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: shortness of breath major surgical or invasive procedure: pulmonary artery catheter placement history of present illness: 81 yo m with cad s/p mi x3 (last ') and ptca w/stent x2 to rca and lcx(@ , ), systolic heart failure ef ~20% (by cath report; 35% by echo ) and iddm, p/w sob. pt reports that he has been having periodic episodes of dyspnea since , requiring x3 prior admits to . he underwent cardiac cath last month, as he was not a good candidate for cabg, but notes no improvement in sxs since the procedure. he was last admitted to , where he was treated for hyperkalemia in the setting of arf with k 5.4 and cr 4.1 (baseline 1.9-2.0). he also c/o sob at that time, but cxr showed no evidence of failure and he was d/c'ed home after his potassium had come down. this morning, he called ems after waking up multiple times over night feeling as though he "was suffocating." pt states that this has been going on for several weeks but happens more each night over the past week. in the field, ems found him to be hypotensive w/bp in 80s and hypoxic with o2sats 84%. he was bolused 500cc and transferred to for further management. pt has stable 3 pillow orthopnea, occ pnd, can walk several blocks with minor difficulty, but cannot climb a flight of stairs without getting sob. he awakens 3-4x per night to urinate. he denies any recent le swelling, any non-compliance with med regimen, and any change in dietary habits (follows low na diet). he does not use o2 at home. in the ed, he received asa, slntgx1 (which relieved his chest tightness), lasix 40mg ivx2 and 0.5 in ntp. he was hypoxic with o2 sats 84%2l, which increased to 87% on , he was placed on bipap. he responded to the decreased preload/afterload in addition to diuresis, and o2 sats increased to 100% on 4l. he was transferred to the floor for further management. ros neg for f/c, n/v, dysuria, constipation/diarrhea past medical history: -cad as above. cath at showed 95% d2 ostial, 70% cx, and diffuse rca dz. cypher des x2 were placed (rca and cx); estimated ef 20%; prior echo ? showed ef 35%. -ischemic cm, as above -chronic renal insufficiency -gerd social history: pt is originally from . he is a retired diesel mechanical engineer. one of his daughters lives in . he lives alone in jp and has a homemaker come in x3/wk and vna services at home. his daughter lives in and helps him to make most medical decisions - she is a lpn. tob 20py hx, quit ' occ etoh no illicits family history: mother, 2 daughter and 2 sons with dm2 physical exam: 97.5 103 90/77-116/58 20-33 100%4l gen: frail, elderly man lying in bed, speaking in full sentences, appears comfortable heent:perrl, op clear neck: no lad; jvp at 8 cvs: frequent ectopic beats; prom p2; +s3 gallop; no rv heave; pmi ~5-6th ics mal; no m/r appreciated chest: crackles way up abd: soft, nt/nd, nabs ext: no c/c/e neuro: non-focal pertinent results: 06:45am wbc-7.2 rbc-3.92* hgb-11.6* hct-36.3* mcv-93 mch-29.7 mchc-32.0 rdw-14.2 06:45am neuts-58.1 lymphs-31.0 monos-6.7 eos-3.2 basos-1.1 06:45am plt count-151 06:45am ck-mb-5 ctropnt-0.03* 06:45am ck(cpk)-173 01:10pm ck-mb-4 ctropnt-0.02* 01:10pm ck(cpk)-147 ekg: sinus tach @ 100bpm; lad; l ant hemiblock; q in ii, iii, avf; no st-t changes cxr: mild chf with interstitial edema. . pulmonary artery catheter placement: comments: 1. resting hemodynamics revealed severely elevted left and right-heart pressures (ra mean 20mmhg, pa mean 36mmhg, pcwp mean 21 mmhg). the estimated cardiac output was 1.9 l/min. dobutamine 10 mcg/kg/min was started in the catheterization laboratory with systolic augmentation of the aortic pressure. final diagnosis: 1. cardiogenic shock. 2. severely elevated left and right heart filling pressures. brief hospital course: 81 yo m with dm2, cri, cad s/p mix3, ischemic cm, ef ~20%, with x5 months sob not relieved by cath/ptca, whose primary complaint is waking up extremely short of breath multiple times at night for the past few days. 1) heart failure: pt's hypotension (most-likely explaining his acute weakness and lh this am) and hypoxia on presentation decompensated failure as evidenced by cxr and exam. per cath report, ef 20%. acute myocardial infarction was ruled out by ekg and negative enzymes. he was found to have a urinary tract infection which could possibly be the cause of the acute decompensation of his heart failure. he reports compliance to meds and diet. however, he states that his primary doctor has told him that his regimen has not been adequate and may need to be changed. his carvedilol and captopril were discontinued during hospitalization in the setting of hypotension and acute renal failure during hospitalization. during this hospitalization he was first diuresed and improved symptomatically briefly but then began to decompensate with development of acute pre-renal failure, hypotension, and multiple episodes of awakening at night acutely short of breath. during this time he continued to deteriorate and further diuresis was attempted with natrecor without response. he was transferred to the ccu for further management. while in the ccu he was monitored closely and it was found that he was having up to 5 episodes of - breathing perhour, often times with ventricular ectopy and on few occasions with desaturation,. apneic episodes lasted up to 60 seconds. during this time he also had acutely worsening renal failure, elevation of liver enzymes, and demonstrated change in mental status. a pulmonary artery catheter was place with elevated pcwp and elevated right sided pressures and a mixed venous 02 saturation of 24%. he was started on dobutamine and within 24 hours his mental status improved, and the - breathing episodes decreased in frequency as the cardiac index increased. within two days the renal funtion began to improve and the liver enzymes began trending down. after several days on dobutamine he was started on digoxin qd, level was 1.7 and so regimen was decreased to every other day. it was felt that an inotrope was required and though pt had cri digoxin would be the most beneficial medication to him at this time though it would have to be monitored closely. a follow-up appointment was made with his primary cardiologist for two days from discharge for monitoring. beta blocker was held as it was felt that it would not be beneficial to him in the current declined state of cardiac function. he was monitored for three days off the docutamine before discharge. . 2) non-sustained ventricular tachycardia: episodes occurred in setting of apnea and also while on dobutamine. in a family meeting it was decided that dobutamine would be continued despite the increased ectopy. ep was consulted and found that the pt was no currently a icd candidate. . 3) dm2: glyburide and lantus discontinued during episode of arf but restarted on return to baseline creatinine. . 4) acute renal failure on cri: per records, baseline cr around 2.0. currently 1.5. during worsening heart failure prior to ccu and dobutamine initiation acute renal failure developed likely secondary to poor perfusion. during this time bun was elevated to over 100. function returned to baseline as cardiac index improved. . 5) pt was treated for complicated uti with a course of bactrim. . 6) code: dnr/dni. discussed with pt and family extensively. medications on admission: asa captopril 12.5 tid colace lasix 80' glyburide 10" lantus 10u qhs carvedilol 6.25" simvastatin 10' discharge medications: 1. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 2. clopidogrel bisulfate 75 mg tablet sig: one (1) tablet po daily (daily) for 2 months: 3 months beginning from . 3. digoxin 125 mcg tablet sig: one (1) tablet po every other day. 4. docusate sodium 100 mg capsule sig: one (1) capsule po bid:prn. 5. glyburide 5 mg tablet sig: two (2) tablet po twice a day. 6. lantus 100 unit/ml solution sig: ten (10) units subcutaneous at bedtime. 7. simvastatin 10 mg tablet sig: one (1) tablet po once a day. discharge disposition: extended care facility: hospital discharge diagnosis: congestive heart failure coronary artery disease acute renal failure on chronic renal insufficiency diabetes discharge condition: stable discharge instructions: weigh yourself every morning, md if weight changes > 3 lbs. adhere to 2 gm sodium diet fluid restriction: less than 1500 ml per day followup instructions: appointment with your cardiologist dr. on at 2:30 pm at - clinic. procedure: non-invasive mechanical ventilation pulmonary artery wedge monitoring right heart cardiac catheterization injection or infusion of nesiritide pulmonary artery pressure monitoring diagnoses: coronary atherosclerosis of native coronary artery mitral valve disorders urinary tract infection, site not specified congestive heart failure, unspecified unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute kidney failure, unspecified gout, unspecified percutaneous transluminal coronary angioplasty status systolic heart failure, unspecified paroxysmal ventricular tachycardia other specified forms of chronic ischemic heart disease alkalosis cardiogenic shock old myocardial infarction unspecified disorder of kidney and ureter apnea cheyne-stokes respiration 

Answer: The patient is high likely exposed to