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: penicillins attending: chief complaint: cardiac arrest major surgical or invasive procedure: endotracheal intubation cardiac catheterization arterial line history of present illness: this is an 85 year-old male with a history of cad s/p cabg (svg-lcx, lima-lad), redo in (svg>pda) with avr, constrictive pericarditis, type 1 dm who presents from home after pea arrest. history is obtained from his assistant. patient had been in his usual state of health this morning according to his daughter and assistant. at 1245 he ambulated from the kitchen to the bathroom and complained of shortness of breath. he sat down in the chair to rest, turned red then white and was gasping for breath. he then slumped in the chair and became unresponsive. 911 was called and reportedly arrived within 3-5 minutes. according to the ed report, patient had initial rhythm of pea. cpr was initiated and patient was then noted to be in vt. he was given epinephrine, atropine and lidocaine and converted to sinus tach with bp 120. patient was brought to . . on arrival to the ed, bp was 68/41. he was intubated and started on amiodarone gtt and levophed. ekg showed atrial fibrillation with ste in avr, v1 with std in ii, iii, v3-v6. initial labs notable for lactate of 5.1, creatinine 1.4, ck 1119, mb 10 and troponin 0.09. abg was 7.19/43/453. he was taken emergently to cath lab and found to have patent lima and vein grafts. he had a stenosis of his distal lad treated with balloon angioplasty. . on arrival to the ccu, the patient is intubated with good oxygenation. he arrives on amiodarone gtt, off of all pressors. hr 80s in atrial fibrillation, bp 140-150s/80s. he is noted to have mild facial twitching bilaterally. he is unresponsive off of sedation. . of note, the patient was admitted to in for bradycardia. he was admitted to osh on s/p fall and noted to have ste in avr. troponins elevated to 0.53, ckmb 28.6. cath with bms x2 to left main, given amiodarone for atrial ectopy and diuresed for heart failure. he was then admitted to on with bradycardia attributed to amiodarone and improved without other interventions. . patient has 24 hour care at home. at baseline he is dyspneic with minimal exertion and reportedly progressively worse over recent months. past medical history: cad s/p cabg in (lima>lad, svg>lcx), redo in (svg>pda) bioprosthetic avr constrictive/restrictive pericarditis congestive heart failure, unknown ef. recent admission at for decompensated chf. diabetes mellitus, type 1 on nph at home. hypertension . cardiac risk factors: diabetes, dyslipidemia, hypertension . cardiac history: cabg, in anatomy as follows: - lima to lad - svg to lcx - redo in with svg to pda . cath : revealed lm subtotally occluded at origin and lad w/ diffuse calcified 60% proximal stenosis occluded imediately after origin of d1 and d1 has 80% stenosis proximally, left circumflex is proximally totally occluded, rca with ostial/proximal 60-70% stenosis and fills competitively distally via the svg to pda. graft angiography revealed widely patent svg to right pda. bms placed in left main with persistetn 60% stenosis due to recoil so another bms was placed with timi 3 flow throughout. . pacemaker/icd: none. social history: (obtained from d/c summary dated ) lives alone in an elevator access in . works parttime out of his home. he has history of smoking, quit 15 years ago. occasional etoh. very involved family. . unable to obtain review of systems. reportedly patient has been free of chest pain. positive doe, le edema as above. family history: unable to obtain family history, as pt unresponsive and information obtained from assistant. physical exam: vs t 93.4, bp 157/81, hr 77 (af), rr 18, o2sat 100% on cmv 550/16/peep 5. gen: intubated elderly male with oozing from et tube. unresponsive to commands off of sedation. mild facial twitching around bilateral eyes and upper lip. + myoclonic jerks. heent: ncat. sclera anicteric. pupils are constricted, minimally responsive. neck: supple with jvp flat, lying flat. cv: pmi located in 5th intercostal space, midclavicular line. irregularly irregular rhythm, nl s1, loud s2. no murmurs appreciated. chest: intubated. no chest wall deformities, scoliosis or kyphosis. resp were unlabored, no accessory muscle use. cta anteriorly. abd: soft, nondistended. abd aorta not enlarged by palpation. no abdominial bruits. ext: cool extremities with bilateral chronic venous stasis changes. right groin line with oozing. left aline in place. dopplerable pulses in bilateral pt, dp. 1+ edema bilaterally. neuro: pupils reactive but constricted. patient is not responsive to commands. pertinent results: labs on admission: 02:00pm wbc-6.8 rbc-3.43* hgb-10.4* hct-33.2* mcv-97 mch-30.3 mchc-31.3 rdw-16.6* 02:00pm pt-17.3* ptt-32.0 inr(pt)-1.6* 02:00pm plt count-136* 02:00pm fibrinoge-207 02:00pm ctropnt-0.09* 02:00pm ck-mb-10 mb indx-0.9 02:00pm ck(cpk)-1119* 02:00pm lipase-27 02:20pm glucose-224* lactate-5.1* na+-138 k+-4.0 cl--107 tco2-16* 02:00pm urea n-48* creat-1.4* 02:13pm type-art po2-453* pco2-43 ph-7.19* total co2-17* base xs--11 intubated-intubated vent-controlled 03:00pm glucose-98 lactate-3.0* k+-3.9 03:00pm type-art rates-/16 tidal vol-550 o2-100 po2-399* pco2-36 ph-7.27* total co2-17* base xs--9 aado2-291 req o2-54 -assist/con intubated-intubated labs during admission: 04:10am blood wbc-9.6 rbc-3.47* hgb-10.7* hct-32.0* mcv-92 mch-30.9 mchc-33.5 rdw-16.8* plt ct-152 04:20am blood wbc-14.1* rbc-3.33* hgb-9.9* hct-30.8* mcv-92 mch-29.6 mchc-32.0 rdw-16.6* plt ct-163 04:00am blood wbc-11.3* rbc-2.77* hgb-8.7* hct-25.1* mcv-91 mch-31.3 mchc-34.5 rdw-17.1* plt ct-162 04:10am blood pt-16.6* ptt-34.2 inr(pt)-1.5* 04:00am blood pt-18.5* ptt-38.1* inr(pt)-1.7* 04:10pm blood glucose-118* urean-63* creat-1.9* na-137 k-5.0 cl-105 hco3-17* angap-20 02:57pm blood glucose-108* urean-71* creat-3.1* na-131* k-6.3* cl-100 hco3-14* angap-23* 04:00am blood glucose-132* urean-78* creat-3.6* na-132* k-5.5* cl-102 hco3-14* angap-22* 02:00pm blood ck(cpk)-1119* 09:00pm blood ck(cpk)-1076* 04:00am blood alt-533* ast-550* ld(ldh)-519* ck(cpk)-327* alkphos-120* totbili-0.9 04:20am blood alt-145* ast-153* ld(ldh)-497* ck(cpk)-669* alkphos-134* totbili-0.9 02:00pm blood ctropnt-0.09* 02:00pm blood ck-mb-10 mb indx-0.9 04:17pm blood ck-mb-11* ctropnt-0.15* 09:00pm blood ck-mb-15* mb indx-1.4 ctropnt-0.39* 04:10am blood ck-mb-20* mb indx-1.9 ctropnt-0.44* 04:20am blood ck-mb-17* mb indx-2.5 ctropnt-0.73* 04:00am blood ck-mb-8 ctropnt-0.63* 04:10pm blood calcium-8.3* phos-6.1* mg-2.1 04:20am blood albumin-3.5 calcium-7.9* phos-7.6* mg-1.9 04:00am blood albumin-2.9* calcium-8.3* phos-8.6* mg-2.5 04:00am blood phenyto-7.2* 02:13pm blood type-art po2-453* pco2-43 ph-7.19* caltco2-17* base xs--11 intubat-intubated vent-controlled 08:14am blood type-art po2-62* pco2-31* ph-7.33* caltco2-17* base xs--8 intubat-intubated 05:11am blood type- temp-37.3 rates-16/16 tidal v-550 peep-5 fio2-40 po2-48* pco2-28* ph-7.35 caltco2-16* base xs--8 intubat-intubated 02:20pm blood glucose-224* lactate-5.1* na-138 k-4.0 cl-107 calhco3-16* 04:31pm blood lactate-1.6 09:48am blood lactate-2.7* 04:11am blood lactate-1.5 09:30am urine rbc->50 wbc->50 bacteri-many yeast-none epi- 09:30am urine blood-lg nitrite-neg protein-30 glucose-neg ketone-tr bilirub-sm urobiln-neg ph-6.5 leuks-mod 09:30am urine color-yellow appear-cloudy sp -1.035 09:30am urine hours-random creat-63 na-less than 09:30am urine osmolal-318 microbiology: 9:30 am urine source: catheter. **final report ** urine culture (final ): escherichia coli. 10,000-100,000 organisms/ml.. presumptive identification. sensitivities: mic expressed in mcg/ml _________________________________________________________ escherichia coli | ampicillin------------ <=2 s ampicillin/sulbactam-- <=2 s cefazolin------------- <=4 s cefepime-------------- <=1 s ceftazidime----------- <=1 s ceftriaxone----------- <=1 s cefuroxime------------ 4 s ciprofloxacin---------<=0.25 s gentamicin------------ <=1 s meropenem-------------<=0.25 s nitrofurantoin-------- <=16 s piperacillin---------- <=4 s piperacillin/tazo----- <=4 s tobramycin------------ <=1 s trimethoprim/sulfa---- <=1 s . ekg on admission demonstrated atrial fibrillation with rbbb, ste in avr, v1 and std in v3-v6. . post cath ekg with atrial fibrillation, rate 81, rbbb, q waves v1-v2, resolution of ste in v1, 1-2mm residual ste in avr. . telemetry on admission demonstrated: atrial fibrillation . imaging: cardiac cath comments: 1. coronary angiography of this right dominant system revealed diffuse, severe three vessel coronary artery disease. the lmca was severely diseased and subtotally occluded. the lad was occluded proximally and filled distally via the lima graft. there was a distal 80% stenosis in the native lad. the lcx was occluded proximally. the large om fills via the svg graft, which also fills the lcx retrograde, demonstrating a mid vessel 70% lesion. the rca was severely diseased with subtotal occlusion in the proximal to mid vessel. the distal rca fills via the svg with a moderate lesion in the small mid-pda, distal to the graft touchdown. 2. arterial conduit angiography demonstrated patent lima-lad, svg-om, and svg-rca grafts, with severe disease in the native vessels as described. 3. limited resting hemodynamics revealed a low-normal systemic arterial blood pressure on vasopressors (sbp 118 mm hg). 4. successful ptca of the distal lad was performed using 2.0mm and 2.25mm diameter balloons. final angiography showed normal flow, no apparent dissection, and no residual stenosis. final diagnosis: 1. severe native three vessel coronary artery disease. 2. patent lima-lad, svg-om, and svg-rca grafts. 3. ptca of the distal lad was performed. . cxr impression: limited evaluation of the chest due to underlying trauma board and various radiopaque objects. within this limitation no acute intrathoracic abnormality. a repeat pa and lateral chest radiograph is recommended after stabilization to establish the patient's baseline. . ct head w/o contrast impression: 1. no acute intracranial hemorrhage or major vascular territorial infarct. 2. moderate ethmoidal sinus disease. . cta chest impression: 1. negative examination for pulmonary embolism. evidence of pulmonary hypertension. 2. moderate amount of right-sided effusion associated with adjacent atelectasis. 3. pleural and pericardial calcified plaques could suggest prior exposure to asbestos. 4. emphysematous changes in both lungs with scattered bullae. 5. lung fibrosis, more prominent in the left lung. 6. enlarged mediastinal and hilar lymph nodes, measuring up to 10.6 mm. . echo the left atrium is mildly dilated. there is mild symmetric left ventricular hypertrophy with normal cavity size. there is mild global left ventricular hypokinesis (lvef = 50%). the right ventricular cavity is moderately dilated with moderate global free wall hypokinesis. a bioprosthetic aortic valve prosthesis is present. a mitral valve annuloplasty ring is likely present (could be heavy mitral annular calcification). there is mild lv inflow gradient (6 mmhg). mild (1+) mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. moderate tricuspid regurgitation is seen. there is moderate pulmonary artery systolic hypertension. there is no pericardial effusion. impression: mild global left ventricular systolic dysfunction. normally-functioning aortic valve bioprosthesis. likely mitral annuloplasty ring (vs. heavy mitral annular calcification) with mild lv inflow obstruction. moderate tricuspid regurgitation. moderate pulmonary hypertension. . ekg slow atrial flutter versus atrial tachycardia. the q-t interval is prolonged. there are q waves in the anterior leads consistent with prior infarction. non-specific st-t wave changes. compared to the previous tracing the rhythm has changed and the q-t interval is now prolonged. tracing #4 rate pr qrs qt/qtc p qrs t 48 0 110 546/525 0 -10 -100 . cxr findings: in comparison with the study of , the tip of the endotracheal tube lies approximately 5 cm above the carina. there is prominence of ill-defined pulmonary vessels, consistent with vascular congestion secondary either to overhydration or cardiac failure in a patient who has undergone a previous cabg procedure. nasogastric tube has been inserted and extends at least to the upper stomach. old healed rib fractures are again seen. . ct head w/o contrast study date of 4:38 pm impression: no acute abnormality or evidence for herniation. . neurophysiology report eeg study date of impression: this telemetry captured a single pushbutton activation, likely a test, with no change in the very suppressed eeg or in movement by video. early in the record there was a very fast activity background suggestive of medication effect. beginning with the afternoon of , the background was of such low voltage that no clearly cortical electrical activity was evident. this suggests an extemely severe encephalopathy, but it could be caused by medication or temperature change. the cardiac monitor suggested some form of conduction block, this would be assessed much better by routine cardiac tracings. . neurophysiology report eeg study date of impression: this telemetry captured no pushbutton activations. routine sampling and automated detection programs showed a very low voltage slow background with occasional additional bursts of slowing and a very infrequent sharp features. there were no simple spike or sharp and slow wave complexes. there were no electrographic seizures. overall, the recording indicates a severe encephalopathy. this can be due to medications, anoxia, or hypothermia. other causes are possible, but less common. there was no seizure activity. . neurophysiology report eeg study date of impression: this telemetry captured no pushbutton activations. however, it did capture a relatively long period of high voltage fast activity with sharp morphologies over the left side. during at least some of this period, the patient's head was being rubbed, suggesting that this activity was artifactual in nature, although at other times the patient was not being manipulated and the possibility of underlying epileptic activity given the sharp morphologies could not be ruled out. the background activity was slow and of low voltage throughout the recording, suggesting a severe encephalopathy. brief hospital course: this is an 85 year-old male with a history of cad s/p cabg (svg-lcx, lima-lad), redo in (svg>pda) with avr, constrictive pericarditis, type 1 dm who presented from home after pea arrest. the patient was reportedly in pea arrest initially with conversion to vt after cpr. he was intubated in the ed and started on amiodarone gtt. there was no evidence for hypovolemia/bleeding, hyper/hypokalemia (k on arrival to ed was 4.0), medication overdoses, or trauma. the patient was taken emergently to cath lab and found to have distal lad lesion treated with poba. ct head was negative for intracranial hemorrhage. cooling protocol with arctic sun was initally induced. neurology was consulted and the patient underwent continuous eeg monitoring. eeg was concerning for severe encephalopathy and exam concerning for anoxic injury; the patient was warmed to allow for proper eeg/neurologic testing. the patient's repeated neurologic exam and eeg findings continued to be consistent with anoxic encephalopathy. after dicussion with family, the patient was made cmo to best reflect his personal wishes. he was extubated on and a morphine drip was initiated for comfort care. the patient expired shortly thereafter. # comm: - daughter - granddaughter . - grandson - , medications on admission: multivitamin daily nystatin powder insulin nph 15 , regular 2 in the am, for lunch, in the afternoon iron supplement 325mg daily nitroglycerin sl ntg lipitor 80mg daily omeprazole 20mg daily milk of magnesia colace 100mg tid lasix 40mg daily plavix 75mg daily halcion trazodone 100mg imdur 60mg daily aspirin 325mg daily discharge medications: none; pt deceased discharge disposition: expired discharge diagnosis: pea arrest with subsequent anoxic brain injury coronary artery disease cardiopulonary arrest discharge condition: deceased procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours coronary arteriography using two catheters left heart cardiac catheterization excision of lingual thyroid percutaneous transluminal coronary angioplasty [ptca] procedure on single vessel diagnoses: hyperpotassemia coronary atherosclerosis of native coronary artery diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute and subacute necrosis of liver acute kidney failure, unspecified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified atrial fibrillation aortocoronary bypass status chronic kidney disease, unspecified acute respiratory failure cardiac arrest long-term (current) use of insulin ventricular fibrillation heart valve replaced by transplant constrictive pericarditis 

Answer: The patient is high likely exposed to