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: shortness of breath, respiratory failure major surgical or invasive procedure: endotracheal intubation history of present illness: 68 yo male, h/o cad s/p cabg, multiple ptca's showing diffuse 3vd, with known systolic and diastolic dysfunction (ef 7/02=15%), presenting now with shortness of breath and pulmonary edema. as per his wife, he had some ?dietary indiscretions (salty foods) the night prior to admission. he woke up this morning with acute shortness of breath requiring tripod positioning. ems wa called, and he was intubate en route to the ed for hypercarbic respiratory failure. on arrival, he was hypertensive, requiring a nitro gtt that bottomed out his pressures. he was then started on a dopamine gtt, and right sc central line placement was complicated by arterial stick. he became tachycardic to the 130's on dopamine, and he was changed to levophed for pressure support. bedside tte showed 2+ mr, ef=20% (on dopa). multiple attempts to place an arterial line resulted in hematoma (line was finally placed), and blood was aspirated via his ngt. he was transferred to the ccu for further managment where he was maintained on levophed, started on a lasix drip. his pacemaker was also interrogated by ep (?fired for svt 130's, causing v-tach, then fired resulting in reversion to nsr in 50's). past medical history: 1. cad, s/p cabg with 3vd; has grafts svg to om, svg to d1, lima to lad. recent cath showing patent grafts with severe native disease 2. chf, ef 15-30% 3. aicd placed for recurrent vtach, -ventricular, 4. htn 5. hypercholesterolemia 6. colonoscopy showing diverticulosis, polyps 7. egd wnl 8. pvd, s/p iliac stent 9. hypothyroidism social history: retired surgeon, married, non smoker, occasional etoh family history: nc physical exam: vs: on levophed: hr=131, bp 82/45 100%, intubated gen:nad, intubated, elderly gentleman heent: perrl, op clear neck: no jvd lungs: bibasilar rhonchi heart: rrr, tachy s1/s2, no m/r/g appreciated abd: soft, nt/nd, nabs, no masses extr: no c/c/e, pt 1+ bilat neuro: awake, alert, can respond yes/no; moving all 4 extremities pertinent results: 04:34pm type-art temp-37.8 rates- tidal vol-450 peep-5 o2-40 po2-124* pco2-47* ph-7.36 total co2-28 base xs-0 -assist/con intubated-intubated 01:51pm lactate-2.1* 12:28pm glucose-194* urea n-40* creat-1.6* sodium-134 potassium-5.0 chloride-102 total co2-22 anion gap-15 12:28pm ck(cpk)-88 12:28pm ck-mb-notdone ctropnt-0.05* 12:28pm wbc-14.2* rbc-3.44* hgb-11.4* hct-34.7* mcv-101* mch-33.0* mchc-32.7 rdw-13.2 12:28pm plt count-286 08:10am digoxin-<0.2* brief hospital course: 1. cad: he has a history of severe 3vd, s/p cabg with recent catheterization showing patent grafts with totally occluded native vessels. he is not a candidate for any further intervention at this time. it is possible that his salty dietary indiscretions caused an increase in sbp leading to a ?new ischemic event leading to flash pulmonary edema. his enzymes were elevated on admission and remained stable. the decision was made not to anticoagulate given his bleeding. he was continued on his outpatient regimen of coreg, lisinopril, and imdur (imdur at decreased dose of 60 mg daily secondary to low systolic blood pressures). he never had any symptoms of chest pain or anginal equivalents. he will follow up with dr. at , where he is enrolled in a vegf trial. 2. chf: he has a known ischemic cardiomyopathy with systolic and diastolic dysfunction. bedside tte on admission showed ef=20% with 2+ mr. likely had flash pulmonary edema in the setting of hypertension. he was initially started on a lasix drip. he declined swan evaluation to determine co/ci and pulmonary pressures (recent swan at showing pcwp =30, pa 50/36 with mean of 42, rv 50/25 with ra 25). he was intubated for hypercarbic respiratory failure given his pulmonary edema. he was able to be extubated 1 day after admission. diuresis was continued with iv lasix with good effect. he also received 1 day of lasix with zaroxalyn to maximize diuresis. he was symptomatically improved at time of discharge, and chest x-ray showed improvement in his failure. he was discharged on his outpatient dose of 80 mg po lasix. he was instructed to weigh himself daily and to adhere to a low salt diet on discharge. 3. rhythm: he was tachycardic on admission after dopamine (svt), and he then had episodes of ?ventricular tachycardia. his aicd (biventricular, atrial sensing with ventricular pacing) was interrogated by electrophysiology who believed that the device interpreted the svt as possible v-tach, fired which caused actual ventricular tachycardia. his pacer was reprogrammed to fire in response to a higher rate (136). when he reverted to sinus rhythm in the 50's, his blood pressure improved. he remained in paced rhythm, 50-60's throughout the rest of his hospital course. he was continued on his amiodarone and had no further events on telemetry. he will follow up in device clinic at . 4. hypotension: he was likely in cardiogenic shock on admission and was started on dopamine, changed to levophed (tachycardia in response to dopamine). pt declined swan, and his blood pressure improved when his tachycardia resolved. levophed was discontinued on hospital day 2 (overall hemodynamic status improved with reversion to sinus/paced rhythm). 5. respiratory: he was intubated in the field for hypercarbic respiratory failure, likely secondary to decreased gas exchange from pulmonary edema. he was extubated on hospital day 2 and remained stable on nasal cannula o2. he was discharged, saturating stably on room air. 6. arf/crf: creatinine was between 1.4-1.8 during hospitalization. this was likely his baseline. he was instructed to have his creatinine and potassium checked within 3-4 days of discharge. 7. leukocytosis: likely was a reaction to ischemia, but cultures were checked to rule out infectious etiologies. all cultures were negative (urine, blood, sputum), and chest x-ray was without signs of infiltrate or focal process. he spiked a fever >101.5 during admission, but no source was ever identified and antibiotics were not started. he was afebrile with a normal white count at time of discharge. 8. anemia: he had a small hematocrit drop in the setting of some ivf, hematoma a line, and guaiac positive stools (blood initially aspirated from ngt). serial cxr's were checked to rule out hemothorax given arterial stick when subclavian line was attempted. he had some blood on top of stools attributed to his hemorrhoids. he had egd/colonoscopy in that were basically within normal limits (reports were obtained; colonoscopy showing polyps and diverticulosis). he required 1 u prbc while in-house for a hct of 26.9. hemolysis labs were checked and were negative. upon discharge, he was instructed to follow up with his pcp/gastroenterologist to ensure that hematocrit remained stable. 9. disposition: he was discharged in good condition and will follow up with his cardiologists at . medications on admission: asa 81 mg plavix 75 mg lipitor 80 mg lasix 80 mg amiodarone 200 mg imdur 90 mg coreg 6.25 mg levothyroxine 75 mcg ativan 2 mg monopril 30 mg nkda discharge medications: 1. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 2. clopidogrel bisulfate 75 mg tablet sig: one (1) tablet po daily (daily). 3. atorvastatin calcium 80 mg tablet sig: one (1) tablet po daily (daily). 4. amiodarone hcl 200 mg tablet sig: two (2) tablet po daily (daily). 5. pantoprazole sodium 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). disp:*30 tablet, delayed release (e.c.)(s)* refills:*2* 6. levothyroxine sodium 75 mcg tablet sig: one (1) tablet po daily (daily). 7. lorazepam 1 mg tablet sig: two (2) tablet po hs (at bedtime) as needed. disp:*90 tablet(s)* refills:*3* 8. carvedilol 6.25 mg tablet sig: one (1) tablet po bid (2 times a day). 9. fosinopril sodium 10 mg tablet sig: three (3) tablet po once a day. 10. lasix 80 mg tablet sig: one (1) tablet po once a day. 11. isosorbide mononitrate 30 mg tablet sustained release 24hr sig: two (2) tablet sustained release 24hr po daily (daily). discharge disposition: home discharge diagnosis: primary diagnoses: 1. congestive heart failure 2. hypercarbic respiratory failure 3. coronary artery disease secondary diagnoses: 1. biventricular pacemaker 2. hypothyroidism 3. anemia discharge condition: good discharge instructions: 1. please take all your medications as prescribed and described in this discharge paperwork. we made the following changes to your medication regimen: - we changed your imdur from 90 mg daily to 60 mg daily. this can be titrated up as tolerated as an outpatient 2. please follow up with your cardiologists at as described below. 3. please weigh yourself daily. if you notice weight gain more than 3 lb, please call your doctor. please adhere to a low salt diet (less than 2 gm each day). 4. please call your cardiologist if you are experiencing chest pain, shortness of breath, fever, chills, abdominal pain, or with any other concerns followup instructions: 1. please follow up with drs. and at . please call dr. office to schedule an appointment for thursday or friday of this week (). at this time, you should have your creatinine and potassium checked, and the need for potassium supplementation can be assessed. 2. you should have gi follow up as an outpatient. you were anemic during this hospitalization and had hemorrhoids. your hematocrit should be followed to ensure that your blood counts are stable. procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified diagnostic ultrasound of heart insertion of endotracheal tube non-invasive mechanical ventilation arterial catheterization transfusion of packed cells automatic implantable cardioverter/defibrillator (aicd) check diagnoses: anemia, unspecified coronary atherosclerosis of native coronary artery mitral valve disorders congestive heart failure, unspecified acute kidney failure, unspecified iron deficiency anemia secondary to blood loss (chronic) unspecified acquired hypothyroidism percutaneous transluminal coronary angioplasty status other specified forms of chronic ischemic heart disease other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure acute respiratory failure cardiogenic shock mechanical complication of automatic implantable cardiac defibrillator other complications due to other vascular device, implant, and graft internal hemorrhoids with other complication combined systolic and diastolic heart failure, unspecified 

Answer: The patient is high likely exposed to