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: history of present illness: this is a 61-year-old gentleman with past medical history significant for copd, bullous emphysema, pulmonary embolus, chronic thromboembolic disease, pulmonary hypertension, and atrial fibrillation who presented from house with a one day history of increased shortness of breath, bilateral lower extremity edema and facial swelling. on presentation, denied chest pain and palpitations, fever, chills, cough. in the emergency room was found to be 74% on room air, was placed on a non rebreather with increased sats to 94-95% and chest x-ray showed bilateral effusions, right greater than left with interstitial edema. initially was treated as a chf exacerbation on a nitro drip and lasix; eventually required bi-pap because of continued trouble with breathing. because of the patient's bilateral lower extremity swelling, the patient had lower extremity dopplers which did demonstrate a left sided clot, dvt, in his common femoral vein extending to his popliteal vein. the patient also had an emergent echo done in the emergency room which showed pa pressures of 97, severe right ventricular dysfunction and patient was then sent for a ct angiogram which showed extensive clot burden of the bilateral pulmonary arteries. the patient was stable on bi-pap and was not intubated and was then transferred to the intensive care unit. past medical history: includes history of pulmonary emboli, reportedly per patient first in . from records from noted to have pulmonary embolus a year ago and was evaluated at for pulmonary hypertension, chronic thromboembolic disease and was started on anticoagulation at that time. the patient has history of copd with bullous emphysema on two liters nasal cannula at home, history of hypertension, history of prostate cancer just followed by psa's, no intervention yet. history of hydrocele, history of atrial fibrillation, history of perforated ulcers requiring a billroth ii surgery, history of restrictive pulmonary function test and otherwise no known drug allergies. medications: as an outpatient, coumadin, advair, combivent, ibuprofen, folate and multivitamin. social history: lives at the house, formerly heavy alcohol drinker, formerly 1?????? pack per day smoker, previous 140 pack year history, quit 6-8 years ago, former security guard. no children. survived by his two nieces. family history: no coronary artery disease, no peripheral vascular disease. no history of clots. physical examination: vital signs on admission, heart rate 77 with blood pressure 110/80, o2 saturation 97% on bi-pap, respiratory rate 26. temperature 96.5. in general he was a thin, cachectic man in respiratory distress. heent: mask in place. extraocular movements intact. significant right sided edema, periorbital. neck with jvp increased. cardiovascular was prominent pmi, prominent right sided heave, positive gallop, no murmurs appreciated, no evidence of tachycardia, regular rate and rhythm. respiratory was faint crackles at the lateral bases bilaterally, otherwise clear to auscultation. abdomen was active, soft, nontender, non distended. well healed vertical scars. extremities, 2+ pitting edema of the lower extremities, warmer to pulsation, 2+ dp pulses, amputated 4th left toe. rectal was guaiac negative, normal tone. laboratory data: white count 6.7, hematocrit 38.9, platelet count 285,000, mcv 69, sodium 137, potassium 6.5, repeat was 4.3, chloride 109, co2 21, bun 23, creatinine 0.7, glucose 66. arterial blood gases on the non rebreather, ph 7.45, pco2 28, po2 42. inr 2.8. hospital course: this was a 61-year-old gentleman with past medical history of chronic thromboembolic disease, history of chronic obstructive pulmonary disease with bullous emphysema, history of prostate cancer, atrial fibrillation, who presents with acute on chronic pulmonary embolism while on therapeutic coumadin. 1. pulmonary embolus: the patient had a pulmonary embolus while on therapeutic coumadin and was considered a coumadin failure. the patient was initially started on heparin drip and transitioned to a lovenox regimen . the patient's lovenox regimen was adjusted per his factor x-a level and was eventually maintained on an 80 mg dosing of lovenox. however, the patient had ct angiogram with large clot burden bilaterally, no evidence of extension of clot into the right atrium on echocardiogram. however, two days following admission the patient had an acute episode of hypotension, hypoxia and tachycardia and as was considered less hemodynamically stable, the patient received treatment with tpa, no evidence of bleed or neurologic change after this, however, patient's oxygenation remained stable in the 80's to 90's as had been prior to episode of acute decompensation. as patient continued to require increased oxygen requirements on non rebreather and eventually to c-pap. patient was tried on a regimen of inhaled nitric oxide to help pulmonary vasodilation. the patient tolerated this well and patient's oxygenation improved rapidly while on the inhaled regimen. however, this was a short-term therapy and patient was started on viagra to help bridge pulmonary vasodilation until nitric oxide could be weaned off. however, patient remained on the nitric oxide for around 72 hours before it was titrated off and this was turned off (was on a 25 mg q 8 regimen of the viagra) and was then requiring c-pap ventilation to maintain oxygenation. during the course of his stay, the patient had repeated echocardiograms including echocardiogram with a bubble study which did show improvement in his pr gradient from 97 on admission to 84 as was noted from his previous discharge summaries from , was noted to have elevated pa pressures on echocardiogram a year prior to this and had chronic history of pulmonary hypertension. the patient otherwise had good lv function but did have a bubble study which showed stretched patent foramen ovale or atrial septal defect which was likely a shunt secondary to patient's chronic right heart failure as a compensation. echo study also showed severe global right ventricular free wall hypokinesis which was also consistent with previous echocardiogram reports from his hospitalization including a right heart catheterization during that hospitalization. his echocardiogram did show presence of pericardial effusion which was determined to be stable in size and asymptomatic and which was continued to be followed. eventually patient continued to not tolerate the c-pap mask and ventilation and continued to pull off the mask because of discomfort. the patient was tried on a non rebreather mask which was more comfortable, however, his oxygen saturations remained in the low 80's during this. the patient remained asymptomatic and was probably chronically hypoxic. patient's pcp did note that on office visits, the patient's room air saturation was rarely greater than 80 and on his two liters patient's oxygen saturation was rarely greater than 86%. eventually patient had family meeting including his nieces and his pcp and the primary team and as concerns for chronicity of patient's condition and limited options in terms of treatments secondary to his large clot burden and large pulmonary artery pressures, the patient's code status was changed to dnr, dni. patient was agreeable to this but wanted to continue to have aggressive management as tolerated. the patient was continued to be treated with c-pap machine as tolerated, however, eventually patient was refusing this secondary to discomfort and was maintained on a non rebreather mask as tolerated. eventually as patient continued to remain hypoxic, patient was started on prn doses of ativan and morphine for increased agitation and discomfort and eventually patient's nieces were called back and decision was made to move toward comfort measures on a morphine drip. eventually patient was transitioned from a non rebreather mask to nasal cannula which was more comfortable and eventually at 5:55 p.m. the patient's saturations decreased and patient was pronounced dead secondary to respiratory failure, secondary to chronic pulmonary hypertension, secondary to chronic thromboembolic disease complicated by acute on chronic pulmonary emboli. discharge diagnosis: 1. pulmonary embolus. 2. lower extremity dvt. 3. pulmonary hypertension. 4. chronic obstructive pulmonary disease, bullous emphysema. 5. severe right heart failure. 6. prostate cancer. 7. atrial fibrillation. discharge condition: discharged to morgue. discharge follow-up: patient's family present. patient's pcp and patient's attending were also notified. , m.d. dictated by: medquist36 procedure: insertion of endotracheal tube injection or infusion of thrombolytic agent non-invasive mechanical ventilation non-invasive mechanical ventilation arterial catheterization administration of inhaled nitric oxide diagnoses: congestive heart failure, unspecified chronic airway obstruction, not elsewhere classified atrial fibrillation acute respiratory failure cachexia malignant neoplasm of prostate primary pulmonary hypertension other pulmonary embolism and infarction 

Answer: The patient is high likely exposed to