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: heparin agents attending: chief complaint: b/l ankle ulcers major surgical or invasive procedure: angiogram with pelvic vessels and rt. leg runoff cardiac cath with of lad/dg1, ptca of lad, attempted ptca of rca with catheter transection rt. cfa-akpop-at w nrsvg,angioscopy and valve lysis history of present illness: this is a 66yo f with history of congestive heart failure, diabetes mellitus, peripheral vascular disease who presents with 6 weeks history of bilateral medial malleoulus ulcers (complicated by recent pta fracture) and bilateral lower extremities cellulitis(r>l). she was admitted under vascular surgery. in pre-op assessment by medicine, she noted to have abnormal pmibi past medical history: 1.chf 2.myelodysplasia with refractory anemiarequiring transfusion and procrit 3.hypercholesterolemia 4.diabetes on oral hypoglycemics 5.s/p cva 14years ago(no residual weakness) 6.peripheral vascular disease 7.cad 8.gout 9.partial thyroidectomy 10.hitt social history: retired medical transciptionistlives alone lives alone neg etoh neg ivda neg tob family history: deferred physical exam: vital signs of 98.5, 96, 22, blood pressure of 146/82, oxygen saturation of 95%. general appearance is a very pleasant white female in no acutedistress. neurological exam is remarkable for left facial drooping. chest exam reveals lungs are with crackles bilaterally at the bases. heart has a regular rate and rhythm without murmur. heent exam shows bilateral carotid bruits and jvd. abdominal exam is unremarkable. extremity exam with 2+ edema bilaterally with shallow ulcerations on the medial aspect of both ulcerations. pulse exam shows palpableradial's and femoral's bilaterally. dp's are triphasic signals only. pt's are monophasic dopplerable signals on the right and triphasic on the left. pertinent results: echo the left atrium is moderately dilated. there is mild symmetric left ventricular hypertrophy with normal cavity size. there is mild global left ventricular hypokinesis with regional akinesis of the distal half of the septum, severe hypokinesis of the inferior wall, and mild apical dyskinesis. no intracavitary thrombus is seen. the right ventricular cavity is mildly dilated with mild global free wall hypokinesis. the ascending aorta is moderately dilated. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. mild (1+) aortic regurgitation is seen. the mitral valve leaflets are structurally normal. mild (1+) mitral regurgitation is seen. the left ventricular inflow pattern suggests a restrictive filling abnormality, with elevated left atrial pressure. moderate tricuspid regurgitation is seen. there is moderate pulmonary artery systolic hypertension. there is a small circumferential pericardial effusion. mibi3/10: 1. moderate, reversible defect involving the mid and distal inferolateral wall. 2. moderate, partially reversible defect involving the apex. 3. moderate, reversible defect involving the mid and distal anteroseptal wall. 4. transient left ventricular dilatation with stress. global hypokinesis with ejection fraction of 29%. impression: symmetric left ventricular hypertrophy with global and regional systolic dysfunction c/w multivessel cad (or other diffuse process; in the absence of a history of systolic hypertension, an infiltrative process should be considered). moderate pulmonary artery systolic hypertension. moderate tricuspid regurgitation. right ventricular cavity enlargement/free wall hypokinesis. arterial study moderate diffuse calcified plaque with bilateral less than 40% carotid stenosis. significant aorto-right iliac and bilateral superficial femoral artery occlusive disease.abi right 0.83, left 0.66 cath : co/ci 4.37/2.73 pcwp 36 cvp 19 pap 67/32 lmca-ok lad-mid 99%, distal to, d1 70% prox lcx-30% prox, 50% before om1 rca-90% after am 3vd with /d1 and pca lad, partially successful ptca rca vein mapping technique and findings: scale examination was performed at the level of the superficial veins of the bilateral upper extremities with compression maneuvers. in the upper extremities, the bilateral cephalic and basilic veins are patent and fully compressible. their caliber varies between 2.8 mm and 4.2 mm for the right cephalic vein, between 1.5 and 3.9 mm for the right basilic vein, between 2.3 and 3.0 mm for the left cephalic vein, and between 2.6 and 4.7 mm for the left basilic vein. conclusion: pre-operative vein mapping with patency of the bilateral cephalic and basilic veins and dimensions as stated above. wbc-6.7 rbc-2.71* hgb-8.3* hct-24.6* mcv-91 mch-30.6 mchc-33.7 rdw-15.7* plt ct-119* pt-14.2* ptt-28.4 inr(pt)-1.3 glucose-120* urean-61* creat-1.1 na-141 k-4.9 cl-105 hco3-30* angap-11 calcium-8.4 phos-2.7 mg-2.1 brief hospital course: the patient was admitted to the vascular service. wound cultures were obtained. cardiology medicine was requested to see the patient because of her congestive heart failure on admission chest x-ray. the patient was transferred to the medicine service for further evaluation and treatment of congestive heart failure. the patient an echocardiogram done which showed symmetrical left ventricular hypertrophy with global and regional systolic dysfunction, consistent with multivessel coronary artery disease or other diffuse process. in the absence of systolic hypertension and infiltrative process should be considered. there is moderate pulmonary systolic hypertension, moderate tricuspid regurgitation, right ventricular cavity is enlarged, free wall is hypokinetic. the patient underwent a myocardial perfusion stress which demonstrated a transient dilatation of the left ventricle with stress. the stress perfusion images showed a moderate reduction in tracer distribution involving the mid and distal inferolateral wall. he rest perfusion images demonstrated this defect to be reversible. stress perfusion images additionally demonstrate a moderate defect in the tracer uptake of the apex, and this defect was partially reversible. the stress also demonstrated moderately reversible defects in the mid and distal anteroseptal wall. calculated ejection fraction was 29%. once the patient was compensated for her congestive heart failure and her renal function stabilized, she underwent a cardiac catheterization on with documented 3- vessel disease with markedly elevated and right and left- sided filling pressures. she underwent /diagonal and an angioplasty to the lad with partially successful ptca of the right coronary. this was transected by catheter during the catheterization. the patient was transferred to the ccu for continued monitoring and rule out. troponin levels were 0.59, 0.19, 0.08. the patient remained on the cardiology service. aspirin, plavix, and lopressor were continued. she required a transfusion for a low hematocrit. this was related to her chronic myelodysplasia disorder. a transesophageal echocardiogram was obtained immediately post cardiac catheterization. there was a small pericardial effusion. there was no echocardiographic sign of tamponade. the patient did experience contrast renal failure post cardiac catheterization and required aggressive treatment for hyperkalemia. the peak creatinine was 3.0. the patient finally returned to baseline renal function with a creatinine of 1.9 on . the patient was transferred to the vascular service that same day. the patient was pre hydrated with mucomyst and sodium bicarbonate infusion and underwent a peripheral arteriogram on . the patient tolerated the procedure. she was without hematoma, and her creatinine remained stable. the patient was seen by the orthopaedic service for her ankle fracture. recommendations were bivalved cast with nonweightbearing and that further surgical orthopaedic intervention would be done after her cardiac and peripheral vascular problems were addressed. the patient requested on a desire to be discharged to home during the holiday. dr. was agreeable. the patient has discussed this with family and made arrangements for discharge over the weekend. the patient will return on to be readmitted for elective revascularization of the right lower extremity on . pt readmitted to vascular surgery for elective revascularization of the right lower extremity. on patient underwent a right femoral to anterior tibialis bypass graft with composite ptfe and vein graft. transfered to the pacu in stable condition. pt was transfused with 2 units prbc post procedure. with the following drop in hct a heme/onc consult was put in. they diagnosed the person with hitt, all heparin was dc'd. pt' hct and plt improved after heparin items were dc'd. on pt foley was dc'd, she was allowed oob to chair, a pt / case management consult was put in. on discharge pt is stable, able to urinate taking po, and ambulating with asst. medications on admission: lipitor 10, vandia 4", asa 81', zantac 150", colace 100", senna 1", allopurinol 100", vicodin 1"", lasix 80', compazine 10, recently d/c'd metformin, toprol 200', diovan, procrit 40,000 discharge medications: 1. atorvastatin calcium 80 mg tablet sig: one (1) tablet po daily (daily). :*30 tablet(s)* refills:*2* 2. aspirin 325 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 3. clopidogrel bisulfate 75 mg tablet sig: one (1) tablet po daily (daily). :*30 tablet(s)* refills:*2* 4. metoprolol succinate 50 mg tablet sustained release 24hr sig: one (1) tablet sustained release 24hr po daily (daily). 5. isosorbide mononitrate 30 mg tablet sustained release 24hr sig: one (1) tablet sustained release 24hr po daily (daily). :*30 tablet sustained release 24hr(s)* refills:*2* 6. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 7. hydrocodone-acetaminophen 5-500 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed. 8. hydralazine hcl 50 mg tablet sig: one (1) tablet po q6h (every 6 hours). :*120 tablet(s)* refills:*2* 9. calcium carbonate 500 mg tablet, chewable sig: one (1) tablet, chewable po qid (4 times a day). :*100 tablet, chewable(s)* refills:*2* 10. cholecalciferol (vitamin d3) 400 unit tablet sig: one (1) tablet po daily (daily). 11. insulin glargine 100 unit/ml cartridge sig: fifteen (15) units subcutaneous at bedtime. :*qs 2* refills:*2* 12. insulin regular human 100 unit/ml solution sig: as directed injection four times a day: ac/hs sliding scale: glucoses <150/1 units insulin glucoses 151-200/3u glucoses 201-250/5u glucoses 251-300/7u glucoses 301-350/9u glucoses 351-400/11u glucoses >400 md. :*qs * refills:*2* 13. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4-6h (every 4 to 6 hours) as needed. 14. amoxicillin-pot clavulanate 500-125 mg tablet sig: one (1) tablet po q12h (every 12 hours) for 7 days. 15. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). discharge disposition: extended care facility: - discharge diagnosis: bilateral ankle ulcers diabetes type 2,uncontrolled, new insulin dependant myleodysplastic anemia, refractory,transfused chf,compensated chronic renal insuffiency with contrast incude atn,resolved cad w + stress ,s/p angiio with stenting of lad,dg1,ptca of lad, ptca-rca with catheter transection, mi discharge condition: stable discharge instructions: look at wound care and pt instructions followup instructions: 2 weeks w dr. . call for appointment . he will take staples out when he see her in the office. procedure: combined right and left heart cardiac catheterization coronary arteriography using two catheters injection or infusion of platelet inhibitor arteriography of femoral and other lower extremity arteries other (peripheral) vascular shunt or bypass aortography transfusion of packed cells application of other cast injection or infusion of nesiritide insertion of drug-eluting coronary artery stent(s) diagnoses: anemia, unspecified coronary atherosclerosis of native coronary artery acute kidney failure with lesion of tubular necrosis congestive heart failure, unspecified accidental puncture or laceration during a procedure, not elsewhere classified unspecified disease of pericardium cellulitis and abscess of leg, except foot long-term (current) use of insulin unspecified accident diabetes mellitus without mention of complication, type ii or unspecified type, uncontrolled anticoagulants causing adverse effects in therapeutic use urinary complications, not elsewhere classified atherosclerosis of native arteries of the extremities with ulceration unspecified fracture of ankle, closed ulcer of ankle accidental cut, puncture, perforation or hemorrhage during heart catheterization 

Answer: The patient is high likely exposed to