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: no known allergies / adverse drug reactions attending: chief complaint: shortness of breath major surgical or invasive procedure: cardiac catheterization, with 2 drug eluting stents placed in the mid-left anterior descending artery. history of present illness: 70 yo m with pmh of htn, hld and recent admission (d/c )for syncope attributed to orthostasis without appropriate heart response secondary to medications and beta blockade who presented to ed with four days of worsening sob, chest fullness, diaphoresis. normally has excellent exercise tolerance and walks 3 miles a day, but over last several days, becaome sob just walking in his house. he reports no antecedent symptoms such as fever, chills, or recent uri. he denied sputum production or cough at the time of admission. triggered on arrival for tachycardia to 154 and found to be in af with rvr. . in the ed, initial vs 96.8 154 143/99 24 97% ra, received iv dilt with good hr response and got dilt 60mg po x1. labs with metabolic gap acidosis, lactate normal, normal wbc with slight left shift, bnp >21,000, trop 0.03 with normal ck. cxr with large rml infiltrate, treated with ctx and azithro for cap. vs prior to transfer. 1l ivf. ekg with flipped tw v2-v6. developed worsening hypoxia and o2 requirement increased to 4l nc, crackles on exam, got 20iv lasix. vs prior to transfer: 98.2 102 138/97 92% on 2l, 89%l on ra. . ros: denies fever, chills, night sweats, headache, vision changes, rhinorrhea, congestion, sore throat, cough, chest pain, abdominal pain, nausea, vomiting, diarrhea, constipation, brbpr, melena, hematochezia, dysuria, hematuria. . he was subsequently found to have twi on his ecg on the lateral leads and he underwent echo to determine whether or not need needs to undergo emergent cath. he does not have a previous echo in the system. . upon evaluation on the floor, he endorsed the history given above but became acutely short of breath and desated to the mid 80's during a rectal exam, and became cyanotic. he was sat upright with an improvement in his o2 sat to the low 90s. his hr at the time was in the 100's with an ecg that showed a nsr at 97 with lateral twi in v3-v6. he was given 40 mg iv lasix, and an abg was 7.48/32/81/ on nbr. . on review of systems, s/he denies any prior history of stroke, tia, deep venous thrombosis, pulmonary embolism, bleeding at the time of surgery, myalgias, joint pains, cough, hemoptysis, black stools or red stools. all of the other review of systems were negative. . cardiac review of systems is notable for absence of chest pain, dyspnea on exertion, paroxysmal nocturnal dyspnea, orthopnea, ankle edema, palpitations, syncope or presyncope. past medical history: 1. cardiac risk factors: diabetes, + dyslipidemia, + hypertension 2. cardiac history: -cabg: none -percutaneous coronary interventions: none -pacing/icd: none 3. other past medical history: hypertension hyperlipidemia h/o etoh abuse social history: lives alone. has a significant other, widower. drinks 2-3 "good" size hard liquor drinks a night, sometimes more. no h/o withdrawal, is interested in cutting back. does not remember the last day he did not have something to drink. denies any history of dts. he goes to the liquor store twice a week for to purchase a fifth of alcohol. tobacco quit 22 years ago. family history: no family history of early mi, arrhythmia, cardiomyopathies, or sudden cardiac death; otherwise non-contributory. . physical exam: on admission: vs: t=98.2 bp=124/84 hr=92 rr=18 o2 sat= 92 4l (with drop noted above) general: labored breathing, uncomfrortable oriented x3. mood, affect appropriate. heent: ncat. sclera anicteric. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. no xanthalesma. neck: supple with jvp of 20 cm. + hepatojugular reflex. cardiac: pmi located in 5th intercostal space, midclavicular line. rr, normal s1, s2. no m/r/g. no thrills, lifts. no s3 or s4. lungs: speaking in short sentences, pursed lipped breathing when lying flat, no dullness to percusion, bronchovesicular sounds with crackles at the bases, with left sided wheezes. abdomen: soft, ntnd. no hsm or tenderness. abd aorta not enlarged by palpation. no abdominial bruits. guiac negative. notable small round prostate, posterior compressable hemorrhoid. no palpable masses. extremities: no c/c/e. skin: no stasis dermatitis, ulcers, small healed excoriations pulses: right: carotid 1+ left: carotid 1+ pertinent results: admission: 11:30pm blood wbc-8.7# rbc-3.99* hgb-13.6* hct-41.5 mcv-104* mch-34.0* mchc-32.7 rdw-15.7* plt ct-127* 11:30pm blood pt-15.0* ptt-25.0 inr(pt)-1.3* 11:30pm blood glucose-163* urean-18 creat-0.9 na-139 k-4.0 cl-95* hco3-18* angap-30* 11:30pm blood alt-35 ast-62* ck(cpk)-120 alkphos-126 11:30pm blood ck-mb-5 probnp-* 11:30pm blood calcium-9.6 phos-4.1 mg-1.7 04:55am blood vitb12-1195* folate-greater th 06:35am blood triglyc-100 hdl-72 chol/hd-2.3 ldlcalc-77 04:55am blood tsh-1.9 07:55am blood hiv ab-negative . discharge: 06:35am blood wbc-4.8 rbc-3.87* hgb-13.2* hct-37.6* mcv-97 mch-34.1* mchc-35.1* rdw-14.7 plt ct-174 10:40am blood pt-14.2* ptt-23.2 inr(pt)-1.2* 06:35am blood glucose-101* urean-31* creat-1.1 na-135 k-3.6 cl-93* hco3-31 angap-15 06:04am blood alt-23 ast-31 ck(cpk)-41* alkphos-91 totbili-1.1 05:15am blood ck-mb-3 06:04am blood ck-mb-3 ctropnt-0.02* 06:35am blood calcium-9.1 phos-4.5 mg-1.8 cholest-169 . ct chest: impression: . 1. moderate right and small left lower lobe consolidations, consistent with pneumonia. 2. medial ground-glass opacity, smooth gravity dependent intralobular septal thickening and bilateral pleural effusions, consistent with pulmonary edema. 3. coronary arterial calcification. the study and the report were reviewed by the staff radiologist. . cath: comments: 1. selective coronary angiography in this left dominant system demonstrates single vessel disease. the left anterior descending contains a long 90% lesion in the mid-vessel. the left main contains no angiographically apparent disease, and circumflex contains minor disease only. the right coronary is a small non dominant vessel that is free of angiographically apparent disease. 2. hemodynamics demonstrate a low cardiac output with elevated biventricular filling pressures. 3. successful ptca/stenting of mid lad with overlapping 2.5 x 18 mm and 2.5 x 23 mm promus des, post dilated to 2.75 mm with nc balloon at high pressure. (details under ptca comments). final angiogram showed 0% residual stenosis in the stent, no dissection and normal flow. . final diagnosis: 1. one vessel coronary artery disease. 2. mild systolic and diastolic ventricular dysfunction. 3. successful ptca/stenting of mid lad with overlapping promus des. 4. aspirin 325 mg daily for 1 month, then 81 mg daily 5. plavix 75 mg daily for > 3-6 months as tolerated. . echo: the left atrium is mildly dilated. left ventricular wall thicknesses are normal. the left ventricular cavity is mildly dilated. there is severe regional left ventricular systolic dysfunction with severe hypokinesis to akinesis of the distal two-thirds of the ventricle and preservation of the basal septum and inferior walls. right ventricular chamber size and free wall motion are normal. the aortic root is mildly dilated at the sinus level. the ascending aorta is mildly dilated. the aortic valve is mildly thickened (?#) with no aortic stenosis or regurgitation. the mitral valve leaflets are structurally normal. there is no mitral valve prolapse. trivial mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. there is moderate pulmonary artery systolic hypertension. impression: severe regional left ventricular dysfunction c/w multivessel cad, large wrap-around lad territory lesion, or takotsubo cardiomyopathy. moderate pulmonary hypertension. mildly dilated thoracic aorta. brief hospital course: 70 year old male with history of alcohol abuse, htn, hyperlipidemia who presents with congestive heart failure and new onset af with twi and depressed systolic ef mid-lad lesion, complicated by acute onset hypoxic respiratory distress. . # hypoxic respiratory distress: the patient was initially admitted to the general cardiology service, but was found to have an increasing oxygen requirement, prompting transfer to the ccu. upon admission, he was started on a furosemide drip with a robust response, improving his oxygenation. his cxr was consistent with pulmonary edema, but also had multifocal infiltrates. he was initially started on broad spectrum antibiotic coverage for hcap, but he did not develop any systemic signs or symptoms to suggest pneumonia so these were stopped. given his effective diuresis and uptrending creatinine with decreased oxygen requirement, further treatments were discontinued. we had some concern over his multifocal infiltrates and paucity of symptoms pointing to pcp as potential diagnosis, so we decided to test him for hiv to rule out causes for immunosuppression. we also sent a urinary streptococcal antigen that was negative. he underwent diuresis and cath with an intervention to his lad, subsequently weaned to ra. . # depressed systolic function/acute systolic chf ischemia: he had globally depressed systolic function on tte (with ef of 20-25%) and he had concerning twis in the anterolateral region (v3-v6) with biphasic t waves in v1 and v2. he was taken for cardiac catheterization, which showed a 90% mid-lad lesion and 2 drug-eluting stents were placed. though this culprit lesion is a good reason for the depressed ef and pulmonary edema, there is also concern for a depressed systolic function from alcohol-induced cardiomyopathy in the long-term from heavy etoh use. he should continue on asa indefinitely, plavix for at least 1 year, high-dose atorvastatin, and b-blocker/ace-i on discharge. his ace-i was held until his creatinine returned to baseline and he was discharged home on 5 mg lisinopril. due to the apical akinesis on his echo he was started on anti-coagulation with warfarin. his plan was to have his pcp follow his inr, and have a repeat echo in 6 weeks to 3 months to evaluate his cardiac function. . inactive issues . # htn: after diuresis he was noted to have systolic blood pressures in the 130's-140's with diastolic blood pressures in the 90's. given his cad, he was started on metoprolol in addition to after load reduction with acei. if his echo continues to show a depressed ef he will need to start spironolactone as an outpatient. . # : he had a mild bump in his cr while he was hospitalized and diuresed prior to discharge his cr was 1.1. . # anemia: he had a mild drop in his hgb while on heparin, and his hgb prior to discharge was 13.2. he will need follow up as an outpatient while he is on anti-coagulation. # alcohol abuse: currently a heavy drinker requiring biweekly purchases of alcohol. he did not require any medications, as he did not score on the ciwa scale. he was continued on thiamine, b12, and folate. social work was consulted and provided resources for alcohol abstinence. . # dyslipidemia: last ldl was 98. he was continued on high-dose atorvastatin during his hospitalization and was continued after discharge . # afib with rvr: he was found to have afib with rvr when he was admitted to the hospital the resolved after he was admitted for an acute systolic heart failure exacerbation in the setting of a left dominant lad lesion. he had 1-2 episodes of svt on tele when he was admitted, but they were asymptomatic and he was hd throughout. . transitional issues . # follow-up: he will follow-up with outpatient cardiology and is in the process of transferring his care over to a pcp affiliated with . medications on admission: lansoprazole 30 mg sucralfate 1 gram qid. aspirin 81 mg multivitamin thiamine 100 mg folic acid 1 mg cyanocobalamin 1,000 mcg discharge medications: 1. aspirin 325 mg tablet : one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 2. sucralfate 1 gram tablet : one (1) tablet po qid (4 times a day). 3. thiamine hcl 100 mg tablet : one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 4. cyanocobalamin (vitamin b-12) 100 mcg tablet : 0.5 tablet po daily (daily). disp:*15 tablet(s)* refills:*2* 5. folic acid 1 mg tablet : one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 6. multivitamin tablet : one (1) tablet po daily (daily). 7. atorvastatin 80 mg tablet : one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 8. clopidogrel 75 mg tablet : one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 9. outpatient lab work please check pt/inr on and and fax results to dr. . fax: phone: 10. ranitidine hcl 150 mg tablet : one (1) tablet po twice a day. 11. metoprolol succinate 50 mg tablet extended release 24 hr : one (1) tablet extended release 24 hr po once a day. disp:*30 tablet extended release 24 hr(s)* refills:*2* 12. lisinopril 5 mg tablet : one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 13. warfarin 5 mg tablet : one (1) tablet po days (,mo,tu,we,th,fr,sa). disp:*15 tablet(s)* refills:*2* discharge disposition: home discharge diagnosis: primary diagnosis: non st elevation myocardial infarction pulmonary edema secondary diagnosis: hypertension hyperlipidemia discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: dear mr. , it was a pleasure taking part in your care at . you were admitted with shortness of breath, due to fluid build up in your lung. we believe that this was due to a decrease in your heart function from a blockage in one your coronary arteries. you underwent a catheterization that opened up this artery with 2 stents. we gave you medications to help get this fluid out of your lungs and your shortness of breath improved markedly. we have made the following changes to your medications: start clopidogrel (plavix) 75mg daily for at least one year start atorvastatin start thiamine, folate, and b12 supplementation start warfarin start aspirin take for the rest of your life start metoprolol start lisinopril start ranitidine start sucralfate please call your pcp if your weight increases by more than 3 lbs. followup instructions: primary care: your primary care doctor's office will call you to make an appointment in the next 1-2 days. if you do not hear from them, please call to make an appointment. you will need to seen in days. pcp: phone: you will also need your blood drawn tomorrow () to determine your inr and have your coumadin dose adjusted if necessary. cardiology: please call cardiology clinic for follow up. you need to be seen within the next 1-2 weeks. phone: ( procedure: combined right and left heart cardiac catheterization coronary arteriography using two catheters injection or infusion of platelet inhibitor alcohol detoxification 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 single vessel diagnoses: subendocardial infarction, initial episode of care anemia, unspecified coronary atherosclerosis of native coronary artery congestive heart failure, unspecified unspecified essential hypertension acute kidney failure, unspecified other pulmonary insufficiency, not elsewhere classified atrial fibrillation other and unspecified hyperlipidemia acute systolic heart failure pulmonary congestion and hypostasis alcohol abuse, continuous 

Answer: The patient is high likely exposed to