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 major surgical or invasive procedure: cardiac catheterization with stent placement history of present illness: 65 y/o male c pmh signif for cad s/p cabg, dm, htn, gib, anemia, depression, multiple dvts s/p recent hospital admission for revision of thrombosed av graft ( -). at this time a vdd pacemaker was placed mobitz i c bradycardia to 30s. recent stress test prior to discharge on showed reversible defect in cicrcumflex and posterior descending territories. an elective cardiac catheterization was arranged for later this week. . then this am at 0500 pt awoke from sleep c sudden onset sob. pt noted dyspnea improved on laying flat. he attests to steady 2 pillow orthopnea and pnd. he denies any cp, n/v, diaphoresis, or leg swelling. the night prior he ate a salty meal but otherwise denies any dietary indiscretions. no f/c, cough, diarrhea, or dysuria. . at baseline pt is able to walk 15 steps s difficulty. he does not use home oxygen. . in the pt c tn of 3, mb of 29 c mbi of 20, bnp of . he was given 80mg iv lasix, 325 of asa, 12.5 of lopressor, and 5 of lisinopril. pt's sbp improved from 200s to 170s and sats improved to mid 90s. past medical history: 1. coronary artery disease status post coronary artery bypass graft in . 2. s/p vdd pm placement for av block c bradycardia to 30s 3. s/p failed cadaveric renal transplant end stage fsgs on hd 4. hypertension: developed during teenage year 5. diabetes. 6. multiple gastrointestinal bleed requiring icu admission 7. deep venous thrombosis- ue graft and les; s/p ivc filter placement 8. anemia. 9. depression. 10. gout. 11. appendectomy. 12. hx of tuberculosis infection as a teenager social history: the patient is married and lives with his wife at home. no tobacco use. he owns a medical delivery company. family history: fh: noncontributory. father died when pt was 12 years old physical exam: vs98.2 82 175/64 28 92%ra heent- perrl, eomi, op clr, mm dry, jvp to 6cm l- crackles way up cv- rrr, nl s1s2 abd- sft, nt, nd ext- wwp, no c/c/e pertinent results: 12:30pm pt-12.2 ptt-26.4 inr(pt)-1.0 12:30pm plt count-223 12:30pm wbc-8.7 rbc-3.70* hgb-11.6* hct-35.0* mcv-95 mch-31.3 mchc-33.0 rdw-15.6* 12:30pm ck-mb-29* mb indx-19.9* ctropnt-3.08* probnp-* 12:30pm ck(cpk)-146 12:30pm glucose-96 urea n-72* creat-8.0* sodium-138 potassium-4.4 chloride-97 total co2-27 anion gap-18 12:44pm k+-4.6 cxr: midline sternotomy wires and right-sided pacemaker lead unchanged since . increased pulmonary vascular markings with pulmonary hilar prominence and bilateral pleural effusions, left probably greater than right. lateral view shows fluid in major and minor fissures. probable left retrocardiac opacity. thoracic spine difficult to evaluate due to prominence of pulmonary vascular markings. no fractures identified. bowel gas pattern normal. . cxr (later in course): impression: ap chest compared to , 8 and : lung volumes are lower, and moderate pulmonary edema, moderate cardiomegaly and mediastinal vascular engorgement have all worsened since consistent with volume overload and/or cardiac decompensation. transvenous right ventricular pacer lead follows its expected course. there is no pneumothorax. leftward tracheal deviation of the thoracic inlet due to enlarged right lobe of thyroid gland is longstanding. . ekg: sinus rhythm with atrial sensed - ventricular pacing. no change since the previous tracing of . . echo: conclusions: the left atrium is moderately dilated. the inferior vena cava is dilated (>2.5 cm). the left ventricular cavity size is normal. there is mild to moderate regional left ventricular systolic dysfunction. lv systolic function appears depressed. tissue velocity imaging e/e' is elevated (>15) suggesting increased left ventricular filling pressure (pcwp>18mmhg). resting regional wall motion abnormalities include inferolateral akinesis and inferior hypokinesis. the anterior and anterolateral segments were not fully visualized. estimated left ventricular ejection fraction ?40%. there is mild global right ventricular free wall hypokinesis. the aortic valve leaflets are moderately thickened. there is mild aortic valve stenosis. mild (1+) aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. the mitral valve shows characteristic rheumatic deformity. moderate (2+) mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. moderate tricuspid regurgitation is seen. there is severe pulmonary artery systolic hypertension. there is no pericardial effusion. compared with the prior study (images reviewed) of the left ventricular function is now mildy depressed, the pulmonary pressures are slighly higher. . cardiac catheterization: comments: 1. selective coronary angiography revealed a right dominant system with severe native 3 vessel disease. the lmca had a 90% distal stenosis. the lad was totally occluded after a small d1. the distal lad filled via a patent lima graft. the lcx was totally occluded after a ramus. the left pl branch filled via collaterals from the rca. the rca had a 70% proximal stenosis with diffuse disease throughout (ffr was 0.76). 2. graft angiography showed a patent lima to lad. the svg to om1 and svg to lpl were totally occluded proximally. 3. limited hemodynamics on entry showed severe lv systolic dysfunction. there was no gradient across the aortic valve on pullback. 4. left ventriculography revealed severe systolic dysfunction with 3+ mr. there was global hypokinesis with severe posterobasal and inferior hypokinesis. 5. the proximal rca lesion was predilated with a 3.0 x 15mm voyager balloon and stented with a 3.0 x 18mm vision stent with lesion reduction from 70% to 0%. the final angiogram showed timi iii flow with no dissection and no embolisation. (see ptca comments) final diagnosis: 1. severe native 3 vessel disease. 2. patent lima to lad. occluded svg-om and svg-lpl. 3. severe lv diastolic and systolic dysfunction. 4. moderate to severe mr. 5. successful stenting of the proximal rca lesion. . brief hospital course: 65yo m cad s/p 3 vessel cabg, dm, htn, gib, anemia, depression, multiple dvts p/w worsening doe. symptoms, labs, exam, and imaging all c/w fluid overload from chf. . #dyspnea unclear inciting event for pulmonary edema, most likely from volume overload (vs. ischemia given bump in ces from prior visit). however, it is difficult to interpret these enzymes in the setting of the pt's extreme renal failure. pt's ekg paced. pe was considered given the pt's apparent prothrombotic tendencies and relative hypoxia. however, on exam there was no evidence of rv overload, and the pt is not tachycardic (although he is beta blocked and paced, so this might be masked). also, his dyspnea improved after hd. pneumonia was entertained initally due to a retrocardiac opacity, but without fever and the prompt resolution with medical management and hd, this diagnosis was exceedingly unlikely. also, the patient did not complain of a cough nor was one noted during his hospital course. the patient was managed with hd, nitrates, asa, beta blockade, heparin (initially until the diagnosis of ischemia became less likely and the patient was catheterized). the cath showed a rca lesion which was stented. he had other significant flow limiting lesions with collaterals. the patient's troponins were elevated. the ck and ckmb peaked and trended downward shortly after cath. . #cri pt on hemodialysis and followed by dr. . s/p kidney transplant that has failed. the patient received dialysis frequently during his hospitalization. . #htn pt was hypertensive on outpatient regimen. nitro gtt started and increased bb. will have patient followed as outpatient. . #gib pt had history of multiple prior gibs on anticoagulation. in the setting of what appeared to be probably ischemia, heparin was started and then discontinued after the patient went to the cath lab. he was initially guaiac positive. . #depression continued citalopram. patient was in a stable mood during his stay. continue regimen as outpatient. . # functional status pt lives with wife. pt was consulted to ensure that the patient was safe for home, which was our assessment. pt agreed that there was no further need for pt. . f/u care cardiologist- dr. ; nephrologist- dr. medications on admission: allopurinol 100mg flomax 0.4mg capsule, qd lipitor 10mg tablet qd lisinopril 2.5mg tablet qd norvasc 5mg tablet qd prednisone 5mg tablet qd protonix 40mg tablet, calcium acetate 1334 tid citalopram 10 mg daily b vitamins-folate po daily metoprolol 12.5 mg discharge medications: 1. continuation of medication continue to take your b vitamins and folate as you did before hospitalization 2. aspirin ec 325 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po once a day. disp:*30 tablet, delayed release (e.c.)(s)* refills:*2* 3. calcium acetate 667 mg capsule sig: two (2) capsule po tid w/meals (3 times a day with meals). capsule(s) 4. allopurinol 100 mg tablet sig: one (1) tablet po daily (daily). 5. tamsulosin 0.4 mg capsule, sust. release 24hr sig: one (1) capsule, sust. release 24hr po hs (at bedtime). 6. lisinopril 5 mg tablet sig: 0.5 tablet po daily (daily). 7. amlodipine 5 mg tablet sig: one (1) tablet po daily (daily). 8. prednisone 5 mg tablet sig: one (1) tablet po daily (daily). 9. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q12h (every 12 hours). 10. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 11. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day) for 14 days: do not take if you have more than 1 bowel movement daily. disp:*28 capsule(s)* refills:*0* 12. isosorbide mononitrate 30 mg tablet sustained release 24hr sig: one (1) tablet sustained release 24hr po daily (daily). disp:*30 tablet sustained release 24hr(s)* refills:*2* 13. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) for 14 days: do not take if you have more than 1 bowel movement daily. disp:*28 tablet(s)* refills:*0* 14. escitalopram 10 mg tablet sig: one (1) tablet po daily (daily). 15. toprol xl 50 mg tablet sustained release 24hr sig: one (1) tablet sustained release 24hr po once a day. disp:*30 tablet sustained release 24hr(s)* refills:*2* 16. atorvastatin 20 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* 17. b complex-folic acid 0.5-5-0.2 mg tablet sig: one (1) tablet po once a day. discharge disposition: home discharge diagnosis: congestive heart failure. discharge condition: improved discharge instructions: you have congestive heart failure. the echo studies that look at the heart and the cardiac catheterization show that your heart has decreased ability to pump. you also had a blockage of one artery that was "stented" open (a piece of hardware the keep the vessel open). some of your medications were changed. see the information below for the adjustments. we have added the following medications to your regimen: - isosorbide mononitrate (trade name: imdur) - senna - docusate - clopidogrel (trade name: plavix) - aspirin - metoprolol long acting (trade name: toprol xl). this takes the place of your old metoprolol, which was short acting - do not take the metoprolol that you have at home anymore. - atorvastatin (trade name: lipitor): you were on this medication before, but we have increased the dose from 10 mg daily to 20 mg daily. you may continue taking the bottle you have at home, but take 2 pills daily to equal 20 mg, and then get your new prescription filled for the higher dose. you should continue to take your other medicines as you did before: - allopurinol - calcium acetate (trade name: phoslo) - escitalopram (trade name: celexa) - lisinopril - pantoprazole (trade name: protonix) - prednisone - tamsulosin (trade name: flomax) - b vitamin/folate pill call your doctor or go to the er if: you have black or bloody bowel movements. you have a temperature over 100.5 degrees f your blood pressure is less than 100 or over 50 your pulse (heartbeat) is less than 50 beats each minute or over 100 beats each minute. you have swelling in your ankles, feet, hands, face, or neck. you have gained more than three pounds in one day, or five pounds in one week. you are lightheaded or dizzy, sweaty, or feel sick after you take your medicine. you cough up yellow, green, or pink sputum. you have a dry cough that does not go away. you are wheezing (a high pitched noise when breathing in or out). you do not have an appetite and do not want to eat. you have any questions or concerns about your illness or medicine seek care immediately if: you have more trouble breathing than usual or cannot sleep or rest because of breathing problems. are too dizzy to stand up. you have signs and symptoms of a heart attack. these may include the following: chest pain or discomfort that spreads to your arms, jaw, or back. nausea (sick to your stomach). trouble breathing. sweating. this is an emergency. call 911 or 0 (operator) for an ambulance to take you to the nearest hospital or clinic. do not drive yourself! followup instructions: provider , md phone: date/time: 1:10 provider , .d., ph.d. date/time: 1:00 you should see your cardiologist, dr. , in the next weeks. call ( to schedule a follow up appointment. md, procedure: insertion of non-drug-eluting coronary artery stent(s) angiocardiography of left heart structures left heart cardiac catheterization coronary arteriography using a single catheter hemodialysis cranial or peripheral nerve graft insertion of one vascular stent excision of lingual thyroid percutaneous transluminal coronary angioplasty [ptca] procedure on single vessel diagnoses: end stage renal disease subendocardial infarction, initial episode of care coronary atherosclerosis of native coronary artery diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled gout, unspecified mitral valve insufficiency and aortic valve insufficiency rheumatic heart failure (congestive) hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease other complications due to other cardiac device, implant, and graft diseases of tricuspid valve 

Answer: The patient is high likely exposed to