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: this is a 76 year old gentleman with a history of coronary artery disease status post coronary artery bypass graft and myocardial infarction in with a negative stress echocardiogram in , with an ejection fraction of 31%, who presented to on with increasing shortness of breath and found to be in congestive heart failure with bnp of 3700. also, his dig level was 2.3. the patient was admitted to the intensive care unit. cks were negative times three. the patient had diagnostic catheterization planned. a swan-ganz catheter was placed with a pa pressure of 92/40, cardiac output of 2.0, of 2800. the patient had a cardiac catheterization performed on which showed severe native three vessel disease, saphenous vein graft to left circumflex was occluded, saphenous vein graft to obtuse marginal 1 was occluded, saphenous vein graft to pda with distal 95% stenosis; severe plus four mitral regurgitation, ejection fraction of 15 to 20%. the patient was started on dobutamine and natrecor, heparin drip and intravenous lasix with good diuresis. creatinine improved from 1.8 to 1.4. his digoxin was held and the patient had occasional complete heart block which resolved at the time of transfer. his last pa numbers were 60/30, cardiac output of 2.3, of 2200. he was transferred to for catheterization with pre-cath hydration and mucomyst. he is currently comfortable with no shortness of breath, no chest pain, no right groin pain. past medical history: 1. coronary artery disease status post myocardial infarction, coronary artery bypass graft in . 2. non-insulin dependent diabetes mellitus type 2. 3. bladder cancer. 4. prostate cancer. 5. status post radiation therapy. 6. hypertension. 7. hyperlipidemia. 8. hypothyroidism. 9. congestive heart failure with four plus mitral regurgitation. medications on transfer: 1. dobutamine. 2. natrecor. 3. heparin. 4. lasix. 5. mucomyst. 6. aspirin. 7. plavix. 8. glyburide. 9. synthroid. 10. captopril. 11. protonix. 12. lipitor. 13. . 14. nitroglycerin. 15. nystatin. allergies: penicillin. social history: married; lives with his wife. tobacco or alcohol history. physical examination: on admission, temperature 96.4 f.; pulse 83; blood pressure 117/50; pa pressure 52/25; cvp of 6, cardiac output 3.3, cardiac index 1.92, respiratory rate 15, saturation of 99% on four liters. in general, he was well appearing, in no acute distress. heent: pupils equally round and reactive to light. oropharynx is clear. mucous membranes were moist. neck with jugular venous pressure about 6 cm and 45 degrees. no lymphadenopathy. chest is clear to auscultation bilaterally. cardiac is s1, s2, ii/vi systolic ejection murmur at the apex. abdomen was soft, nontender, positive bowel sounds. extremities with right groin with femoral line. distal pulses were doppler-able but depressed. extremities were warm. laboratory: on admission, white blood cell count 13.2, hematocrit 39.4, platelets 154. sodium 135, potassium 3.8, chloride 95, bicarbonate 32, bun 30, creatinine 1.5, glucose 146. ptt 41, inr 1.2, phosphorus of 1.2. ekg is normal sinus rhythm, pr of greater than 240, left axis deviation with qrs of 120; left bundle branch block. j-point in v1 through v3. hospital course: this is a 76 year old gentleman with ischemia cardiomyopathy and ejection fraction of 10 to 15%, status post coronary artery bypass graft in , admitted to on with congestive heart failure, swan-ganz catheter with cardiogenic shock treated with dobutamine, nesiritide and lasix. catheterization revealed two out of three grafts occluded and was admitted to for intervention. 1. ischemic cardiomyopathy: the patient initially was admitted for a cardiac catheterization and stent which he underwent the following morning. he tolerated the procedure well and had stents placed. he was continued on aspirin, plavix, statin and eventually was weaned off the heparin and nitroglycerin drip and tolerated this well. ejection fraction of 10 to 15%. admitted in heart failure. attempted diuresis was eventually weaned off of the dobutamine and natrecor while at cardiac catheterization and this was discontinued at that time. the patient was otherwise euvolemic. the next day, his swan-ganz catheter was pulled later that afternoon. the patient was transferred to the floor. eventually the next morning, he was restarted on his home regimen of 80 lasix q. day and aldactone was added. the patient was started on carvedilol and an ace inhibitor upon transfer. eventually, the patient had an episode of hypotension and bradycardia and was temporarily on dopamine and pressors which were weaned off and the patient's blood pressure was supported with hydration. etiology of the patient's hypotension was unclear, whether secondary to over anti-hypertensives or over diuresis. the patient was given an intravenous fluid bolus and started on low dose dopamine. the patient had a stat chest x-ray and kub done which were otherwise normal. the patient's blood pressure came up on dopamine and so did his heart rate eventually. he was weaned off the dopamine and his blood pressure was supported with hydration. the patient's blood pressure remained relatively stable with p.r.n. fluid boluses. the patient did not have any further episodes of bradycardia after the episode on the 31st in the evening. 2. elevated liver function tests and inr: the patient likely had shock liver after his hypotensive episode and had rising liver function tests and inr secondary to hypo-perfusion of his liver. the patient's liver function tests and inr coagulopathy was followed closely but the patient was not improving and did have slight right upper quadrant tenderness. discussed plans with family and as they would not prefer further intervention, ultrasound was not indicated and antibiotics were discontinued. 3. acute on chronic renal failure: the patient's creatinine was rising during the course of the day, likely prerenal and dehydrated per his fena and also may have had symptoms of atn from his episode of hypotension. the patient's creatinine was rising and plateaued around 2.6. the patient was hyperkalemic without ekg changes and the patient and family refused kayexalate dosing which was not pushed secondary to lack of ekg changes. 4. peripheral vascular disease: the patient on cardiac catheterization was found to have claudication of his right superficial femoral artery. the patient had diminished but doppler-able posterior tibial pulses on the right and palpable pulses on the left. otherwise, was stable from this and the patient did not have further episodes of leg pain except during his cardiac catheterization. 5. diabetes mellitus: the patient was continued on sliding scale insulin. his glyburide was held for his catheterization. condition at discharge: fair. the patient and family wants to take patient home to be comfortable. the patient's goal at this point is comfort and refusing further invasive tests and monitoring. the plan is to send the patient home with hospice care which is being arranged at present. discharge diagnoses: 1. congestive heart failure. 2. cardiogenic shock. 3. hypotension. 4. shock liver. 5. coronary artery disease. 6. peripheral vascular disease. 7. acute on chronic renal failure. 8. diabetes mellitus. discharge medications: 1. morphine sulfate 10 mg p.o. p.r.n. 2. ativan 0.5 mg p.o. p.r.n. the rest of the medications are per hospice. discharge instructions: discharge follow-up is per hospice. , md procedure: injection or infusion of platelet inhibitor injection or infusion of nesiritide insertion of drug-eluting coronary artery stent(s) diagnoses: coronary atherosclerosis of native coronary artery mitral valve disorders congestive heart failure, unspecified diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute kidney failure, unspecified coronary atherosclerosis of autologous vein bypass graft personal history of malignant neoplasm of prostate other specified forms of chronic ischemic heart disease 

Answer: The patient is high likely exposed to