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: stemi, s/p pci with rca perforation at osh major surgical or invasive procedure: iabp and swan ganz catheter placement rvad placement history of present illness: 64 m with htn and hyperlipidemia admitted to osh for elective r knee replacement. post-operatively, he developed symtpoms of indigestion and chest pain with ste's in the inferior leads. he was sent to for catheterization. apparently, two days prior to his surgery he reported intermittent chest pain to his wife that he minimized. pre-operatively, there were no ekg changes compared to prior tracings. . at osh cath, he was found to have a right dominant system and had subtotally occluded rca. there was 60% mid lad and 80-90% d1 disease; no disease in lcx. thrombectomy of the rca lesion was performed. the procedure was complicated by a perforation and dissection of his rca. a 9x20 balloon was deployed at the perforation and he was started on neo and dopamine for hypotension. he also had a bradycardic arrest and needed temporary pacing. he was then transferred to . . at catherization here, he was semi-electively intubated. his pressures dropped and a balloon pump was placed with neo and dopamine running. two coated stents were placed at rca along with one bms distally. he is then transferred to the ccu. . ros: from his wife, he had been feeling well prior to surgery: denies sob, stable 2 pillow orthopnea, stable mild ankle edema, no pnd, no claudications, no stroke, no bleeding disorder, no gi bleeding, no palpitations, no syncope. past medical history: htn hyperchol s/p r tkr r knee and l knee meniscetomy appendectomy ? impaired glucose tolerance social history: occasional pipe smoker; mild tobacco use in the past. currently lives with wife, semi retired plumber. family history: no known fh of early cad per family physical exam: gen: intubated and sedated heent: right pupil 6mm reacting to 5mm, left 5mm to 4mm. neck: obese, cannot assess jvp. cv: distant heart sounds. s1, s2, rrr, intraaortic balloon pump, no murmurs, gallops or rubs. pulm: ctab anteriorly abd: soft, nt, nd, +bs. obese. ext: trace peripheral edema, balloon pump r groin, dp/pt dopplerable bl pertinent results: admission labs wbc-13.5* rbc-3.71* hgb-11.2* hct-33.8* mcv-91 mch-30.1 mchc-33.1 rdw-13.7 plt ct-222 neuts-92.3* lymphs-4.7* monos-2.8 eos-0.1 baso-0.1 pt-15.1* ptt-30.1 inr(pt)-1.3* glucose-315* urean-19 creat-1.0 na-137 k-5.9* cl-107 hco3-18* angap-18 alt-70* ast-256* ld(ldh)-820* alkphos-34* totbili-1.0 %hba1c-6.0* triglyc-117 hdl-31 chol/hd-4.9 ldlcalc-99 art rates-/20 po2-39* pco2-48* ph-7.22* caltco2-21 base xs--8 intubat-not intuba comment-non-rebrea conclusions study performed in the cvicu, under sedation, with care team present to dynamically assess rvad weaning. no spontaneous echo contrast or thrombus is seen in the body of the left atrium or left atrial appendage. the right atrium is dilated. the interatrial septum is dynamic and bows into the left atrium but no atrial septal defect is seen by 2d or color doppler. there is moderate symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. regional left ventricular wall motion is normal. left ventricular systolic function is hyperdynamic (ef>75%). the right ventricular cavity is dilated. there is severe hypokinesis of the basal and mid right ventricular free wall with sparing of the right ventricular apex. comparted to the study from , the basal and mid walls appear improved. with weaning of rvad support, little if any change in right ventricular size and/or function is appreciated. no changes are appreciated in the left ventricle either. there are simple atheroma in the aortic arch. the descending thoracic aorta is mildly dilated. there are simple atheroma in the descending thoracic aorta. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. very trace aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. mild (1+) mitral regurgitation is seen. there is a small pericardial effusion. there is a left pleural effusion. dr. was notified in person of the results in the icu at the time of the study. i certify that i was present for this procedure in compliance with hcfa regulations. electronically signed by , md, interpreting physician 15:24 04:42am blood wbc-18.0* rbc-3.33* hgb-11.0* hct-30.9* mcv-93 mch-33.0* mchc-35.6* rdw-22.1* plt ct-146*# 04:42am blood pt-19.0* ptt-76.3* inr(pt)-1.8* 04:41pm blood glucose-137* urean-41* creat-1.6* na-131* k-4.6 cl-97 hco3-18* angap-21* echocardiography report , portable tee (complete) done at 4:53:29 pm final referring physician information , r. , division of cardiothorac , status: inpatient dob: age (years): 64 m hgt (in): 71 bp (mm hg): 100/62 wgt (lb): 270 hr (bpm): 90 bsa (m2): 2.40 m2 indication: congestive heart failure. icd-9 codes: 428.0, 427.31, 424.0 test information date/time: at 16:53 interpret md: , md test type: portable tee (complete) son: doppler: full doppler and color doppler test location: west echo lab contrast: none tech quality: adequate tape #: 2009w004-1:50 machine: vivid i-4 sedation: versed: 4 mg fentanyl: 150 mcg (see comments below for other sedation.) patient was monitored by a nurse throughout the procedure echocardiographic measurements results measurements normal range left ventricle - ejection fraction: 40% to 50% >= 55% findings patient was intubated, sedated (on midazolam and fentanyl drips), and paralyzed (with cisatracurium besylate) for the procedure. this study was compared to the prior study of . left atrium: moderate la enlargement. right atrium/interatrial septum: markedly dilated ra. no asd by 2d or color doppler. left ventricle: moderate symmetric lvh. low normal lvef. right ventricle: small rv cavity. severe global rv free wall hypokinesis. aorta: mildly dilated ascending aorta. simple atheroma in descending aorta. aortic valve: mildly thickened aortic valve leaflets (3). mitral valve: mildly thickened mitral valve leaflets. mild (1+) mr. tricuspid valve: mildly thickened tricuspid valve leaflets. mild tr. pericardium: trivial/physiologic pericardial effusion. general comments: a tee was performed in the location listed above. i certify i was present in compliance with hcfa regulations. the patient was monitored by a nurse throughout the procedure. the patient was monitored by a nurse in throughout the procedure. the patient was sedated for the tee. medications and dosages are listed above (see test information section). image quality was suboptimald - poor esophageal contact. the patient appears to be in sinus rhythm. compared with the findings of the prior study, the findings are similar. echocardiographic results were reviewed by telephone with the md caring for the patient. conclusions the left atrium is moderately dilated. the right atrium is markedly dilated. no atrial septal defect is seen by 2d or color doppler but marked bowing of the intra-atrial septum leftward was noted, indicative of elevated right-sided pressure. overall left ventricular systolic function is normal (lvef 50-55%) with inferior wall hypokinesis. the right ventricular cavity appears somewhat small with severe global free wall hypokinesis. a catheter was noted at the rv outflow tract. the ascending aorta is mildly dilated.there are simple atheroma in the thoracic aorta. the aortic valve leaflets (3) are mildly thickened. the mitral valve leaflets are mildly thickened. mild (1+) mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. there is a trivial/physiologic pericardial effusion. large pleural effusion was incidentally noted. compared with the prior study (images reviewed) of :the rv appeared smaller. impression: low-normal lvef with inferior hypokinesis. severely dilated ra, the rv was smaller than seen on previous studies and remains severely depressed. large pleural effusion. dr. was notified by telephone after the procedure. i certify that i was present for this procedure in compliance with hcfa regulations. electronically signed by , md, interpreting physician 18:03 brief hospital course: ccu course: patient was initially transferred from cath lab to ccu intubated with iabp and swan ganz catheter in place. he was initially on dopamine and neosynephrine to maintain maps in 50s but subsequently had increased pressor requirement, maxed out on dobutamine, dopamine, neosynephrine and levophed. initial cvp was high around 20 so he did not receive fluids but subsequently received 3l ns boluses due to low cvps around . he developed afib and cardioversion was attempted x 3 with 200j, 300j, then 350 j. he converted to junctioanl rhythm then sinus, but bps remained low with maps in 40s-50s. c- was consulted and he was taken emergently to the or for rvad placement. transferred to the cvicu in critical condition on levophed, epinephrine, and propofol drips. iabp removed on pod #2. over the course of the week, drips were titrated while rv and lv function were monitored closely. cvvh was instituted for volume management with acute renal failure. liver failure also noted post- rv failure. necrotic areas noted on left hand and left foot.continued to require epinephrine and levophed support. head/ abd ct scan negative on . vasopressin required for escalating pressor support. continued to have intermittent a fib. emergent bedside bronchoscopy done on for thickened bloody secretions. his marked acidosis continued with hypotension despite maximal pressor support. family decided to withdraw support and comfort measures only were instituted. pt. expired at 19:55 with family at bedside. medications on admission: dobutamine drip dopamine drip levophed drip discharge disposition: expired discharge diagnosis: myocardial infarction s/p intra-aortic balloon pump right heart failure s/p right ventricular assist device cardiogenic shock hypertension hyperlipidemia coronary artery disease s/p pci of rca right total knee replacement liver failure renal failure discharge condition: death procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more extracorporeal circulation auxiliary to open heart surgery insertion of non-drug-eluting coronary artery stent(s) coronary arteriography using two catheters diagnostic ultrasound of heart hemodialysis venous catheterization for renal dialysis insertion of temporary transvenous pacemaker system implant of pulsation balloon insertion of implantable heart assist system excision of lingual thyroid percutaneous transluminal coronary angioplasty [ptca] procedure on single vessel insertion of three vascular stents diagnoses: thrombocytopenia, unspecified coronary atherosclerosis of native coronary artery acute and subacute necrosis of liver acute kidney failure, unspecified cardiac complications, not elsewhere classified atrial fibrillation accidental puncture or laceration during a procedure, not elsewhere classified acute respiratory failure cardiogenic shock acute myocardial infarction of other inferior wall, initial episode of care primary pulmonary hypertension left heart failure accidental cut, puncture, perforation or hemorrhage during other specified medical care urinary complications, not elsewhere classified 

Answer: The patient is high likely exposed to