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: outpatient cardiologist: dr chief complaint: chest pain major surgical or invasive procedure: cardiac catheterization placement and removal of intra-aortic balloon pump swan-ganz catheter history of present illness: this is a 83 y/o m with h/o cad s/p cabg (lima to lad, svg to om, svg to d1, svg to pda) who presented with chest pain. . patient reports that his chest pain started at 5pm on the day prior to admission while eating at a birthday party. it was a sharp, constant, radiated to the left arm chest pain. it was also associated with sob and vomiting x1 this am. he took 2 ntg with no improvement. on admission refer chest pain . he felt that it was the same pain he had with prior mi. . of note he was seen on at for chest pain but per omr note there were no interventions done. he was seen by cardiology on were his lisinopril was re-started. . in the ed t 94.4, hr 83, bp 134/75 rr 26 sat 95% on ra. he was given lopressor 5 mg x2, nitroglycerin and heparin were started. ekg showed normal sinus, normal axes, hr 82, 1st degree av delay, st depression v2-v5, t waive inversion on i-, elevation on avr. ck: 406 mb: 49 mbi: 12.1 troponin 0.77. . in the cath lab: ra: 20 (mean), rv 52/11 (20), pa 55/27 (42), pcw 34, ao 103/57 (68)ci 1.29 --> 1.93 iabp findings: mr, right dominant, lmca: severe diffuse disease with moderate calcification; lad- occluded proximally, distal flow from patent ; lcx 90% lesion proximal, rca dominant vessel and occluded proximally; svg- rca patent with diffuse disease in the pda/plb; svg- om occluded; lima-lad patent. distal lcx lesion was left untreated. balloon angioplasty-- lcx and left main. dobutamine was started, iabp and lasix was given. . allergies: *nkda past medical history: cad, mi and s/p cabg () lima to lad, svg to om, svg to d1, svg to pda) diabetes type 2 gout arthritis cabg rt leg bypass - nos chf hypertension hypercholesterolemia chronic renal insufficiency peripheral vascular disease psoriasis social history: the patient currently lives at home with services for assistance with adls. he was an accountant in . he denied smoking, alcohol or illicit drugs. he does not recall any family history of premature coronary artery disease of sudden death. family history: no history of premature cad physical exam: vs: t 96.7 bp 134/58 hr 89 rr 26 95% on 5 l general: the patient was well developed, well nourished and well groomed. the patient was oriented to person, place and time. heent: no xanthalesma. conjuctiva pink. dry oral mucose. neck supple. there was no thyromegaly. jvd - lying flat ~ 7cm chest: no chest wall deformities, scolisosis or kyphosis. lungs: + crackles bilaterally anteriorly. cardiac: palpation of the heart revealed the pmi to be located in the 5th intercostal space, mid clavicular line. regular rate and rhythm, distant. balloon pump audible. abdominal: the abdominal aorta was not enlarged by palpation. there was no hepatosplenomegaly or tenderness. the abdomen was soft nontender and nondistended. extremities: no pallor, no cyanosis. there were no abdominal, femoral or carotid bruits. leg immobilizer bilaterally skin: = psoriatic plaques over extensor surface forearms right and left groin + lines. guaiac + per ed note pulses: right: carotid 2+ femoral 2+ popliteal unable to asses dp 1+ pt 1+ left: carotid 2+ femoral 2+ popliteal unable to assess dp 1+ pt 1+ pertinent results: 09:10am blood wbc-10.4 rbc-3.67* hgb-10.6* hct-33.4* mcv-91 mch-29.0 mchc-31.9 rdw-14.5 plt ct-219 06:45am blood wbc-11.2* rbc-3.72* hgb-10.7* hct-32.1* mcv-86 mch-28.8 mchc-33.4 rdw-14.5 plt ct-134* 09:10am blood neuts-89.2* bands-0 lymphs-7.6* monos-2.8 eos-0.2 baso-0.2 09:39am blood pt-12.8 ptt-91.2* inr(pt)-1.1 09:10am blood glucose-575* urean-47* creat-2.5* na-136 k-6.8* cl-95* hco3-21* angap-27* 06:45am blood glucose-181* urean-31* creat-1.6* na-143 k-4.4 cl-106 hco3-30 angap-11 09:10am blood alt-98* ast-129* ck(cpk)-406* alkphos-130* amylase-99 totbili-0.3 04:20pm blood alt-83* ast-197* alkphos-97 totbili-0.3 07:15pm blood ck(cpk)-1376* 03:15am blood alt-70* ast-162* ck(cpk)-976* alkphos-83 totbili-0.3 09:10am blood ck-mb-49* mb indx-12.1* 09:10am blood ctropnt-0.77* 07:15pm blood ck-mb-176* mb indx-12.8* ctropnt-10.65* 03:15am blood ck-mb-84* mb indx-8.6* ctropnt-7.58* 04:20pm blood calcium-9.3 phos-3.3 mg-2.7* 06:45am blood calcium-8.8 phos-2.9 mg-2.5 03:15am blood triglyc-64 hdl-51 chol/hd-3.6 ldlcalc-122 . cxr impression: improved pulmonary edema. . c cath final diagnosis: 1. acute posterior myocardial infarction. 2. three vessel coronary artery disease. 3. widely patent lima-lad and svg-rca, occluded svg-om. 4. severely elevated right and left sided filling pressures. 5. iabp placement due to low cardiac output. 6. successful ptca of the left main and ostial cx. . echo impression: regional left ventricular systolic function consistent with cad. mild pulmonary artery systolic hypertension. compared with the prior study (images reviewed) of , there is new regional dysfunction in the anterolateral wall. estimated pulmonary artery pressures are slightly higher. mitral regurgitation is not well seen on the current study. brief hospital course: this is a 83 y/o m with h/o htn, dyslipidemia, cad s/p cabg who presents with chest pain and positive enzymes. hospital course complication by: . cardiac # cad/ chest pain: patient with h/o of cad. + st changes on ekg, positive cardiac enzymes --> nstmi s/p cardiac cath with balloon angioplasty to lm + lcx. no stents placed. hemodynamics compatible with poor ci + elevated wedge. ck peaked at 1376. - received heparin/integrilin (18h) - continued aspirin/ plavix - weaned off dobutamine and then iabp - re-started acei/b-blocker once bp tolerated - no additional chest pain during his hospital course . pump: ef 30% patient with elevated pressures in the cath lab. he was in pulmonary edema on admission but was euvolemic on discharge. - he was re-started on his outpt diuretic on discharge . rhythm: nsr . # htn: blood pressure medicines initially held but lisinopril and metoprolol were re-started by discharge . # hyperlipidemia: continued high dose statin. . # acute on chronic renal insufficiency: most likely pre-renal in the setting of low cardiac index. cr 2.5 on admission but back to baseline of 1.6 on discharge. on lisinopril. . # hyperkalemia: hyperkalemic on admission likely acute renal failure. no ekg changes suggested of hyperkalemia. received calcium gluconate. resolved by discharge. . # dm/hyperglycemia: elevated on admission. apparently he was using his insulin as prescribed. anion gap acidosis on admission which may also represent his worsening renal failure with accumulation of organic anions. was not in dka. insulin gtt was started but d/c'd once taking pos. was re-started on home insulin doses on discharge. . # elevated lft's: currently on statins as outpatient. prior records on omr showed normal lft's. no history of alcohol abuse. - ? statin use, may need to decrease dose as outpatient . # fen: - cardiac/renal diet . # ??depression: will continue celexa as per outpatient regimen. . # communication: hcp (son) . # code: dnr/dni confirmed with the patient medications on admission: aspirin 81 mg once daily, celexa 10 mg once daily, clobetasol 0.05. p.r.n. colace 100 mg p.o. b.i.d humulin nph 14 units in morning and 6 units at night lipitor 80 mg q.h.s., neurontin 600 mg b.i.d. nitro-dur 0.8 one patch once daily norvasc 5 mg once daily, plavix 75 mg once daily, renexa 500 mg once daily senna two tablets b.i.d. toprol-xl 50 mg once daily, torsemide 20 mg once daily. lisinopril 5 mg /day discharge medications: 1. aspirin 325 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 2. renexa sig: five hundred (500) mg once a day. 3. atorvastatin 80 mg tablet sig: one (1) tablet po daily (daily). 4. celexa 10 mg tablet sig: one (1) tablet po once a day. 5. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). 6. insulin nph human recomb 100 unit/ml cartridge sig: as directed uniuts subcutaneous twice a day: inject 14 units each morning and 6 units each evening. 7. toprol xl 50 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po once a day. 8. torsemide 20 mg tablet sig: one (1) tablet po once a day. 9. lisinopril 5 mg tablet sig: one (1) tablet po daily (daily). 10. colace 100 mg capsule sig: one (1) capsule po twice a day. 11. senna 8.6 mg capsule sig: one (1) capsule po twice a day as needed for constipation. discharge disposition: home with service facility: , discharge diagnosis: 1. acute coronary syndrome, posterior mi 2. cardiogenic shock, s/p intra-aortic balloon pump discharge condition: stable, maintaining bp and chest pain free. discharge instructions: you were admitted with chest pain, found to have a heart attack, and underwent angioplasty to open up the arteries. in addition, your heart does not pump as well as it should. * please take all medications as prescribed * follow up with your cardiologist, dr. as previously scheduled. * follow up with your primary care physician 1 month. * weigh yourself every morning, md if weight > 3 lbs. * adhere to 2 gm sodium diet followup instructions: your cardiologist: provider: , md phone: date/time: 10:40 . your primary care physician: : , md phone: date/time: 9:30 procedure: coronary arteriography using two catheters injection or infusion of platelet inhibitor other and unspecified coronary arteriography implant of pulsation balloon pulmonary artery wedge monitoring transfusion of packed cells right heart cardiac catheterization excision of lingual thyroid percutaneous transluminal coronary angioplasty [ptca] procedure on two vessels diagnoses: anemia, unspecified coronary atherosclerosis of native coronary artery pure hypercholesterolemia congestive heart failure, unspecified diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute kidney failure, unspecified coronary atherosclerosis of autologous vein bypass graft atherosclerosis of native arteries of the extremities with intermittent claudication hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified depressive disorder, not elsewhere classified chronic kidney disease, unspecified systolic heart failure, unspecified true posterior wall infarction, initial episode of care cardiogenic shock long-term (current) use of insulin old myocardial infarction other psoriasis unspecified cataract spinal stenosis, lumbar region, without neurogenic claudication nonspecific abnormal results of function study of liver 

Answer: The patient is high likely exposed to