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: codeine / scopolamine hydrobromide attending: chief complaint: back/jaw pain and nausea - admitted s/p cardiac cath major surgical or invasive procedure: cardiac catheterization with placement of drug-eluting stent to left main coronary artery. history of present illness: 88yo f hx htn, cki, hypothyroidism, sjogren??????s syndrome presented s/p cardiac cath with drug eluting stent to lmca extending to lad. the pt presented to her pcp c/o several month history of exertional back pain between the shoulder blades. in the past few days it has been occurring at rest and associated with left arm pain as well as nausea. the pain is difficult to categorize (achy/sharp) and generally goes away after minutes. she c/o some palpitations occasionally associated with these episodes. she takes baby aspirin and rests which help the pain. this morning she had some pain at rest which radiated to her jaw. she denies dyspnea on exertion, pnd, orthopnea and ankle swelling. she ambulates well at home up and down stairs. . she was scheduled for stress thallium which showed normal myocardial perfusion at rest, however the pt was sent to the cath lab as st changes were shown on ecg concerning for myocardial infarction. cardiac cath showed 99% proximal and 90% distal lmca lesions. she underwent cypher des to lmain extending to lad with slight jailing of lcx but persistent flow. there was also a residual 40-50% mid lesion which was left alone. rca was large with mild disease. in the cath lab she had a vagal response with sheath pull which responded to atropine 1 mg. of note, her central sbps were 25 mmhg > than her noninvasive bps. she was transferred to the ccu in stable condition. . on ros pt c/o hearing problems with l worse than r. dry mouth, eyes secondary to sjogrens. denies abdominal pain. stool stress incontinence. denies constipation or diarrhea. denies increased urination or burning on urination. no skin changes, lumps or masses noticed. denies weight changes, fatigue, fevers/chills. all other review of systems negative in detail. past medical history: 1. cardiac risk factors: hypertension, cad 2. cardiac history: no history of cath, echo, stress test 3. other past medical history: endometrial ca stage 1b s/p hysterectomy and s/p pelvic radiation in hypothyroidism sjogren's syndrome sbo x2 with ex-lap & loa in social history: lives alone in n . 2 adult children. retired high school art teacher. daughter is involved in care. -tobacco history: none -etoh: none -illicit drugs: none family history: non contributory. physical exam: vs: t=35.9 bp=141/55 hr=69 rr=2- o2=96% on 2l nc general appearance: no acute distress, appears anxious, hoarse / trembling voice. aaox3. eyes / conjunctiva: perrl. eomi head, ears, nose, throat: normocephalic atraumatic. oropharynx clear. nasal cannula. bilateral carotid bruits. lymphatic: cervical wnl, supraclavicular wnl cardiovascular: normal s1 & s2, no s3, no s4, 3/6 systolic ejection murmur heard best at lusb. not heard at apex. does not radiate to clavicles. no rubs. peripheral vascular: (right radial pulse: present), (left radial pulse: present), (right dp pulse: diminished), (left dp pulse: diminished) respiratory/chest: clear to auscultation bilaterally ?????? limited to anterior exam only abdominal: soft, non-tender, bowel sounds present, not distended, not tender. extremities: right lower extremity edema: absent, left lower extremity edema: absent, right groin cath site cdi. pertinent results: on admission: 11:34pm blood hct-22.3*# 04:53am blood wbc-10.6# rbc-2.90* hgb-8.4* hct-25.4* mcv-88 mch-28.9 mchc-33.0 rdw-15.7* plt ct-211 04:53am blood neuts-89.6* lymphs-6.9* monos-3.2 eos-0.1 baso-0.1 03:05pm blood pt-12.3 inr(pt)-1.0 04:53am blood ret aut-1.8 03:05pm blood glucose-136* urean-41* creat-1.7* na-140 k-4.8 cl-108 hco3-23 angap-14 04:53am blood ck-mb-notdone ctropnt-0.02* 03:05pm blood calcium-9.3 phos-3.2 mg-1.8 04:53am blood caltibc-202* ferritn-135 trf-155* . cardiac catheterization: 1. selective coronary angiography in this right dominant system demonstrated left main disease. the lmca had a 99% proximal stenosis, a 50% mid-portion stenosis and a 90% distal stenosis. the lad had a 40-50% mid stenosis. the d1 had an 80-90% stenosis at the origin. the cx was small and had moderate plaque at the origin. the rca was a large calibur vessel with mild disease. 2. severe systemic arterial hypertension with sbp of 182mm hg and dbp 82mm hg. 3. successful ptca and stenting of the lmca with a 3.5 x 23mm cypher drug eluting stent which was postdilated to 4.5mm. final angiography revealed no residual stenosis, no angiographically apparent dissection, and timi 3 flow. (see ptca comments for details) 4. presumed bilateral subclavian stenosis (left > right) with a 40mmhg resting gradient between central aortic and left brachial non-invasive blood pressure. final diagnosis: 1. left main coronary artery disease. 2. bilateral subclavian stenosis (left > right). 3. successful ptca and stenting of the lmca. . echocardiogram: the left atrium is normal in size. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity is unusually small. regional left ventricular wall motion is normal. overall left ventricular systolic function is normal (lvef>55%). no masses or thrombi are seen in the left ventricle. transmitral doppler and tissue velocity imaging are consistent with grade i (mild) lv diastolic dysfunction. 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. trivial mitral regurgitation is seen. the estimated pulmonary artery systolic pressure is normal. there is no pericardial effusion. impression: small, hypertrophied left ventricle with normal global and regional systolic function. mild diastolic lv dysfunction. no clinically-significant valvular disease or pulmonary hypertension. . ct abdomen and pelvis: 1. large hyperdense structure in the right pelvis concerning for a large extraperitoneal hematoma, tracking along the medial thigh. unable to comment on active extravasation due to lack of iv contrast administration. 2. compression of the right distal ureter due to large pevic hematoma, causing right kidney hydroureteronephrosis, and calyceal rupture at the lower pole. atrophic left kidney. urology consult is recommended. . mag3 renal scan: the differential function obtained by analysis of tracer concentration in the parenchyma from 2 to 3 minutes post tracer injection shows the left kidney to be performing 40% of the total renal function and the right kidney performing 60%. impression: 1. right pelvic hematoma causes no significant right ureteral obstruction. right renal function is mildly reduced. 2. persistent nephrogram in the left kidney is likely related to chronic renal disease or contrast nephropathy. . on discharge: : hbg 10.7, hct 31.6, k 4.2, bun 59, cr 2.3, wbc 6.9, plt 163 brief hospital course: 88 year old female with a history of htn, chronic kidney injury, hypothyroidism, sjogrens syndrome presented status post cardiac catheterization with drug eluting stent placed to the left main with extension to lad now with pelvic hematoma and renal caliceal rupture. . # coronaries: the patient's anginal equivalent is intrascapular back pain with nausea. precath ecg showed 1mm st elevations in v1-2 and avr with depressions in 2,3,avl. left main disease seen on cath and stent placed to lmca extending to the lad. post-cath ecgs have been essentially unchaged. post-cath tnt 0.02 ck 88. no anginal equivalent during hospital stay. the patient was started on aspirin 325 po qd, plavix 75 po qd and atorvastatin 80 po qd. . # hematoma: developed as the patient began sundowning and became very anxious/restless ~2hrs after cath. ultrasound was negative for hematoma, but induration and brusing along the inguinal ligament and suprapubic area developed afterwards. ct abd/pelvis showed 10x7cm pelvic fluid collection. it also showed the hematoma possibly compressing the right ureter causing hydronephrosis and possible calyceal rupture. hematocrit dropped from 31 two days prior to admission to 23. the patient received 4units prbc and hematocrit has increased and stabilized. vascular surgery was consulted and the recommended no intervention at this point. urology was consulted and the recommended a mag3 renal scan to evaluate the function of non-obstructed kidney. the scan showed non-obstructed r ureter and decreased function of bilateral kidneys likely due to chronic kidney injury vs contrast-induced nephropathy. follow up with dr. in urology was recommended in weeks. . # acute on chronic kidney injury: the patient's baseline creatinine 1 year ago was 1.3. two days prior to admission the patient was advised to stop olmesartan over concerns of an increased creatinine to 2.0. her creatinine was 1.7 on admission. fena was 3.3 so a prerenal component was felt to be unlikely. serum creatinine increased since admission likely due to obstruction of the right kidney as well as possible effects from the dye load during catheterization. creatinine trended down in the days leading up to discharge. follow up with the patient's primary care physician 1 weeks was recommended as well as a repeat measurement of a labs including a bmp. . # delirium: the patient has a history of sundowning on previous hospital admissions. she was given benzos on the day of admission and her mental status deteriorated. she pulled out an iv as well as her foley catheter. restraints were used temporarily. we stayed away from benzos for the rest of the admission, and the patient did not have any recurrences of delirium or notable sundowning. . # pump: the patient had no previous caths or echos. no history or symptoms of previous hf. echo showed mild diastolic dysfunction with ef>55%. she was placed on carvedilol 6.25 po bid. an acei or was held given the elevated creatinine. we have recommended outpatient follow up and restarting of acei or upon resolution of serum creatinine. . # hypertension: the patient was on atenolol at home. she was started on amlodipine 5 po qd and carvedilol 6.25 po bid and remained normotensive. . # hypothyroidism: the patient's tsh was normal two days prior to admission. we continued levothyroxine 88mcg po qd. . # anemia: baseline outpatient h/h , mcv 93. anemia of chronic disease on iron studies. . # fen: heart healthy low sodium diet. . access: piv's . code: full . comm: patient, daughter is involved in care. . dispo: home with home pt medications on admission: atenolol - 25 mg tablet - one tablet(s) by mouth daily levothyroxine - 88 mcg tablet - 1 tablet(s) by mouth every day nitroglycerin - 0.3 mg tablet, sublingual - one tablet(s) sublingually prn chest pain aspirin, buffered - 325 mg tablet - one tablet(s) by mouth daily discharge medications: 1. outpatient lab work please check chem-7, cbc on . call results to dr. at 2. aspirin 325 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 3. levothyroxine 88 mcg tablet sig: one (1) tablet po daily (daily). 4. nitroglycerin 0.3 mg tablet, sublingual sig: one (1) sublingual prn as needed for chest pain. 5. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 6. amlodipine 5 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 7. atorvastatin 80 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 8. carvedilol 6.25 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* discharge disposition: home with service facility: home health care discharge diagnosis: primary diagnosis: st elevation myocardial infarction . secondary diagnoses: hypertension cki hypothyroidism sjogren??????s syndrome endometrial ca stage 1b s/p hysterectomy and s/p pelvic radiation in discharge condition: good; hemodynamically stable and improved. discharge instructions: you were admitted to the hospital for back pain and found to be having a myocardial infarction (commonly known as a heart attack). you had a cardiac catheterization and a stent was placed in your left main coronary artery. after your catheterization, you developed a hematoma in your pelvis that compressed your right ureter, causing a decline in your kidney function. you were treated with several blood transfusions and close monitoring. the bleeding resolved, and your kidney function improved. however, it is important that you follow-up with a urologist(dr. - see below for appointment time and date) to continue to monitor your overall kidney function. please also follow up with your pcp and cardiologist (appointments below). . we have made the following changes to your medications: stop atenolol stop olmesartan start plavix - this is a medication that helps to keep your blood thin and prevent further clots from forming in your coronary arteries. do not stop this medication without speaking your cardiologist. start carvedilol - this is a medication to help control your blood pressure. start atorvastatin - this is a medication for cholesterol, but is also important for stabilizing disease within your coronary arteries. start amlodopine - this is another medication to help control your blood pressure please continue to take your other medications as prescribed. . if you experience any further episodes of chest pain, shortness of breath, dizziness or other concerning symptoms, please call 911 or call your pcp . . followup instructions: provider: , . phone: date/time: at 10:15am. . urology: provider: md division of urology , clinical center, , phone: date/time: tuesday at 10;45 am. . cardiology: phone: date/time: at 2:20pm clinical center, procedure: left heart cardiac catheterization insertion of drug-eluting coronary artery stent(s) cranial or peripheral nerve graft insertion of one vascular stent excision of lingual thyroid percutaneous transluminal coronary angioplasty [ptca] procedure on single vessel diagnoses: other iatrogenic hypotension coronary atherosclerosis of native coronary artery acute posthemorrhagic anemia unspecified acquired hypothyroidism acute myocardial infarction of other anterior wall, initial episode of care hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified hematoma complicating a procedure accidental puncture or laceration during a procedure, not elsewhere classified chronic kidney disease, unspecified personal history of malignant neoplasm of other parts of uterus cardiac catheterization as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure hydronephrosis stricture of artery delirium due to conditions classified elsewhere stricture or kinking of ureter injury to kidney without mention of open wound into cavity, laceration other drugs and medicinal substances causing adverse effects in therapeutic use acute kidney failure with other specified pathological lesion in kidney accidental cut, puncture, perforation or hemorrhage during heart catheterization 

Answer: The patient is high likely exposed to