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: codeine attending: chief complaint: chest pain major surgical or invasive procedure: cardiac catheterization history of present illness: 64 m h/o obesity, pvd, ckd (baseline unknown), dvt ~6-10y ago, recently d/c'd from after presenting s/p fall x 2 (described sscp 15m prior, non-radiating, in am, then lh/dizzy after leaving the shower, fell x 2 10 min apart, no loc, preceding sob, palp, n/v), with negative p-mibi and tte with normal valves, ef. . pt in his usoh at home until ~7pm , went outside, slid on ice, fell, landing on both knees, then falling towards right, bruised r elbow. no loc, no head trauma. no antecedent cp/sob/palp/lh/n/v/diaphoresis. neighbors brought him inside, ~1hr later, pt started c/o mid-back and central chest pain with some radiation to both shoulders, dull, no sob/n/v/diaphoresis, starting ~7pm, at 930pm pain persisted, pt called ems. no pain with inspiration, no pain with exertion (though pt not moving much). states pain worse with bending over. . ems initial vs= bp 126/80 99%ra, ekg per report, sinus arrythmia, nonspecific st changes, poor r-wave progression. given nitro with resolution of cp prior to arrival at osh ~1030 (unclear if before or after nitro). at osh, ck 421 mb trop 7.16, inr 2.3, heparin gtt ordered however not given pharmacy refused due to inr. per report, dr. decided against heparin gtt today, instead pt given plavix 300mg 6am on , and again at 10:30. no other meds given o/n. . on morning of transfer , 7am vs= nsr, 97.7, 75-68, rr 20, bp 108/54 (108/54-124/84), 96%ra->100%2l, pt given asa 325, lopressor 25mg po x 1, mucomyst 600mg x 1, percocet for bilateral feet pain, ivf= 2amphco3 + 1/2 ns @ 11:15am 100/hr. rn pt denied cp, though reported intermittent pain to cardiologist. pt being transferred to ccu for further workup of chest discomfort, described as radiating from the back towards chest. . with regard to cardiac review of systems, pt denies any h/o regular angina or chest pain with exertion. he has stable doe with occasionally with dressing himself more often with a flight of stairs. his bilateral ankle edema is chronic and unchanged of late, with chronic venous stasis changes. he denies pnd/orthopnea, but notes an episode of syncope prior to his most recent hospilazation, though it is unclear if he truly lost consciousness. he denies any preceding cp/sob/palpitation/n/v/diaphoresis, and states he slipped getting out of the tub. of note, ~15min later, he admits to falling again in his bedroom. at that time he endorses lh/dizzy prior to fall, but cannot recall if he lost consciousness. . ros: +cough, non-productive, +doe, claudication - after walking 20-30 feet, bilateral calf pain, improves within 10-15min, no rest pain, but + "numbness" bilateral feet with "pins and needles" which improves with walking. . on review of symptoms, he denies any prior history of stroke, tia, deep venous thrombosis, pulmonary embolism, bleeding at the time of surgery, myalgias, joint pains, hemoptysis, black stools or red stools. he denies recent fevers, chills or rigors. he denies exertional buttock pain. all of the other review of systems were negative. past medical history: - ckd (bl creatinine 1.6 - 1.8, stable over the past 10 years) - h/o dvt on coumadin (date=6-10y ago) with low protein c - morbid obesity s/p gastic bypass - h/o b knee pain oa - scheduled for r knee replacement - spinal stenosis - h/o falls x 1/month x 1 yr "balance" - h/o hypokalemia - s/p appendectomy as child. social history: social history is significant for the absence of current tobacco use. +etoh, drink 2 beers/day family history: mother died at 60 of mi, father died at 73 "from diabetes." physical exam: vs: 97.1 70 100/74 20 99%, lue bp 95/68, rue 89/78. gen: obese middle aged male in nad, resp or otherwise. oriented x3. mood, affect appropriate. anxious. heent: ncat. sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. neck: supple with jvp of 12 cm @ 90 degrees. cv: unable to appreciate pmi. rr, normal s1, s2. ?s4, no s3. no m/r chest: no chest wall deformities, scoliosis or kyphosis. resp were unlabored, no accessory muscle use. no crackles, wheeze, rhonchi. abd: obese, soft, ntnd, no hsm or tenderness. no abdominial bruits. midline vertical scar rlq (appy), epigastric horizontal well healed scar. no palpable aorta, no renal bruit. ext: no c/c. no femoral bruits. 2+ b le edema to knee. skin: +chronic venous stasous changes. pulses: right: carotid 2+ w/o bruit; femoral 2+ without bruit; 1+ dp, dopplerable pt. left: carotid 2+ w/o bruit; femoral 2+ without bruit; dopplerable dp, pt pertinent results: labs: 11:00pm blood wbc-10.2 rbc-3.65* hgb-11.7* hct-36.8* mcv-101* mch-32.1* mchc-31.9 rdw-14.4 plt ct-292 07:15am blood wbc-8.3 rbc-3.26* hgb-10.5* hct-32.6* mcv-100* mch-32.2* mchc-32.2 rdw-14.5 plt ct-256 06:25am blood wbc-7.0 rbc-3.05* hgb-10.0* hct-29.8* mcv-98 mch-32.7* mchc-33.4 rdw-14.6 plt ct-203 11:00pm blood pt-27.8* ptt-61.0* inr(pt)-2.8* 07:15am blood pt-30.3* ptt-37.5* inr(pt)-3.1* 07:10pm blood pt-20.7* ptt-77.6* inr(pt)-1.9* 06:25am blood pt-17.7* ptt-65.5* inr(pt)-1.6* 11:00pm blood glucose-98 urean-25* creat-1.7* na-142 k-4.2 cl-109* hco3-20* angap-17 06:25am blood glucose-96 urean-24* creat-1.6* na-139 k-4.4 cl-109* hco3-20* angap-14 11:00pm blood alt-28 ast-56* ck(cpk)-1104* alkphos-75 amylase-51 totbili-0.4 07:15am blood alt-24 ast-43* ck(cpk)-731* alkphos-64 totbili-0.3 07:10pm blood ck(cpk)-871* 11:00pm blood ck-mb-14* mb indx-1.3 ctropnt-0.38* 07:15am blood ck-mb-9 ctropnt-0.25* 07:10pm blood ck-mb-7 ctropnt-0.18* 07:15am blood vitb12-434 folate-6.9 11:00pm blood %hba1c-5.3 11:00pm blood triglyc-89 hdl-64 chol/hd-1.7 ldlcalc-28 11:00pm blood tsh-5.1* 07:15am blood free t4-0.88* 07:33am blood lactate-0.7 . osh labs: @ 11:45pm: (no labs except cardiac enzymes). na 139 k 4.3 cl 113 co2 20 bun 25 cre 1.6 glucose not done . cpk 421 -> 712 cpk mb 20.6 -> 23.5 mbi 4.9 -> 4.3 tropi (0.02-0.50) 7.16 -> 5.31 (@8:45am) . wbc 9.1 hct 36.7 plt 249 mcv 98 . ptt 40 on . pt 24.8->26.4 @ 9am inr 2.3->2.5 . . studies: tte: the left atrium is mildly dilated. there is mild symmetric left ventricular hypertrophy with normal cavity size. there is moderate regional left ventricular systolic dysfunction with severe hypokinesis of the distal half of the inferior, septal and anterior walls, and apex. the remaining segments contract normally (lvef = 30 %). no defininte left ventricular thrombus is seen, but views of the apex are suboptimal. 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 leaflets appear structurally normal with good leaflet excursion. there is no aortic valve stenosis. no aortic regurgitation is seen. the mitral valve appears structurally normal with trivial mitral regurgitation. there is no mitral valve prolapse. the estimated pulmonary artery systolic pressure is normal. there is no pericardial effusion. . impression: mild symmetric left ventricular hypertrophy with regional systolic dysfunction c/w multivessel cad (mid-lad and pda lesions). . . lhc: . . . 0100 osh ekg demonstrated: nsr, nl axis, prolonged pr 180s, normal qrs (some notching on downstroke of v3), qtc 500s, but qt normal on inspection, ~1mm ste in i, biphasic tw v1, iii, no std. . 1053 osh ekg demonstrated: nsr, nl axis, prolonged pr, normal qrs, qtc 500s, but qt normal on inspection, <1mm ste in i, ii, biphasic tw v1, iii, no std. . 1424 osh ekg demonstrated: nsr, nl axis, prolonged pr 182, normal qrs, qtc 484, but qt normal on inspection, <1mm ste in i, ii, biphasic tw v1, iii, no std. decreased s wave amplitude in v1-2. . osh tte demonstrated: ef 55-60%. lv size normal. mild lvh. left /contractility wnl ra nl. no ar/as. no mr. tricuspid not well visualized. pericardium normal. aortic root appears normal. aorootdiam 35mm. impression: technically liited study pt's copd and obesity. . osh p-mibi demonstrated: appropriate hr increase 67->77, bp dropped 128/54->113/63. no cp, no diagnostic ecg chagnes, no arrythmias. inferior wall defect on rest and , most liekly diaphragmatic attenuation. no definitive evidence of ischemia or prior infract. normal ef 61%. brief hospital course: 64 m h/o ckd, pvd, morbid obesity, transferred from osh after presenting with cp s/p fall, with positive ce. . # chest pain - initial differential included acs, pe, dissection, or mechanical pain fall. given cardiac risk factors, +enzymes, and tte with new wall motion abnormality on tte, felt acs more likely, pt hydrated with 1l ivf bolus, bicarb, and mucomyst. left heart catheterization revealed clean coronaries on , ef=20%, with severe hk and ak apically more suggestive of ?takasubo's pain from fall. continued asa 325 qd. discontinued plavix given clean coronaries. continued betablocker, statin, ace inhibitor. . # cad/ischemia: no frank h/o cad, tte c/w multivessel cad, however clean coronaries on cath. asa/plavix/metoprolol/statin/ace inhibitor. . # pump: pt grossly euvolemic currently, ef > 55% on tte and pmibi discharge, now with ef 20% on lv gram, severe hk and ak. transitioned from heparin to coumadin for akinetic wall segments as well as history of deep vein thrombosis. started on ace inhibitor, lasix for afterload/preload reduction. . # rhythm: normal sinus rhythm . # valves: f/u tte. . # htn: normotensive currently. . # pvd - dopplerable pulses bilaterally, and palpable on r le. unclear if le pain is clearly claudication or more neuropathy, esp given h/o dm, and b12 injections. . # ckd - baseline 1.6-1.8 per pcp, unclear no known htn or dm. initially held ace cre 1.7, improved over course. a1c <6, no obvious htn, spep and upep negative. . # ? rhabdo - pt on ground for ?1hr, cks trending down (peak 1100), with renal failure. given iv fluid hydration and ck trended down. urine negative for myoglobin. . # knee pain - likely oa weight, with recent meniscal tear. - continued percocet prn. . # fen: - cardiac diet for now, npo p mn for cath . . # prophylaxis: - heparin gtt -> will transition back to coumadin. - ppi given heparin gtt. - bowel regimen. . # code: full code - discussed with pt . . # communication: - - floor = , main = . - brother-in-law . . # dispo - needed home services, currently lives alone, pt consult cleared to home, set up home vna, arranged for inr check. medications on admission: current medications: upon transfer: aspirin 325mg po qdaily plavix 300mg x 2 po given 10am lopressor 25mg po bid mucmyst 600mg po bid ativan 0.5mg prn . . home meds: (from discharge summary) prozac 10mg po qdaily coumadin 4mg po qdaily b12 1000mcg qmonthly percocet prn (foot pain) discharge medications: 1. oxycodone-acetaminophen 5-325 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for knee pain. 2. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 3. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 4. lisinopril 5 mg tablet sig: 0.5 tablet po daily (daily). disp:*15 tablet(s)* refills:*2* 5. citalopram 20 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 6. metoprolol succinate 25 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po daily (daily). disp:*30 tablet sustained release 24 hr(s)* refills:*2* 7. warfarin 2 mg tablet sig: two (2) tablet po daily16 (once daily at 16). disp:*60 tablet(s)* refills:*2* 8. furosemide 40 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 9. outpatient lab work please draw pt/ptt/inr on . fax results to dr. at discharge disposition: home with service facility: vna discharge diagnosis: primary: stress cardiomyopathy secondary: chronic kidney disease, h/o dvt on anticoagulation discharge condition: good, chest pain free, vital signs stable discharge instructions: you were admitted to the hospital with chest pain. you were noted to have poor pumping function of the heart secondary to stress. you did not have a heart attack. . you were started on new medications including: toprol xl 25mg daily lisinopril 2.5mg daily furosemide (lasix) 40mg daily citalopram 20mg daily . you will have a visiting nurse you with medications. . you need to have your blood drawn on to make sure your dose of coumadin is correct. . dr. office will contact you to set up an appointment. please follow up with your new cardiologist, dr. as below. . call your doctor or return to the emergency room if you develop worrisome symptoms such as chest pain, shortness of breath, fluttering in your chest, etc. followup instructions: please followup with dr. , a cardiologist recommended by dr. . his phone number is . dr. office will call you to schedule followup. if you do not hear from them on wednesday , please call his office. procedure: angiocardiography of left heart structures left heart cardiac catheterization coronary arteriography using a single catheter diagnoses: acidosis congestive heart failure, unspecified chronic airway obstruction, not elsewhere classified peripheral vascular disease, unspecified chronic kidney disease, unspecified morbid obesity personal history of venous thrombosis and embolism acute systolic heart failure fall from other slipping, tripping, or stumbling rhabdomyolysis bariatric surgery status history of fall takotsubo syndrome osteoarthrosis, localized, not specified whether primary or secondary, lower leg 

Answer: The patient is high likely exposed to