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: patient recorded as having no known allergies to drugs attending: chief complaint: cardiac arrest. major surgical or invasive procedure: endotracheal intubation. central venous line placement. post-arrest hypothermia. cardiac catheterization. history of present illness: mr. is a 66 yom with no past medical history who has not sought medical care, who was in his usual state of health until this evening when he had an unwitnessed arrest. he was last heard walking down the stairs to do some work in the basement and about 5 minutes later, his wife heard moaning but no fall or crash and found him lying on floor unresponsive. she called 911 and called her son and friend who provided cpr until the police arrived and placed an aed on the patient (who may have been pulseless at that time). the aed detected a shockable rhythm and fired two shocks. estimated time from arrest to shock was 10 minutes. ems arrived and found that the patient had a pulse and stable vital signs but he was breathing shallow breaths on his own. an initial ekg showed st elevations in the inferior leads, most prominent in iii and depressions in v1 through v6. the patient was taken to and received 100 mg lidocane in transport. at he was still unresponsive and had posturing. he was intubated for airway protection. there were no st elevations seen on ekg at that time, but there were depressions in v1 and v2 and evolving q waves in iii and avf. he had a positive ckmb of 8. he underwent head and neck ct which were negative. he was given dilantin and ativan. he was then med-flighted to . . upon arrival to the ed he was hemodynamically stable with t 98.4 hr 99 and bp 117/70 100% o2sat intubated with fio2 100%. he was intubated with peak 14, peep 5, on 100% fio2, and sedated on benzodiazepines without pain medication. his ekg showed nsr, 88 bpm, no st elevations and q waves in iii and avf. he had a bedside echo, which showed hypokinesis of the mid and basal inferioseptal and inferolateral walls with ef 45%. cardiology did not feel that he needed an urgent cath given the resolution of st elevations and he was started on a heparin gtt and given aspirin and plavix 300 mg. blood pressure was found to be elevated at 202/105. neurological exam revealed cortical posturing and lack of gag and pupilary reflexes. . ros unable to be obtained due to unresponsiveness/ sedation/ intubation. but by report from his wife he has been feeling fatigued today. also has had ? left sided chest pain and shortness of breath with exertion for a while, but never had it checked out. denied knowledge of fever, chills, ha. past medical history: - does not seek medical care, not having seen doctor for some years and last time for stiches after chain saw accident. - hypertension (known to have sbps in the 150s at the grocery store) - question of exertional angina, shortness of breath and circumoral cyanosis per family - patient denies. social history: worked in construction for his working life and now continues to do some odd-jobs and carpentry. plays the guitar and writes his own music. married with children. all three children live nearby and family is close. -tobacco history: quit 40 years ago -etoh: none -illicit drugs: none family history: brother had cabg, sister had breast cancer, mother had copd. physical exam: general: intubated, sedated heent: ett in place, sclera anicteric, pupils 1.5 mm and reactive neck: supple with no jvd cardiac: pmi located in 5th intercostal space, midclavicular line. rr, normal s1, s2. hsm lungs: ctab, no rales or rhonchi. abdomen: soft, nd, no abdominial bruits. extremities: no c/c/e. skin: no stasis dermatitis, ulcers, scars, or xanthomas. pulses: right: 2+ dp 2+ pt 2+ left: 2+ dp 2+ pt 2+ on morning after admission: overweight man with no spontaneous behavior. ventilated, intubated. -j in place. presently cooled. scleral edema. heart sounds dual, no murmur, no s3, s4 appreciated chest expansion symmetric without adventitious sounds laterally belly tense, but bowel sounds present trace peripheral edema gcs 3, without response to pain ?????? no eeg desynchronization noted on pain (nailbed compression) or very loud clap. cns without activity (s/p cessation of paralysis 3-4 hours earlier) ?????? no papillary response, cannot evaluate doll??????s eye in -j. caloric testing not performed. areflexic (brachial, brachioradialis, plantar, snout). eeg (when connected with theta and superimposed beta ?????? no changes to sounds, pain, other environmental stimuli). at discharge: pertinent results: pertinent labs at admission 10:40pm blood wbc-13.4* rbc-4.65 hgb-13.7* hct-40.3 mcv-87 mch-29.5 mchc-34.0 rdw-13.2 plt ct-189 10:40pm blood neuts-91.3* lymphs-3.9* monos-4.2 eos-0.2 baso-0.4 10:40pm blood pt-12.9 ptt-71.1* inr(pt)-1.1 04:36am blood glucose-158* urean-18 creat-1.1 na-143 k-3.8 cl-111* hco3-21* angap-15 10:40pm blood alt-489* ast-365* ck(cpk)-756* alkphos-41 totbili-0.3 10:40pm blood ck-mb-48* mb indx-6.3* 10:40pm blood ctropnt-1.91* 10:40pm blood albumin-4.0 calcium-7.4* phos-3.2 mg-1.9 10:40pm blood asa-neg ethanol-neg acetmnp-neg bnzodzp-neg barbitr-neg tricycl-neg 10:56pm blood type-art temp-37.4 tidal v-100 peep-5 po2-340* pco2-59* ph-7.21* caltco2-25 base xs--5 intubat-intubated vent-controlled 10:41pm blood glucose-114* lactate-1.5 na-145 k-4.2 cl-104 calhco3-23 01:59pm blood freeca-1.06* pertinent labs from the admission 10:40pm blood ck-mb-48* mb indx-6.3* 10:40pm blood ctropnt-1.91* 04:36am blood ctropnt-1.22* 03:38pm blood ck-mb-93* mb indx-3.9 ctropnt-0.77* 04:12am blood ck-mb-76* mb indx-4.1 12:45pm blood ck-mb-56* mb indx-3.8 ctropnt-0.38* 05:52am blood ck-mb-42* mb indx-3.0 ctropnt-0.67* 06:00am blood %hba1c-5.3 eag-105 06:00am blood triglyc-264* hdl-37 chol/hd-4.6 ldlcalc-81 labs at discharge: 05:34am blood wbc-13.6* rbc-3.82* hgb-10.9* hct-32.5* mcv-85 mch-28.6 mchc-33.6 rdw-14.0 plt ct-341 05:34am blood glucose-105* urean-13 creat-0.9 na-140 k-4.2 cl-103 hco3-27 angap-14 05:34am blood calcium-8.7 phos-3.2 mg-2.4 06:00am blood %hba1c-5.3 eag-105 06:00am blood triglyc-264* hdl-37 chol/hd-4.6 ldlcalc-81 cardiac catheterization : comments: 1. coronary angiography in this right dominant system revealed significant three vessel coronary artery disease. the lmca was without disease. the lad had an 80% proximal stenosis, with an 80% mid and 99% distal stenosis, as well as a 70% stenosis of the second major diagonal branch. the lcx had a 60% stenosis at the origin, with a 70% stenosis of the om1 branch and a 99% stenosis of the om2 branch. the rca was totally occluded after the mid-portion, with the distal vessel filling via collaterals from the left coronary artery. the acute marginal branch of rca was a large vessel with 70% stenosis. 2. left ventriculography revealed normal ef of 59% with hypokinesis of the mid inferobasal segment. there was no evidence of mitral regurgitation. 3. resting hemodynamics revealed severely elevated left-sided filling pressures with lvedp of 41 mmhg. the systemic blood pressure was moderately elevated, with sbp of 178 mmhg. there was no aortic stenosis detected by left ventricular pullback technique. . echo : the left atrium is mildly dilated. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. overall left ventricular systolic function is low normal (lvef 50%) secondary to hypokinesis of the inferior septum, inferior free wall, and posterior wall. the other walls of the left ventricle are hyperdynamic. there is no ventricular septal defect. right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. trivial mitral regurgitation is seen. the pulmonary artery systolic pressure could not be determined. there is no pericardial effusion. . cxr : findings: as compared to the previous radiograph, the pre-existing retrocardiac opacities have increased in extent and now extend along the right lateral chest wall. blunting of the left costophrenic sinus makes the presence of a minimal left pleural effusion likely. on this basis, the possibility of developing pneumonia should be excluded by short-term radiological followup. no evidence of other focal parenchymal opacities. no evidence of pulmonary edema. no pneumothorax. brief hospital course: this 66-year-old man with possible angina, perioral cyanosis on exertion, without past medical attention presents after collapsing at home. sudden cardiac death r/t ischemia and likely vf. given moaning and then likely vf on aed, and upon enzymes, ekg, it seems likely that he suffered an ami/acs which resulted in collapse and moaning before vf. given that troponin had already peaked at admission, it seems likely that there had been an acute myocardial infarction some hours prior to presentation. it is of course still possible that this enzyme leak was produced by electrical cardioversion and chest compressions. cpr was given at the scene by son. cardiac cath showed severe threee vessal disease involving the lad, rca (presumed culprit) and lcx. cardiac surgery spoke to patient at length and recommended immediate surgery. mr. refused surgery and said he wanted to go home and consider his options before consenting to what he felt was a risky surgery. the ccu attending, family and ccu team all attempted to pursuade pt to consent to surgery without success. he insisted on going home and was discharged with close follow up appts and a lifevest. we were not able to determine a safe level of activity for this patient given his history and anatomy. patient was discharge on asa, plavix, atorvastatin, metoprolol, and imdur. an ace inhibitor should be started at his first appt. mental status pt with some signs of neurologic injury at early presentation ?????? absent papillary reflexes and posturing. this was concerning for poor prognosis, however spinal and brainstem reflexes reappeared quickly over the following three days, along with some initially concerning false localizing sign, likely due to sedation. he was successfully extubated and showed good cognitive function complicated by poor insight, jocular behavior (both apparently somewhat near baseline) and delirium with hallucinations. delerium resolved over hospital stay and although pt was not cooperative with psychiatric evaluation at discharge, there was no evidence that pt was not competant or was suicidal. memory appears to be relatively intact for recent events, so prognosis is excellent. dr. ask for f/u with neurology (dr. . patient refused this and was not planned at discharge. pneumonia: initially intubated for airway protection. drawing large tidal volumes prior to paralysis. fever and infiltrate on cxr likely aspiration. completed 9 day course of vancomycin/zosyn with resolution of fever although wbc slightly elevated at discharge to 13.9. pt refused to stay the final day in hospital to complete a 10 day course. on discharge, he had no cough, sob and o2 sat was mid 90's on ra. hypertension hypertension when agitated immediately after extubation. blood pressures subsequently were low after extubation and delerium resolved. he was started on metoprolol and imdur for ant-anginal effect. an ace inhibitor should be started after discharge for post mi care. his lvedp was elevated in the cath lab possibly indicating long standing hypertension. acute renal failure with urinary obstruction. foley was obstructed briefly (hypospadia and difficult urinary tract to catheterize) while cooled and we think that renal perfusion was likely poor peri-arrest. urology replaced foley. he briefly developed arf which was thus likely mild atn versus reversible obstructive nephropathy. renal failure resolved. anemia hemodilution with warming and then positive fluid balance produced apparently worsening anemia. no concern for losses or hemolysis. uti moderate bacteria seen on ua. covered with antibiotics for pna. no symptoms on discharge. medications on admission: none. discharge medications: 1. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*11* 2. atorvastatin 80 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 3. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 4. metoprolol succinate 50 mg tablet sustained release 24 hr sig: 1.5 tablet sustained release 24 hrs po once a day. disp:*45 tablet sustained release 24 hr(s)* refills:*2* 5. isosorbide mononitrate 30 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* 6. nitroglycerin 0.4 mg tablet, sublingual sig: one (1) tablet, sublingual sublingual prn (as needed) as needed for chest pain: take up to 3 tablets 5 minutes apart. call 911 if you take this medicine. disp:*25 tablet, sublingual(s)* refills:*0* discharge disposition: home with service facility: vna discharge diagnosis: st elevation myocardial infarction severe coronary artery disease dyslipidemia discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you collapsed and your heart stopped requiring cpr and a shock. you had a large heart attack and you were in the icu while your heart recovered. you were quite confused after waking up and your memory has slowly returned. a cardiac catheterization showed severe muti- vessel blockages and a bypass operation was recommended to be done immediately. you asked to go home and think about this before consenting to the operation. we are worried that your heart may stop again so we want you to wear a lifevest that would shock your heart back in to a regular rhythm if needed. if you have any symptoms of chest pain, arm pain, sweating or trouble breathing, you should call 911 and try taking nitroglycerin. . medication changes: 1. plavix and aspirin, to prevent blood clots in the arteries that are clogged. 2. imdur: to keep the clogged arteries as open as possible 3. atorvastatin: to lower your cholesterol as much as possible. 4. nitroglycerin: to take if you have chest pain or pressure as described above. 5. metoprolol xl to keep your heart rate low and help your heart recover from the heart attack. . please keep all of the appts that we have scheduled for you. it is critically important that you take all of your medicines. followup instructions: cardiology: dr. healthcare - 15 brothers , phone: fax: at 1:15 pm . primary care: , md healthcare - , phone: fax: date/time: at 2:45pm. procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more coronary arteriography using two catheters angiocardiography of left heart structures left heart cardiac catheterization enteral infusion of concentrated nutritional substances arterial catheterization hypothermia (central) (local) diagnoses: acidosis anemia, unspecified coronary atherosclerosis of native coronary artery acute kidney failure with lesion of tubular necrosis urinary tract infection, site not specified other and unspecified hyperlipidemia acute respiratory failure pneumonitis due to inhalation of food or vomitus cardiac arrest anoxic brain damage acute myocardial infarction of other inferior wall, initial episode of care ventricular fibrillation other alteration of consciousness benign essential hypertension hallucinations other specified disorders of kidney and ureter 

Answer: The patient is high likely exposed to