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: epinephrine attending: chief complaint: chest pain major surgical or invasive procedure: cardiac catheterization without intervention history of present illness: patient is a 68m h/o cad s/p cabg, dm2, cri presented to osh with chest pain. initially noted intermittent 'shooting' pains in his chest on that radiated throughout body. on at 10am, developed substernal chest pressure while defecating that radiated to the neck. associated with diaphoresis and nausea but no sob. he took sl nitro x 3 without improvement and called ems. at osh, ecg revealed sub-mm st elevations and twis in v5- depressions v1-v4. cardiac enzymes were positive (ck 409, mb 17, mbi 4, tnt 2.4). given aspirin 325mg, plavix 600mg load, iv lopressor, and heparin gtt. he became pain free on nitro gtt and morphine prn. bnp 4300 with normal cxr. on early am, he was found to be in af with rvr 120's. no prior h/o af or palpitations per his report. transferred to for cath. received pre-cath hydration. cath revealed totally occluded native vessels, fresh thrombus in svg->om, and occluded stubs in the svg->diag and svg->rca; the svg->pda and lima->lad were patent. no intervention given >48hrs since event. right heart cath was not performed. while in holding area s/p cath, became increasingly dyspnic. noted to be in af with hr 110's. denies palpitations. also somnolent s/p fentanyl with observed apneic episodes. chest pain free. on ros, reports claudication for years. currently can walk only 10 feet without pain, resolves with rest. no resting claudication. denies pnd and ankle edema. recent worsened orthopnea (1->2 pillow). no abdominal pain, nausea, vomiting, diarrhea, melena, hematochezia, headache, fevers, or chills. past medical history: 1) cad s/p cabg () - lima->lad - svg->om - svg->diag - svg->rca - svg->pda 2) imi () c/b transient complete heart block 3) htn 4) hypercholesterolemia 5) tobacco abuse 6) dm2 with nephropathy, neuropathy 7) obesity 8) cri 9) pvd h/o right femoral artery occlusion 10) cataracts 11) low back pain social history: retired, lives alone. current smoker, 50 pack-year history. glasses wine with dinner. no illicits. family history: mother with mi (died 62). father with dm2 and metastatic prostate ca. physical exam: vitals t 97.0 hr 107 irregular bp 121/72 rr 16 sao2 97% ra weight 93kg general: wdwn, mild tachypnea heent: perrl, eomi, anicteric sclera, conjunctivae pink neck: supple, trachea midline, no lad, unable to assess jvp, no bruits cardiac: irregularly irregular, s1s2 normal, no m/r/g pulmonary: crackles left base, scattered mild expiratory wheeze abdomen: +bs, soft, obese, voluntary guarding, no rebound, no hsm extremities: cool, 1+ dp pulses, no edema neuro: somnolent but arousable, oriented, speech clear, follows commands, cnii-xii intact, grip strength upper extremities, 5/5 strength lower extremities, ftn intact, dtrs 2+ biceps and patellar, downgoing toes bilaterally pertinent results: laboratory results: 01:42pm wbc-10.8 rbc-4.68 hgb-15.1 hct-42.2 mcv-90 mch-32.2* mchc-35.8* rdw-13.7 01:42pm plt count-197 01:42pm pt-12.0 ptt-25.5 inr(pt)-1.0 01:42pm glucose-269* urea n-39* creat-1.7* sodium-139 potassium-4.0 chloride-97 total co2-29 anion gap-17 01:42pm alt(sgpt)-32 ast(sgot)-48* ld(ldh)-583* ck(cpk)-283* alk phos-71 amylase-42 tot bili-1.4 01:42pm lipase-20 01:42pm ck-mb-12* mb indx-4.2 ctropnt-2.56* 01:42pm calcium-8.7 phosphate-3.7 magnesium-2.3 01:42pm tsh-1.7 07:00am blood wbc-12.6* rbc-4.10* hgb-13.2* hct-36.5* mcv-89 mch-32.2* mchc-36.1* rdw-13.8 plt ct-199 10:20am blood pt-13.7* ptt-112.4* inr(pt)-1.2* 07:00am blood glucose-72 urean-42* creat-1.5* na-141 k-3.6 cl-100 hco3-27 angap-18 . ecg (): atrial fibrillation, 109 bpm, normal axis and intervals, sub-mm ste and twi v5-6, std v1-v4 . relevant imaging: 1)cardiac cath (): 1. coronary angiography in this right dominant system demonstrated lmca without angiographically significant disease. the lad, lcx and rca were all proximally occluded, as previously known. 2. the lima to lad graft was widely patent and the distal lad was satisfactory. the svg to pda was patent. the svg to r-pl and the svg to om were totally occluded stubs. the svg to diagonal was freshly occluded with thrombus present. 3. limited resting hemodynamics revealed systemic arterial pressure of 98 mmhg systoic and 66 mmhg at diastole. 4. recommend medical therapy; svg to diagonal not suitable for pci or thrombolytics. final diagnosis: 1. three vessel coronary artery disease. 2. patent lima to lad and svg to r-pda. occluded svgs to om, diagonal and r-pl. . 2)echo():1. the left atrium is markedly dilated. the right atrium is moderately dilated. 2. the left ventricular cavity is moderately dilated. overall left ventricular systolic function is severely depressed. inferior and lateral hypokinesis to akinesis is present. 3. the aortic root is mildly dilated. the ascending aorta is mildly dilated. 4. the aortic valve leaflets are mildly thickened. 5. the mitral valve leaflets are mildly thickened. mild to moderate (+) mitral regurgitation is seen. 6. there is mild pulmonary artery systolic hypertension. 7. there is a small to moderate sized pericardial effusion. . 3)cxr ():mild cardiomegaly. cannot exclude small pleural effusion. . 4)cxr (): 1. interval development of infiltrate in right lower lobe worrisome for pneumonia. 2. pulmonary vascular engorgnent with bilateral pleural effusions in the setting of cardiomegaly, likely representing chf. brief hospital course: a/p: 68m h/o cad s/p cabg presents with stemi, new-onset af with rvr, and dyspnea. . # cad: the patient was taken to cardiac cath which revealed fresh thrombus in svg->om graft and likely old totally occlusion of svg->rca and svg->diag grafts. the svg->om and lima->lad grafts were patent. no intervention was performed given that the patient presented >48 hours from symptom onset and infarction completed. tte revealed new lateral wall hypokinesis and diminished systolic function c/w recent infarct. he was given aspirin, plavix, statin, beta-blocker; however plavix was discontinued prior to discharge given no pci. he will f/u with his cardiologist. . # chf: ef 35%. initially volume overloaded but diuresed with lasix and euvolemic at discharge; started on toprol xl and lisinopril. 2gm na diet. . # atrial fibrillation: paroxysmal. af with rvr at presentation, spontaneously converted to sinus rhythm and then back into af. loaded with amiodarone (normal qtc, tfts, and lfts; he will need outpatient pfts) and cont on beta-blocker for rate control. heparin gtt started and bridged to coumadin with goal inr . he was given of hearts monitor at discharge. . # chest/neck pain: multiple episodes of sharp migratory stabbing pains during admission. ddx included pericarditis, musculoskeletal pain, or rate relate angina. atypical for angina, no specific ecg changes, and cardiac enzymes cont to trend down. he was given tylenol prn with good response. . # anemia: hct decreased likely due to blood loss during cath and dilutional componenent from pre-cath fluids. remained stable. no groin hematoma/bleeding and rp bleed unlikely. will need outpatient hct check by pcp. . # dyspnea: likely volume overload from pre-cath hydration for iv contrast nephropathy prophylaxis. cxr revealed small left effusion, rll opacity. low-grade fevers and mild elevation wbc; started ceftriaxone and azithromycin. discharged to complete course of augmentin. . # pericardial effusion: small volume, noted incidentally on echocardiogram. possibly post-mi. no evidence tamponade physiology. pulsus ~ 7. suggest outpatient f/u echo to assess resolution. . # acute on cri: baseline cre ~1.4; initially increased to 1.7 but returned baseline prior to discharge. likely pre-renal. received pre-cath hydration for iv contrast nephropathy prophylaxis. . # dm: hyperglycemic at presentation with daytime blood sugars 200's. cont regimen regimen of nph/humalog and fs qid with hiss. . # altered mental status: pt somewhat confused intially. ddx includes sundowning vs. toxic-metabolic peri-cath medications and hypercarbia, however given af of unclear duration there was initial concern for embolic disease. neuro consulted who believed low likelihood cva. ct head with no bleed, mass effect but did reveal old lacunar infarcts. u/a neg, culture pending. mental status cleared. . # abnormal lfts: elevated ast likely passive hepatic congestion due to volume overload. . # hypercholesterolemia: cont statin . # respiratory alkalosis: resolved. probable hyperventilation due to pain in setting of bicarb infusion for renal protection. pt is likely co2 retainer from osa. . # low back pain: no acute issues, tylenol prn . # ?sleep apnea: noted to have apnic periods during admission. obese body habitus. would recommend outpatient sleep study for osa. . medications on admission: at home: imdur 30mg qd folate 1mg qd lipitor 20mg qd lopressor 25mg nph insulin 16 qam 45qpm humalog insulin 10 qam 18 qpm on transfer: aspirin 325mg qd plavix 75mg qd lipitor 80mg qd lopressor 25mg nitropaste 1" q6h colace 100mg qd folate 1mg qd insulin discharge medications: 1. amiodarone 200 mg tablet sig: 1-2 tablets po bid (2 times a day): please take one pill twice a day for 14 days, then take one pill once a day ongoing. disp:*90 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. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 4. atorvastatin 80 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 5. nitroglycerin 0.3 mg tablet, sublingual sig: one (1) tablet, sublingual sublingual prn (as needed) as needed for chest pain. disp:*30 tablet, sublingual(s)* refills:*0* 6. metoprolol succinate 100 mg tablet sustained release 24hr sig: one (1) tablet sustained release 24hr po daily (daily). disp:*30 tablet sustained release 24hr(s)* refills:*2* 7. lisinopril 5 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 8. warfarin 2 mg tablet sig: one (1) tablet po once a day: start on . disp:*30 tablet(s)* refills:*2* 9. insulin nph human recomb 100 unit/ml suspension sig: one (1) months supply subcutaneous twice a day: 16 units qam 45 units qpm. 10. humalog 100 unit/ml solution sig: one (1) months supply subcutaneous twice a day: 10 units qam 18 units qpm. 11. augmentin xr 1,000-62.5 mg tablet sustained release 12hr sig: two (2) tablet sustained release 12hr po twice a day for 7 days. disp:*28 tablet sustained release 12hr(s)* refills:*0* discharge disposition: home discharge diagnosis: st elevation myocardial infarction atrial fibrillation discharge condition: good discharge instructions: please return to the hospital or call your pcp if you experience any shortness of breath, chest pain, lightheadedness, or any other symptoms that concern you. . you have been started on several new medications during this admission. please make sure to take all medications as prescribed. . new medications: amiodarone, augmentin, lisinopril, coumadin, aspirin, toprol xl, nitroglycerin discontinued medications: imdur, lopressor changed medications: lipitor . note, you have been started on coumadin. you must have your inr checked regularly by your pcp. follow up with all appointments that have been made for you. . you have been diagnosed with atrial fibrillation. you are on a medication called amiodarone which will help keep your heart beating in normal sinus rhythm. this medication must be monitored. you will need to follow up with dr. for your atrial fibrillation and amiodarone dosage. please keep this appointment. followup instructions: you need to have your inr (coumadin) level checked at your pcp's lab on friday . they will call you with a time. call for your appointment time if you have not heard from them by . . you have an post-discharge f/u appointment with your pcp, , at 2:30pm on . phone: . . please follow up with dr. on at 1:15pm. . please follow up with dr. , (, , -4 on at 1:20pm. . procedure: coronary arteriography using two catheters left heart cardiac catheterization other and unspecified coronary arteriography diagnoses: pneumonia, organism unspecified nephritis and nephropathy, not specified as acute or chronic, in diseases classified elsewhere obstructive sleep apnea (adult)(pediatric) pure hypercholesterolemia tobacco use disorder congestive heart failure, unspecified acute posthemorrhagic anemia acute myocardial infarction of other anterior wall, initial episode of care atherosclerosis of native arteries of the extremities with intermittent claudication cardiac complications, not elsewhere classified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified atrial fibrillation diabetes with neurological manifestations, type ii or unspecified type, not stated as uncontrolled polyneuropathy in diabetes chronic kidney disease, unspecified systolic heart failure, unspecified long-term (current) use of insulin old myocardial infarction cardiac catheterization as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure long-term (current) use of anticoagulants other complications due to other cardiac device, implant, and graft obesity, unspecified lumbago diabetes with renal manifestations, type ii or unspecified type, not stated as uncontrolled unspecified cataract family history of diabetes mellitus postmyocardial infarction syndrome family history of malignant neoplasm of prostate 

Answer: The patient is high likely exposed to