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: chest pain major surgical or invasive procedure: cardiac catheterization, cardioversion history of present illness: dr. is an 87yo retired male cardiothoracic surgeon with h/o cad with inoperable multivessel dz, 2 prior anterolateral and inferior mi s/p bms to plad in , des to d1 in c/b gib in setting of anticoag, icm with ef 30-40%, htn, hyperlipidemia, colon and prostate ca, presenting with increased anginal pain. the reports intermittent pain throughout day of admission with relief of his symptoms with nitro. he then developed crushing sscp after taking a long walk which did not respond to ntg. his pain is associated with nausea, but denies dyspnea, cough, or diaphoresis. he denies orthopnea and pnd, but has had increased le edema. . in the ed, initial vitals 99.6, 90, 132/62, 16, 98% 2l. by the time he arrived in the ed he was chest pain free. ekg showed st-e in iii and avf and st-d in the lateral leads. his initial tnt was 0.12. he was given asa 325mg, plavix 300mg, and started on a heparin drip. his cxr showed possible opacity in left so he was given iv levaquin 750mg x 1. he was guaiac. he was transfered to for further management. . on the floor he was evaluated and taken to cath which showed known proximal lcx and rca occlusions, patent plad and d1 stents with known occlusion of the lad after d1, and filling via l-l collaterals to the distal lad and lcx. he developed chf and new afib with rvr to the 120a post cath and was transfered to the ccu for further management. his o2 requirement increased post procedure and required diuresis with furosemide 20mg iv x 3 to which he diuresed 3 litres. he continues to require 2 litres supplemental oxygen. regarding his new afib with rvr, he received 10mg iv metoprolol followed by 12.5mg po metoprolol. he was anticoagulated with heparin and started on warfarin and underwent unsuccessful cardioversion. he was then loaded with amiodarone and converted into sinus. of note, the pt reports that he has had prior episodes of atrial fibrillation in , , and which were asymptomatic except for a pulse in the 120s. at those times it resolved spontaneously. his afib was asymptomatic this admission as well, but given his cad he was unlikely to tolerate it for very long. . on transfer to the floor he is in sinus and stable on 2l o2. he is cp free, able to lie flat, and feeling the best he has since admission. past medical history: cardiac risk factors:: (-)diabetes, (+)dyslipidemia, (+)hypertension -cabg: none -percutaneous coronary interventions: 2 prior anterolateral and inferior mi s/p bms to plad in , des to d1 in - coronary artery disease: he has known multivessel disease which is inoperable in . he underwent angioplasty and stenting of a proximal lad lesion in and then had a repeat pci of an lad diagonal branch lesion in of . he is status post both anterolateral and inferior infarctions, complicating an episode of profound gi bleeding, respiratory insufficiency, and rapid atrial fibrillation. - hyperlipidemia, on statin therapy. - history of hypertension, on pharmacologic therapy. - history of paf, previously not on coumadin prior h/o gib - history of gi bleeding and chronic anemia - prostate cancer, status post xrt - radiation proctitis. - colon cancer status post sigmoidectomy in . - pulmonary tuberculosis diagnosed in . social history: denies alcohol, tobacco, and ivdu. pt is a retired cardiothoracic surgeon. he lives in in family history: no family history of early mi, otherwise non-contributory physical exam: vs: 98.6, 114/64, 84, 16, 93% on 2l general: pleasant elderly man in nad. oriented x3. mood, affect appropriate. heent: ncat. sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. no xanthalesma. neck: supple with jvp of 12 cm. cardiac: pmi located in 5th intercostal space, midclavicular line. rr, normal s1, s2. no m/r/g. no thrills, lifts. no s3 or s4. lungs: bibasilar crackles to lungs, mod air movement. no chest wall deformities, scoliosis or kyphosis. resp were unlabored, no accessory muscle use. abdomen: soft, ntnd. no hsm or tenderness. abd aorta not enlarged by palpation. no abdominial bruits. extremities: 2+ pitting edema to knees bilaterally, lle slightly more than rle. +2 tender hematomas on medial aspect of left knee with ecchymoses and tracking down to ankles. no edema/erythema/pain at left knee. no femoral bruits. skin: no stasis dermatitis, ulcers, scars, or xanthomas. pulses: right: carotid 2+ femoral 2+ popliteal 2+ dp 2+ pt 2+ left: carotid 2+ femoral 2+ popliteal 2+ dp 2+ pt 2+ pertinent results: admission labs- 09:09pm blood wbc-13.6*# rbc-3.28* hgb-11.0* hct-30.6* mcv-93 mch-33.5* mchc-35.9* rdw-14.0 plt ct-174 09:09pm blood neuts-94.9* lymphs-2.2* monos-2.6 eos-0.1 baso-0.2 09:09pm blood pt-13.7* ptt-29.1 inr(pt)-1.2* 09:09pm blood glucose-150* urean-31* creat-1.4* na-145 k-3.9 cl-111* hco3-24 angap-14 09:09pm blood ck(cpk)-90 09:09pm blood ctropnt-0.12* reports comments: 1. selective coronary angiography of this right dominant system revealed severe three vessel disease that was not significantly changed from his last cardiac catheterization. the lmca had a 50% distal stenosis. the lad was occluded in the mid-vessel but had widely patent stents proximally and in the d1 branch. the lcx was occluded proximally and the oms filled via left-left collaterals. the rca was not engaged as it was known to be occluded. 2. central aortic pressure was 134/69/97mmhg. 3. left ventriculography was deferred. final diagnosis: 1. severe three vessel coronary artery disease. 2. widely patent stents in the proximal lad and d1 branch. le doppler impression: no evidence of deep vein thrombosis in the left leg. c cath comments: 1. selective coronary angiography of this right dominant system revealed severe three vessel disease that was not significantly changed from his last cardiac catheterization. the lmca had a 50% distal stenosis. the lad was occluded in the mid-vessel but had widely patent stents proximally and in the d1 branch. the lcx was occluded proximally and the oms filled via left-left collaterals. the rca was not engaged as it was known to be occluded. 2. central aortic pressure was 134/69/97mmhg. 3. left ventriculography was deferred. final diagnosis: 1. severe three vessel coronary artery disease. 2. widely patent stents in the proximal lad and d1 branch. echo the left atrium and right atrium are normal in cavity size. left ventricular wall thicknesses and cavity size are normal. there is moderate regional left ventricular systolic dysfunction with near akinesis of the distal half of the septum and anterior walls, and distal inferolateral walls. the apex is dyskinetic and aneurysmal. the remaining walls contract well (lvef 30-35%). no masses or thrombi are seen in the left ventricle. right ventricular chamber size and free wall motion are normal. complex (>4mm, non-mobile) plaque is seen in the abdominal aorta (clip ). the aortic valve leaflets (3) are mildly thickened. there is no aortic valve stenosis. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. trivial mitral regurgitation is seen. there is borderline pulmonary artery systolic hypertension. there is no pericardial effusion. compared with the prior report (images unavailable for review) of , the findings are similar. brief hospital course: on the floor he was evaluated and taken to cath which showed known proximal lcx and rca occlusions, patent plad and d1 stents with known occlusion of the lad after d1, and filling via l-l collaterals to the distal lad and lcx. he developed chf and new afib with rvr to the 120a post cath and was transfered to the ccu for further management. his o2 requirement increased post procedure and required diuresis with furosemide 20mg iv x 3 to which he diuresed 3 litres. he continues to require 2 litres supplemental oxygen. regarding his new afib with rvr, he received 10mg iv metoprolol followed by 12.5mg po metoprolol. he was anticoagulated with heparin and started on warfarin and underwent unsuccessful cardioversion. he was then loaded with amiodarone and converted into sinus as his amiodarone was started. of note, the pt reports that he has had prior episodes of atrial fibrillation in , , and which were asymptomatic except for a pulse in the 120s. at those times it resolved spontaneously. his afib was asymptomatic this admission as well, but given his cad he was unlikely to tolerate it for very long. after his amio gtt he was transitioned to 200mg tid po. he was also restarted on his imdur, he had been having angina while off of the medication. . on transfer to the floor he is in sinus and stable on 2l o2. he is cp free, able to lie flat, and feeling the best he has since admission. service brief hospital course: patient is a 87m with h/o cad with inoperable multivessel dz, 2 prior mi s/p bms to plad in , des to d1 in c/b gi bleed in setting of anticoag, icm with ef 30-40%, htn, hyperlipidemia, h/o colon and prostate transferred to ccu for chf and atrial fibrillation with rvr now s/p pharmacologic cardioversion and diuresis who returned to cardiology service for further management. he was discharged on warfarin with a goal inr of .5 for afib given his history of gib and amiodarone for rhythm control. . #. cad/angina: unintervenable disease. patient had long history of cad and had 3vd. patient's cardiac cath showed diffuse disease. the plan is for medical management. restarted imdur 30mg po daily with improvement of symptom control. started ranolazine 500mg po bid for anginal control. reduced asa to 81mg po daily and discontinued clopidogrel given his is anticoagulation with a heparin bridge to warfarin and has a history of gib. started patient on toprol xl 75mg daily. cks trended down after chf exacerbation. this was believed to be related to demand ischemia. tnt is difficult to assess in the context of arf. started on amiodarone for rhythm control as below. - continue toprol xl 75mg, valsartan 40mg - continue aspirin 81mg daily - continue imdur 30mg daily and ranolazine 500mg #. pump: ef of 30-35%. echo this admission showed moderate regional left ventricular systolic dysfunction with near akinesis of the distal half of the septum and anterior walls, and distal inferolateral walls. the apex is dyskinetic and aneurysmal. patient was volume overloaded on exam initially, but improved throughout admission. was treated with gentle diuresis with po lasix after initially given iv lasix. - continue lasix 20mg po daily #. rhythm: nsr s/p afib with rvr causing worsening chf. initially cardioverted unsuccessfully. then received amiodarone drip followed by 200mg po tid and then converted to nsr. he will continue with amiodarone 200mg po bid after . - continue amiodarone 200mg tid until , continue regimen for 2 weeks, then 200mg daily thereafter - continue coumadin 1mg daily - check inr in 2 days. goal 2-2.5. #. renal failure: basline 1.3. cr rose to 1.8 from a baseline of 1.3 prior to admission and 1.4 on admission. etiology likely combination of htn, contrast, and lasix. at discharge his cr is 1.7, and is expected to trend downwards. medications on admission: amlodipine 10mg daily atenolol 25mg daily imdur 30mg daily hctz 12.5mg daily prn valsartan 80mg asa 81mg daily lipitor 20mg qhs discharge medications: 1. ranolazine 500 mg tablet sustained release 12 hr sig: one (1) tablet sustained release 12 hr po bid (2 times a day). disp:*60 tablet sustained release 12 hr(s)* refills:*2* 2. amiodarone 200 mg tablet sig: one (1) tablet po tid (3 times a day): continue tid for two more days, then for two weeks, then daily thereafter. disp:*60 tablet(s)* refills:*2* 3. isosorbide mononitrate 30 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po qhs (once a day (at bedtime)). 4. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). disp:*30 tablet, chewable(s)* refills:*2* 5. furosemide 20 mg tablet sig: one (1) tablet po daily (daily). 6. atorvastatin 40 mg tablet sig: one (1) tablet po hs (at bedtime). disp:*30 tablet(s)* refills:*2* 7. metoprolol succinate 50 mg tablet sustained release 24 hr sig: 1.5 tablet sustained release 24 hrs po daily (daily). disp:*60 tablet sustained release 24 hr(s)* refills:*2* 8. valsartan 40 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 9. warfarin 1 mg tablet sig: one (1) tablet po once daily at 4 pm. disp:*30 tablet(s)* refills:*2* 10. ondansetron 4 mg tablet, rapid dissolve sig: one (1) tablet, rapid dissolve po q8h (every 8 hours) as needed. disp:*10 tablet, rapid dissolve(s)* refills:*0* 11. nitroglycerin 0.4 mg tablet, sublingual sig: one (1) tablet, sublingual sublingual prn (as needed) as needed for chest pain: please sit down prior to taking. please take every 5 minutes x 3 until pain free. if pain persists, please call ems. disp:*60 tablet, sublingual(s)* refills:*0* 12. pantoprazole 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:*0* 13. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day) as needed for constipation. 14. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 15. outpatient lab work please have pt/ptt/inr drawn by home nursing on monday, and fax results to dr. / at fax 1-. (phone # is if there are any problems.) discharge disposition: home with service facility: homecare discharge diagnosis: primary: coronary artery disease . secondary: hyperlipidemia, hypertension, atrial fibrillation discharge condition: afebrile, vitals stable. discharge instructions: it was a pleasure taking care of you at . . you were admitted for chest pain. you underwent a cardiac catheterization which showed that several of your coronary arteries had disease. ultimately it was decided that your best course of action is medical management of your coronary artery disease. we adjusted your medications appropriately. you also developed atrial fibrillation which was treated with cardioversion and amiodarone. you were started on warfarin with a goal inr of .5. . please take your medications as ordered and make the following changes: 1. please stop your hydrochlorothiazide. 2. please stop amlodipine. 3. please start coumadin as directed, 1 mg daily. 4. please continue amiodarone for your atrial fibrillation. take 200 mg three times daily for 2 more days and then decrease to twice daily for two weeks. please then decrease to 200 mg daily. 5. please stop atenolol and start toprol xl (metoprolol) 75 mg daily. 6. please continue imdur 30 mg daily. 7. please decrease valsartan 40 mg twice per day. 8. please increase lipitor to 40 mg daily. 9. please continue furosemide (lasix) 20 mg daily. . please attend your follow up appointments. . please call your doctor or come to the emergency room if you experience chest pain, shortness of breath, palpitations, bleeding, passing out, or other concerning symptoms. followup instructions: please follow up with your cardiologist, dr. , on at 9:40 am. please call his office at if there is a problem with this appointment. provider: , .d. phone: date/time: 9:40 please follow up with your primary care physician, . , within the next two weeks; they will contact you with your appointment time. please call dr. assistant, , at if you have not heard from her in the next 1-2 days. please call the clinic to set up an appointment to manage your high blood sugars at (. procedure: left heart cardiac catheterization other and unspecified coronary arteriography atrial cardioversion diagnoses: subendocardial infarction, initial episode of care coronary atherosclerosis of native coronary artery congestive heart failure, unspecified acute kidney failure, unspecified atrial fibrillation personal history of malignant neoplasm of prostate unspecified fall chronic kidney disease, unspecified other and unspecified hyperlipidemia personal history of malignant neoplasm of large intestine acute on chronic systolic heart failure contusion of unspecified part of lower limb 

Answer: The patient is high likely exposed to