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: augmentin / atorvastatin attending: chief complaint: transfer for catheterization, chest pain, nstemi major surgical or invasive procedure: coronary catheterization pacemaker placemenent history of present illness: **patient has severe dementia and most of the history was obtained via medical records 78 yo m with a history of cad s/p three-vessel cabg in (lima-d1, svg-d3 and svg-om2), htn, and hypercholesterolemia who was transferred from an osh tonight for planned cardiac cath in the am for a nstemi. he was at a casino on with his 2 sons when he was noted to have chest pain while climbing stairs. he took 2 sl nitros that did not resolve the pain. he took a 3rd sl ntg when ems arrived resolved cp. at he was found to have st-depressions in v1-v4 and borderline/minimal elevations in iii/avf. he was started on heparin and integrillin drips and plavix as well. labs at the osh were significant for a ck 1350, ck-mb 106.2, and troponin-i 2.66. he was transferred to 3 for cardiac catheterization in the morning. past medical history: cad, s/p mi, cabg , cath w/o intervention (to om2) dementia htn hypercholesterolemia gout social history: by report, no alcohol, tobacco, drugs. family history: non-contributory physical exam: (on admission) vs - 100.4 hr 56 bp 96/39 rr 20 sat 95 4lnc gen: wdwn elderly aged male in nad. alert, a+o x 1. heent: ncat. sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. no xanthalesma. mm dry. neck: supple with no jvd sitting at 45 deg angle. cv: rr, normal s1, s2. distant heart sounds. 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: no c/c/e. no femoral bruits. skin: no stasis dermatitis, ulcers, scars, or xanthomas. neuro: cn 2-12 intact; strength 5/5 throughout; oriented to self; thinks he is in a firestation. / . no deficit in consciousness. unsure of who current president is but he knows that he "is in the " . pulses: right: femoral 1+ dp faint + doppler pt faint + doppler left: femoral 1+ dp faint + dopplerpt faint + doppler pertinent results: coronary cath (): severe 3vd with patent lima to d1 filling lad, cx and rca but cx compromised by intervening disease not readily amenable to pci and patent svg to d3 lmca: total occlusion at ostium lad: fills by lima-d1 --> small intramyocardial vessel lcx: small om 1 fills via flow from lima-d1 to lm with intersposed heavily calcified 90% lesion rca: total occlusion ostial; collaterals from l to pda svg-om2 to svg-d3 patent lima-d1 patent . cxr ap (): moderate cardiomegaly. haziness of the perihilar region and engorged vasculature is consistent with moderate pulmonary edema. there is no pneumothorax. there is a small left pleural effusion. patient is post median sternotomy and cabg. . echo (): mildly dilated left atrium normal left ventricular cavity size overall left ventricular systolic function mildly depressed with probably basal inferoseptal, basal inferior/inferolateral hypokinesis lvef= ?45 % right ventricular chamber size and free wall motion normal moderate pulmonary artery systolic hypertension . cxr ap (): there has been interval placement of a dual-lead pacemaker device with the distal leads overlying the right atrium and right ventricle. the patient is status post median sternotomy and cabg. the heart size is borderline. the aorta is uncoiled and atherosclerotic. trachea is midline. there is mild blunting of the costophrenic angles bilaterally which may represent tiny effusions or pleural thickening. there is no pneumothorax or focal consolidation. there is minimal prominence of the pulmonary vasculature, greatly improved from . impression: pacemaker placement as above. no pneumothorax. mild residual prominence of the pulmonary vasculature. . enzyme peaks: ck 1350, trop 3.72. brief hospital course: on admission to pt was admitted to the service on 3. on presentation, he was cp free and did not complain of shortness of breath. a prior ekg was significant for the presence of 1st degree conduction delay with rbbb. at 12 am, the patient was noted to have a hr in the 30s on telemetry and was found to be in chb. sbps were in the 90s and the pt was assymptomatic. his hr increased back up to the 50s without intervention. half an hour later, the hr dipped back down to the 40s with a bp 70/30. he received ivfs wide open and was given atropine 1 mg x 2. his sbps then improved to the 90s with a hr in the 40-50s. he remained assymptomatic without chest pain, shortness of breath, and lightheadedness. at the time of presentation to the ccu, the patient had received a total of 2 l ivfs. . ccu team course: the following problems were : # cad s/p nstemi the enxymes peaked at ck 1350, trop 3.72. which he had on admission. has remained cp free since presentation to osh. integrillin/heparin gtts were continued until cath the morning after admission to the . in the cath lab he was found to have severe 3vd with patent lima to d1 filling lad, cx and rca but cx compromised by intervening disease not readily amenable to pci and patent svg to d3. therefore the plan was to optimize medical management with asa, plavix, and ezetimibe (statin allergy). low dose bb (motoprolol 12.5mg) was added when ep agreed to start from rhythm standpoint (see below). pt was monitored on telemetry throughout stay without any signs of recurrent ischemia. . # rhythm pt had pre-existing rbbb from ekgs in but as mentioned above was found to be in complete heart block with alternating junctional and idioventricular escape rhythm. hr and bps did not respond considerably to atropine x 2 but sbps improved with total of 2l ivfs. on presentation to the ccu, the pt was assymptomatic with hr in the mid 40-50s, sbps in the 90-100s, and maps in the upper 50's. likely that chb was related to recent ischemic event. therefore ep wanted to manage conservatively since they felt if ischemia resolved after cardiac event. given relative hemodynamic stability of patient and relatively stable escape rhythm, did not place temporary transvenous pacing wire which was discussed with ep fellow and interventional cardiologist on call. atropine and dopamine was kept at the bedside and with trancutaneous pacer pads but never had to be used. pt was monitored on telemetry and spent less and less time in chb. therefore a low dose bb was added but then ended up spending more time in chb. ep at this time (day4) decided to start place a permanent pacemaker which was done on . the evening following the procedure the pt had a few more events of chf without appropriate pacing of the pacer; therefore appropriate adjustments were made by ep the following day (day prior to d/c) . # pt appeared in acute systolic heart failure initially when arriving to the ccu. he was diuresed gently over the next few days with good effect and when euvolemic did not require any additional doses of lasix po. pt had an echo which demonstrated overall left ventricular systolic function mildly depressed with probably basal inferoseptal, basal inferior/inferolateral hypokinesis and a lvef of appr 45 %. supplemental o2 was weaned throughout the hospital stay and when discharged pt was off supplemental o2. . # id pt did have some very low grade temps (99-100) with a slightly elevated wbc. ua, uc, sputum cx, blood cx, were all negative however. the plan was to reculture if he re-spiked he never did. . # neuro/dementia/agitation pt is at baseline ao x 1. home meds aricept and namenda, and clonazepam qhs were continued with good effect. the first 2 nights pt did not get his clonazepam and was very confused and agitated and therefore required a sitter for safety. . # htn - continued bb as above . # hypercholesterolemia - continued ezetimibe due to allergy to statin . medications on admission: lisinopril 10mg isosorbide mononitrate long acting 60 mg daily niaspan 1000 mg metoprolol 50 mg tid clonazepam 0.5 mg daily norvasc 10 mg daily trazadone 100 mg daily asa 325 mg daily zetia 10 mg daily aricept 5 mg daily namenda 5 mg discharge medications: 1. niacin 500 mg capsule, sustained release sig: two (2) capsule, sustained release po bid (2 times a day). 2. ezetimibe 10 mg tablet sig: one (1) tablet po daily (daily). 3. donepezil 5 mg tablet sig: one (1) tablet po hs (at bedtime). 4. trazodone 100 mg tablet sig: one (1) tablet po hs (at bedtime). 5. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 6. memantine 5 mg tablet sig: one (1) tablet po bid (). 7. clonazepam 0.5 mg tablet sig: 1-2 tablets po qhs (once a day (at bedtime)). 8. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). disp:*30 tablet, chewable(s)* refills:*2* 9. metoprolol tartrate 25 mg tablet sig: 0.5 tablet po bid (2 times a day). disp:*30 tablet(s)* refills:*2* 10. nitroglycerin 0.3 mg tablet, sublingual sig: one (1) sublingual prn: please take one tablet for chest pain, may repeat every 5 minutes x2 please call 911 if does not resolve . disp:*30 tabs* refills:*2* discharge disposition: home with service facility: vna discharge diagnosis: primary diagnosis: non-st elevation myocardial infarction complete heart block with placement of pacemaker discharge condition: stable discharge instructions: you were admitted to with an non-st elevation myocardial infarction. please take your medications as prescribed and specifically: - please stop taking lisinopril and isosorbide mononitrate - please start taking plavix - please take 81mg of aspirin instead of 325mg if you develop chest pain, jaw pain, or chest pressure with pain radiating into arm, or if you for any reason become concerned about your medical condition please call 911 or present to nearest ed. - we also gave you nitroglycerin tablets to take if you experience chest pain, please call 911 or your doctor if chest pain recurs even if it dissapears with nitroglycerine **do not stop taking the aspirin or plavix unless instructed to do so by your cardiologist even if another doctor tells you to** - please set up follow-up appointments with the electrophysiology device clinic and dr. as discussed followup instructions: - please set up follow-up appointments with the electrophysiology device clinic to be seen within one week () and dr. ( or as discussed - please set up an appointment with your primary care provider, . . procedure: injection or infusion of platelet inhibitor left heart cardiac catheterization coronary arteriography using a single catheter initial insertion of dual-chamber device initial insertion of transvenous leads [electrodes] into atrium and ventricle angiocardiography of right heart structures diagnoses: subendocardial infarction, initial episode of care coronary atherosclerosis of native coronary artery pure hypercholesterolemia congestive heart failure, unspecified unspecified essential hypertension gout, unspecified aortocoronary bypass status other persistent mental disorders due to conditions classified elsewhere atrioventricular block, complete acute systolic heart failure 

Answer: The patient is high likely exposed to