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: neomycin attending: chief complaint: ankle, thigh, penile edema major surgical or invasive procedure: in ccu had swan catheter placement for hemodynamic monitoring history of present illness: 75 year old male with a history of ischemic cardiomyopathy and ef 10-15% with history of progressive ankle, thigh, penile edema over past 2.5 weeks. weight has increased from baseline of 151-154 lbs to 159 lbs. he has been admitted in the past for treatment of his chf, including monitoring with a swan ganz catheter. he has been taking his medications. he denies increased doe, sob at rest, orthopnea, nocturia, but does note increased fatigue. he has ddd/icd (biv placement considered too risky). complicating factors include recent cessation of amiodarone/statin due to concern for myopathy leading to weakness, however treatment reinstated since holding did not increase strength. also has crf with recent creatinine of 1.6 and chronic hypotension with sbp at 90 mmhg. coronary artery disease status post anteriolateral myocardial infarction in . pci with stent placement in lad and d1 in , complicated by apical thrombus, emergent cabg. lv anterioapical aneurysm. chf with ef 14% from ett-mibi, swan catheter in had evidence of elevated left and right sided pressures. at that time diuresed with iv lasix and milrinone with improvment of pressures (to wedge less than 20, diuresed 18 liters). echo lae, lv dilatation, ef 10-15% severe global lvhk, severe global rv free wall hk, 4+mr, 4+tr, mod pulm htn. past medical history: 1. coronary artery disease status post anteriolateral myocardialinfarction in . pci with stent placement in lad and d1 in , complicated by apical thrombus, emergent cabg. lv anterioapical aneurism.2. congestive heart failure with anejection fraction of 10 to 15%.3. gastrointestinal bleed secondary to small bowel avms.4. atrial fibrillation status post pacer ddd and aicd.5. hypercholesterolemia.6. hypertension.7. benign prostatic hypertrophy.8. depression.9. eczema.10. anemia with a baseline hematocrit of 27 to 32.11. chronic renal failure with a baseline creatinine of 2.0.12. mrsa colonization.13. status post stroke.14. gastroesophageal reflux disease.15. status post appendectomy. social history: the patient lives with his wife and his adopted son who is 8. he has a fifty pack year history of smoking, but quit many years ago. he drinks one to two glasses of alcohol per day. family history: non-contributory physical exam: vitals t 95.5 p 75 bp 70/48 resp 20 96%ra gen alert, oriented, cooperative male in nad heent perrla, mmm, op clear neck jvd at 15 cm, no lymphadenopathy or thyromegally thorax scar on chest, crackles and wheezes at left base cv rrr, s1,s2,s3, systolic murmer at lt sternal base and apex abd soft, slightly distended, no ascites, nt/nd +bs ext 3+ edema to just below the knee, no cyanosis neuro intact pertinent results: 09:30am blood wbc-4.6 rbc-4.06* hgb-11.2* hct-35.3* mcv-87 mch-27.6 mchc-31.7 rdw-17.2* plt ct-257 09:30am blood plt ct-257 09:30am blood glucose-143* urean-25* creat-1.3* na-138 k-3.5 cl-98 hco3-27 angap-17 09:30am blood calcium-9.3 phos-2.5* mg-2.1 05:40am blood ck-mb-notdone ctropnt-0.06* brief hospital course: 1. chf - this 75 year old male with a history of ischemic cardiomyopathy ef 14% from ett-mibi presented with incresing edema indicating acute chf exacerbation. upon admission aggressive diuresis was started with the goal to get back to his dry weight of 151-154lbs. nesiritide drip was started and he was stareted on dopamine drip to maintain sbp >90. upon further evaluation it was determined that he would benefit from having more tailored chf therapy including monitoring with a swan catheter. he was transferred to the ccu. in the ccu a swan was placed and his initial readings were pcwp 38, pa 56/24. he was continued on dopamine and nesiritide. his icd was interrogated and found to be working well, he was being safety paced. after four days in the ccu he had diuresed from 75 to 69.4 kg with dopamine, lasix, and nesiritide. captopril and altactone were started. the swan was dc'd and he was transfered back to the floor for further management. his swan ganz readings upon transfer to the floor were: cvp 12, pap 51/18, co 5.3. initially on the floor he was continued on captopril, aldactone, nesiritide, and bolus lasix. he was converted from nesiritide and iv lasix to captopril and po lasix. after a few days on the floor he had some increased edema and was more aggressively diuresed with dopamine and iv lasix. his pressure was very labile and it was difficult to stop the dopamine, which was maintaining his sbp >90. he was started on sinemet for dopa stimulation and aminophyline. as these medications were titrated up we were able to wean off the iv dopamine and he maintained his blood pressure well. he was converted to oral medications with his final regimen as below. he was on the floor for a total of 14 days after transfer out of the ccu. his discharge weight was 141 lbs. he had limited ankle edema >1+ and no crackles on exam. he had no tremors from the aminophyline or sinemet. generally he is doing very well on his current oral regimen. 2. cad- he is s/p pci with stent placement in lad and d1 in , complicated by apical thrombus, emergent cabg. since he could not be on aspirin due to severe gi bleed he was not treated with any. initially his b-blocker and ace-i were held due to hypotension, but were restarted on the floor prior to discharge. one set of enzymes was drawn which showed a troponin of 0.6, this was felt to be demand ischemia due to fluid overload. 3. valves- he has severe 4+mr and 4+tr. an echo here showed: "the left atrium is markedly dilated. the right atrium is markedly dilated. the left ventricular cavity is severely dilated. there is akinesis of the septum. the is a posterior apical aneurysm. there is hypokinesis of the remaining walls with some preservation of the basal lateral and inferolateral walls. overall left ventricular systolic function is severely depressed (ejection fraction 10%). a left apical thrombus cannot be fully excluded. the right ventricular cavity is dilated. the basal segment of the right ventricular contracts. the aortic valve leaflets (3) are mildly thickened but not stenotic. severe (4+) mitral regurgitation is seen. moderate to severe tricuspid regurgitation is seen. there is moderate pulmonary artery systolic hypertension. mild to moderate pulmonic regurgitation is seen. compared to the prior study of (tape not available for review), there has been a small increase in the pulmonary artery systolic pressures. the posterior apical aneurysm was not previously described." his valve disease was unchanged from previous therefore ruling out worsening valve disease as a cause of his acute exacerbation of chf. 4. cri- his baseline creatinine is 1.6, we continued to monitor his creatinine during his hospital stay and it was 1.2 at discharge. his sbp was maintained greater than 90 throughout his hospital stay to keep his kidneys adequately perfused. 5. gerd-he was continued on protonix for his gerd throughout his hospital stay. he had no evidence of gi bleed. 6. depression-he was continued on zoloft throughout his hospital stay. he was started on olanzapine at night secondary to some increased confusion and sundowning while in the ccu. it was continued on the floor as it assisted with his sleeping and he had no further episodes of confusion. 7. atrial fibrillation: the patient has a pacemaker. he is not on anticoagulation secondary to his chronic gastrointestinal bleed. 8. anemia: his hct was stable throughout his hospital stay and was 35.3 on discharge. medications on admission: 1. toprol xl 25 mg/day 2. lasix 80mg bid3. aldactone 12.5mg/day 4. rabeprazole 20mg 5. digoxin 0.125mg qd 6. zoloft 200mg qd 7. mvi qd8. procrit 30,000 units/week 9. lisinopril 7.5mg/day discharge medications: 1. epoetin alfa 10,000 unit/ml solution sig: one (1) injection injection qmowefr (monday -wednesday-friday). 2. pantoprazole sodium 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q12h (every 12 hours). 3. sertraline hcl 100 mg tablet sig: two (2) tablet po qd (once a day). 4. multivitamin capsule sig: one (1) cap po qd (once a day). 5. heparin sodium (porcine) 5,000 unit/ml solution sig: one (1) injection injection tid (3 times a day). 6. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 7. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed. 8. acetaminophen 325 mg tablet sig: 1-2 tablets po q4-6h (every 4 to 6 hours) as needed. 9. spironolactone 25 mg tablet sig: one (1) tablet po qd (once a day). 10. olanzapine 2.5 mg tablet sig: one (1) tablet po hs (at bedtime). 11. atorvastatin calcium 20 mg tablet sig: one (1) tablet po qd (once a day). 12. carvedilol 3.125 mg tablet sig: one (1) tablet po bid (2 times a day). 13. digoxin 125 mcg tablet sig: 0.5 tablet po qd (once a day) as needed for heart failure. 14. aminophylline 200 mg tablet sig: one (1) tablet po q8h (every 8 hours). 15. tramadol hcl 50 mg tablet sig: one (1) tablet po q4-6h (every 4 to 6 hours) as needed. 16. captopril 12.5 mg tablet sig: 0.5 tablet po tid (3 times a day). 17. carbidopa-levodopa 10-100 mg tablet sig: four (4) tablet po qid (4 times a day). 18. furosemide 80 mg tablet sig: one (1) tablet po bid (2 times a day). discharge disposition: extended care facility: of discharge diagnosis: chf (ef 10-15%) had less than 6 month life expectancy cad a.flutter htn depression gerd discharge condition: stable, same level of ability as prior to admission discharge instructions: weigh yourself every morning, md if weight increases by > 3 lbs. adhere to 2 gm sodium diet fluid restriction: 1500 ml/day take all of your medications return to the hospital if you have any shortnes of breath, chest pain, leg swelling followup instructions: call to make appointment for follow up with primary care doctor dr. ( in weeks. call to make appointment for follow up with dr. ( in weeks. md procedure: injection or infusion of nesiritide diagnoses: esophageal reflux mitral valve disorders congestive heart failure, unspecified unspecified essential hypertension atrial fibrillation other specified forms of chronic ischemic heart disease hypotension, unspecified unspecified disorder of kidney and ureter diseases of tricuspid valve 

Answer: The patient is high likely exposed to