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: cefepime attending: chief complaint: bradycardia, chest pain major surgical or invasive procedure: dialysis history of present illness: mr is a 60 year old spanish speaking man with diabetes, hypertenion, hyperlipideamia, history of esrd on hd (tues, thurs, sat), presenting with chest pain radiating to the left arm. patient reports his symptoms started yesterday, at rest while sitting. he describes the pain as localized over the left chest, dull pressure with radiation to the back mid scapular area. no palpitations, diaphoresis or nausea. patient took nitroglycerin at home without improvement in symptoms. patient has been taking all medications as prescribed and has not skipped any dialysis sessions. he does report difficulty breathing starting with above symptoms. ems gave patient asa, atropine 1mg and nitro spray x 1. in the ed, vital signs temp 97.1 bp 150/36 rr 24 o2 sat: 99% ra patient was found to be hyperkalemic, bradycardic (junctional rhythm per report). patient underwent cta chest/abdomen and pelvis without evidence of dissection or pe. per ed report a "small amount of contrast extravasated" on the right hand. right ij line was attempted but not successful, left subclavian line was placed. patient did not receive any aspirin, plavix or heparin. renal, cardiology and ep teams were made consulted. patient was given morphine, atropine (0.5mg x 2), 10 units of iv insulin with 1 amp of dextrose, kayexalate and 2gm of calcium gluconate. past medical history: 1. coronary artery disease - s/p cabg lima-> lad, svg -> rca/pda, svg -> om1 - s/p ptca and des to proximal lad with des, poba rescue of the d1 () - s/p ptca and des sent to lm/lcx () 2. dm 3. dyslipidemia 4. hypertension 5. congestive heart failure (lvef 60%, 1+ mr (eccentric), + tr, mod pa htn) 6. peripheral disease: s/p stent to bilateral cias (genesis) and stent to , s/p poba and atherectomy of l sfa bilateral iliac artery stenting and atherectomy of the left sfa in and . 7. end-stage renal disease: diabetic nephropathy - on hd t/th/sat 8. copd 9. tracheomalacia 10. h/o c.diff colitis 11. h/o ugi bleed : egd () showed non-bleeding tear, gastropathy, and gastritis 12. pulmonary fibrosis: pet scan , no areas of abnormal fdg uptake. cannot rule out broncheoalveolar carcinoma. 13. av fistula in left arm 14. retinopathy 15. neuropathy social history: patient is originally from , . his wife and family are still there. patient currently lives alone, but his brother is nearby. he is on disability. his sister-in law works @ in housekeeping. family history: # mother, died 71: dm2 # father, died 97: htn physical exam: vs: t 95.9 hr:51 bp: 95/47 o2 sat: 95% 2l nc gen: ill appearing man, uncomfortable but in good spirits. heent: perrl, sclera anicteric, conjunctiva non injected. dry mucous membranes. cv: regular rate, loud early peaking systolic crescend murmur at rusb lungs: clear to auscultation bilaterally, no rales/rhonchi/wheezes abdomen: soft, non tender non distended, normoactive bowel sounds. no guarding, no hepato/splenomegaly extremities: cold, right hand edematous, non pitting, with impaired finger flexion and cyanotic decoloration. pulses present on doppler. pertinent results: ================== admisison labs ================== wbc-7.4 rbc-3.10* hgb-10.1*# hct-31.9* mcv-103* mch-32.6* mchc-31.7 rdw-15.0 plt ct-177 neuts-70.1* lymphs-20.0 monos-6.0 eos-3.0 baso-0.9 pt-13.0 ptt-36.4* inr(pt)-1.1 glucose-80 urean-60* creat-8.3*# na-140 k-6.3* cl-113* hco3-15* angap-18 ctropnt-0.04* ck-mb-4 calcium-6.8* phos-4.6* mg-2.5 glucose-122* lactate-1.5 na-136 k-9.0* cl-103 calhco3-22 ecg: ( @2200)bradycardic at 44, likely junctional escape rhythm (narrow qrs, no p waves, regular without variation. right bundleoid pattern, deep q waves on lead iii and deep s wave on lead i, no t wave inversion on lead iii. peaked t waves with lateral t-wave flattening . ecg: (on arrival) regular rate, likely sinus bradycardia although varying p wave morphology. peaked t waves, prolonged qtc (478), unchanged inferior q wave in iii and twi in i. echo the left atrium is elongated. there is mild symmetric left ventricular hypertrophy with normal cavity size. overall left ventricular systolic function is normal (lvef>55%). right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. physiologic mitral regurgitation is seen (within normal limits). the tricuspid valve leaflets are mildly thickened. the pulmonary artery systolic pressure could not be determined. there is no pericardial effusion. impression: mild symmetric left ventricular hypertrophy with preserved global and regional biventricular systolic function brief hospital course: 60 year old man with complicated medical history, relevant for diabetes, end stage renal disease on hd, pvd / cad s/p cabg and repeated stenting, presenting with chest pain, hyperkalemia, bradycardia. #. chest pain: acute onset of pain at rest was very concerning for unstable angina. patient with timi risk score of 5 (known stenosis, greater than 3 cad risk factors, aspirin use, recurring angina in 24 hrs and positive troponins). nonetheless, it is possible that this event constituted demand ischemia from metabolic disturbance or new valvular disease (loud murmur) leading to increase in demand. degree of known cad however severely limits interventions as pt is s/p cabg and stenting. patient was closely monitored and dialysis started at the bedside. with correction of hyperkalemia, heart rate improved spontaneously and sinus rhythm was again noted. chest pain improved significantly and remaining pain was easily reproducible to light palpation. echocardiogram was obtained to evaluate for new wall motion abnormalities or new valvular disease. results revealed preserved global systolic function and no new valvular process. with availabe information, it appears symptoms at presentation were related to bradycardia and do not warrant further workup at this time. patient no longer complaining of chest pain or shortness of breath on walking at discharge. #. right hand contrast infiltration: per report this ocurred in ed at time of cta chest/abdomen/pelvis. hand was very edematous, tight and painful, concerning for compartment syndrome. hand surgery team was and hand was elevated and splinted. patient will need follow up with hand surgery clinic. #. hyperkalemia: unclear etiology, as pt has been complient with dietary restrictions and has not missed dialysis sessions. this quickly resolved with adequate dialysis, raising concerns for sub-optimal dialysis as an outpatient. per renal team, no evidence of fistula disfunction at this time. patient to resume dialysis per outpatient regimen. #. bradycardia / junctional escape rythm: although well documented in medical record to correspond to hyperkalemia, we considered beta blocker toxicity in differential. after dialysis, rhythm spontaneouly returned to sinus and no more bradycardia was observed. there is no evidence of beta blocker toxicity. #. esrd: received dialysis, resume outpatient schedule of tues, thurs, sat. medications on admission: atorvastatin - 80 mg tablet b complex-vitamin c-folic acid - 1 mg capsule clopidogrel - 75 mg tablet daily esomeprazole magnesium - 20 mg daily lisinopril - 2.5 mg tablet daily metoprolol succinate daily nitroglycerin - 0.3 mg tablet, sublingual prn oxycodone-acetaminophen - 5 mg-325 mg tablet prn pregabalin - 25 mg capsule - capsule(s) daily ranitidine hcl - 150 mg tablet - daily hcl - 1 tablet(s) by mouth three times a day aspirin - 325 mg tablet, delayed release (e.c.) senna - 8.6 mg capsule - 1 capsule(s) by mouth prn discharge medications: 1. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). 2. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 3. atorvastatin 40 mg tablet sig: two (2) tablet po daily (daily). 4. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 5. nitroglycerin 0.3 mg tablet, sublingual sig: one (1) tablet, sublingual sublingual prn (as needed) as needed for chest pain. 6. b complex-vitamin c-folic acid 1 mg capsule sig: one (1) cap po daily (daily). 7. hcl 800 mg tablet sig: one (1) tablet po tid w/meals (3 times a day with meals). 8. acetaminophen 325 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed. 9. metoprolol succinate 25 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po daily (daily). discharge disposition: home discharge diagnosis: primary 1. junctional bradycardia secondary to hyperkalemia 2. contrast extravasation in r. hand secondary 1. coronary artery disease 2. chronic kidney disease, stage v, on hd 3. peripheral disease discharge condition: ambulating without any shortness of breath, stable, no complaints, eating, drinking well, r. arm strength 5/5 with good range of motion. discharge instructions: you were admitted for chest pain and during a scan, you had contrast extravasation which caused your hand/arm pain. you also had an incident where some of the chemicals in your blood increased to high levels (the potassium in your blood went up too high) -- as a result, we had to give you some medicatiosn to remove those chemicals along with your dialysis. you have several scheduled appointments listed below - please go to them all, and attend dialysis as scheduled. if you have any more chest pain, severe shortness of breath, severe back pain, please return back to the emergency room. followup instructions: 1. provider: clinic phone: date/time: 10:30 2. provider: function lab phone: date/time: 9:40 3. provider: , : date/time: 9:00 4. dr. :30 am md procedure: venous catheterization, not elsewhere classified hemodialysis diagnoses: hyperpotassemia end stage renal disease congestive heart failure, unspecified chronic airway obstruction, not elsewhere classified coronary atherosclerosis of unspecified type of vessel, native or graft aortocoronary bypass status diabetes with neurological manifestations, type ii or unspecified type, not stated as uncontrolled polyneuropathy in diabetes percutaneous transluminal coronary angioplasty status hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease other and unspecified hyperlipidemia other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure other specified cardiac dysrhythmias other vascular complications of medical care, not elsewhere classified diabetes with renal manifestations, type ii or unspecified type, not stated as uncontrolled chronic diastolic heart failure diabetes with ophthalmic manifestations, type ii or unspecified type, not stated as uncontrolled background diabetic retinopathy 

Answer: The patient is high likely exposed to