. cardiac and mediastinal contours are stable allowing for positional differences. there has been interval worsening of a pattern of perihilar haziness and interstitial opacities suggesting worsening pulmonary edema. a small left pleural effusion is noted. right costophrenic angle has been excluded from the study and cannot be assessed. . cxr indication: 72-year-old man with chf. comments: portable erect ap radiograph of the chest is reviewed, and compared with the previous study of . the patient has prior cabg and median sternotomy. the swan-ganz catheter has been removed. no pneumothorax is identified. the previously identified congestive heart failure has been improving. there is small bilateral pleural effusion and bibasilar patchy atelectasis. . cxr comments: portable erect ap radiograph of the chest is reviewed, and compared with the previous study of yesterday. the previously identified mild congestive heart failure has been resolving. the heart is normal in size. the patient has prior cabg and median sternotomy. no pneumothorax is identified. . brief hospital course: 73m s/p cabg x 2, chf ef 20%, afib, dm2, abnormal mibi, p/w worsening sob/doe, noted to have nstemi via markers. he was admitted to the medical service on for decompensated heart failure, nstemi and abnormal mibi. he had inr reversed in preparation for c. cath and renal consulted for possible cvvh. at cardiac cath a cypher stent was deployed to the ramus (3.0x13) and to the lima anastomosis (2.5x13). patient was then transferred to the ccu for further monitoring and diuretic therapy. hd notable for elevated wedge to 29. he was diuresed with lasix 60mm iv, fluid restricted. beta blocker held d/t hr, ace i held d/t renal insufficiency. hct 25 and recieved 2 units prbc's without complications, lasix iv in between units. patient was tranferred back to floor where he was stable and asymptomatic, breathing comfortably. he had no chest pain or recurrence of sob, and he was continued on asa, avorvastatin, plavix, bb until discharge. no ace i was prescribed given cri, and the decision to start this medication will be decided by dr. as an outpatient. he resumed lasix, standing, at 80 mg po bid and required no prn doses. an echo is planned as an outpatient to see if ef has improved now that he is s/p intervention. . patient is chronically in afib and coumadin was held (supratherapeutic) for cardiac cath. he was restarted on coumadin after cath, and no heparin bridge was used. digoxin was held d/t elevated level of 1.6, and he is due to restart this medication on the day after discharge, per dr. , every other day. . diabetes was well controlled with fsqid, diabetic diet, riss. held glyburide d/t renal failure, but this was restarted on discharge as patient was back to baseline. . developed acute on chronic renal failure (2.8 from baseline ~1.8), likely secondary to decompensated heart failure and poor forward flow. renal function improved with diuresis. renal team followed patient and decided cvvh was not necessary during this admission. cr returned to baseline of 2.0 by discharge. epo continued. . medications on admission: 1. vitamin e 400 unit capsule sig: one (1) capsule po daily 2. atorvastatin 20 mg tablet sig: one (1) tablet po daily 3. ferrous sulfate 325 (65) mg tab qd 4. epoetin alfa 4,000 unit/ml qmowefr (monday -wednesday-friday). 5. aspirin 81 mg tablet qd 6. furosemide 80 mg tablet sig: one (1) tablet po bid 7. digoxin 125 mcg tablet sig: one (1) tablet po daily 8. nexium 40 mg capsule, qd 9. magnesium oxide 400 mg tablet sig: two (2) tablet po bid * 10 coumadin 5 mg tablet sig: one (1) tablet po once a day. 11 glyburide 1.25 mg tablet sig: one (1) tablet po once a day. discharge medications: 1. atorvastatin 20 mg tablet sig: one (1) tablet po daily (daily). 2. epoetin alfa 4,000 unit/ml solution sig: 4000 (4000) units/ml injection qmowefr (monday -wednesday-friday). 3. vitamin e 400 unit capsule sig: one (1) capsule po daily (daily). 4. ferrous sulfate 325 (65) mg tablet sig: one (1) tablet po daily (daily). 5. nexium 40 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po once a day. 6. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*8* 7. warfarin 5 mg tablet sig: one (1) tablet po hs (at bedtime). 8. glyburide 1.25 mg tablet sig: one (1) tablet po once a day. 9. furosemide 80 mg tablet sig: one (1) tablet po bid (2 times a day). 10. aspirin 81 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily). 11. digoxin 125 mcg tablet sig: one (1) tablet po qod: every other day. 12. magnesium oxide 400 mg tablet sig: two (2) tablet po twice a day. 13. coreg 6.25 mg tablet sig: one (1) tablet po twice a day. disp:*60 tablet(s)* refills:*2* discharge disposition: home discharge diagnosis: congestive heart failure non st elevation myocardial infarction atrial fibrillation acute on chronic renal insufficiency discharge condition: good. patient ambulating without shortness of breath. no chest pain. feels well. discharge instructions: weigh yourself every morning, md if weight > 3 lbs. adhere to 2 gm sodium diet fluid restriction: 1 liter please note the following changes in your medications: 1) plavix 75 mg po qd to prevent clots after stent placement 2) coreg 6.25 mg po bid to help with blood pressure and cardiac function 3) increase asa to 162 mg po qd from 81 mg po qd 4) digoxin has been changed from 125mcg every day to 125mcg every other day followup instructions: provider: . phone: date/time: 10:00 provider: , cardiology-private date/time: 8:30 provider: , cardiology-private date/time: 11:00 procedure: combined right and left heart cardiac catheterization coronary arteriography using two catheters injection or infusion of platelet inhibitor insertion of drug-eluting coronary artery stent(s) transposition of cranial and peripheral nerves insertion of two vascular stents excision of lingual thyroid percutaneous transluminal coronary angioplasty [ptca] procedure on two vessels diagnoses: subendocardial infarction, initial episode of care coronary atherosclerosis of native coronary artery esophageal reflux congestive heart failure, unspecified acute kidney failure, unspecified chronic kidney disease, stage iv (severe) gout, unspecified atrial fibrillation acute on chronic diastolic heart failure aortocoronary bypass status peripheral vascular disease, unspecified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease other specified forms of chronic ischemic heart disease diabetes with renal manifestations, type ii or unspecified type, not stated as uncontrolled 

Answer: The patient is high likely exposed to