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: chest pain major surgical or invasive procedure: none history of present illness: 58m pmh cad--s/p cabg , most recent cath with diffuse 3vd, patent grafts, and no intervention; esrd on hd; s/p recent admission 1 month ago for hyperkalemia, bradycardia, fluid overload, and chest pain in the setting of renal failure from only 2 hd sessions in 10 days, who now returns with chest pain, hyperkalemia, and bradycardia, in the setting of renal failure. past medical history: 1. cad - s/p cabg lima-> lad, svg -> rca/pda, svg -> om1 - cardiac cath: lmca 40%, lad mid 70%, lcx 60%, rca previously known proximal 99% occlusion; patent grafts. - stress : unchanged from ; moderately reversible inferolateral to inferior walls perfusion defects with ef 44%; repeat ett (6 min modified , stopped fatigue and chest pain, blunted hr response) with inferior wall defect now fixed--not reversible--on mibi - cath , 3vd with patent grafts. pressure wire of 60% lcx ostial lesion: ffr 0.97 to 0.91 with adenosine indicating non-flow limiting 2. diabetes mellitus: diet controlled 3. dyslipidemia 4. hypertension 5. congestive heart failure: echo revealed biatrial enlargement; lvef 60%, 1+ mr (eccentric), + tr, mod pa htn 6. peripheral disease: s/p stent to bilateral cias (genesis) and steft to - s/p poba and atherectomy of l sfa 7. end-stage renal disease: diabetic nephropathy - on hd t/th/sat - currently undergoing evaluation for renal transplant although considered high risk 8. ? copd - no pfts available 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. 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: father died of cad mother and brother with physical exam: per dr. vs: t:97 bp:134/49 hr:51 rr: o2:100 gen: wdwn middle aged male in nad. oriented x3. mood, affect appropriate. heent: ncat. sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. no xanthalesma. neck: supple with jvp of up to ear lobes. cv: pmi located in 5th intercostal space, midclavicular line. rr, normal s1, s2. loud systolic and dialstolic murmur heard. no thrills, lifts. no s3 or s4. chest: no chest wall deformities, scoliosis or kyphosis. resp were unlabored, no accessory muscle use. ctab, no crackles, wheezes or rhonchi. abd: soft, ntnd. no hsm or tenderness. abd aorta not enlarged by palpation. no abdominial bruits. ext: no c/c/e. no femoral bruits. skin: no stasis dermatitis, ulcers, scars, or xanthomas. pertinent results: labs: 129 100 60 ---------------< 392 7.4 19 9.2 ck: 67 to 49 mb: notdone to notdone trop-t: 0.16 to 0.18 ca: 8.3 mg: 3.1 p: 4.8 . 14.1 9.0 >====< 241 43 n:80.8 l:10.6 m:3.8 e:4.4 bas:0.4 . pt: 11.8 ptt: 29.2 inr: 1.0 lactate 1.6 hct to 37.1 at discharge potassium to 4.1 morning of discharge. . admission cxr: there is evidence of prior coronary artery bypass grafting. the cardiomediastinal silhouette is stable. the lung volumes are low. moderate cardiomegaly and pulmonary engorgements are longstanding. right pleural thickening vs loculated fluid and rounded atelectasis in the right lower lobe is stable. there is new blunting of the left costophrenic angle, which may be consistent with atelectasis versus effusion. unchanged from previous . echo: the left atrium is mildly dilated. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. overall left ventricular systolic function is low normal (lvef 50%). tissue doppler imaging suggests an increased left ventricular filling pressure (pcwp>18mmhg). transmitral doppler and tissue velocity imaging are consistent with grade ii (moderate) lv dysfunction. right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic regurgitation. the mitral valve leaflets are structurally normal. there is no mitral valve prolapse. mild (1+) mitral regurgitation is seen. there is mild pulmonary artery systolic hypertension. there is no pericardial effusion. compared with the findings of the prior study (images reviewed) of , the left ventricular ejection fraction is somewhat reduced; other findings are similar. . ekg on admission: demonstrated sinus bradycardia with pr prolongation, long qt interval, inverted t-waves in leads i, avl, v5-v6, and peaked t-waves in the precordial leads v1, v2. incomplete right bundle branch block. no significant change compared with prior dated . ekg the following day: sinus brady resolved. nsr with resolution of long qt. inverted t waves persist, peaked t waves have resolved. . brief hospital course: 58m pmh cad-s/p cabg, dm, esrd on hd, presented with hyperkalemia, fluid overload, and chest pain in the setting of acute renal failure. hospital course by problem: . # hyperkalemia - likely esrd. unclear precipitant. patient has been compliant with meds. he reports diarrhea so if anything it would likely have decreased his potassium. patient does report some dietary indiscretion though which may account for hyperkalemia. ekg as above. patient received urgent hd on evening of admission. the following morning, his potassium was 4.3. he received scheduled hd. we discontinued his lisinopril thinking that if anything it may lead to increased potassium. patient will otherwise resume normal hd schedule. followup ekg showed resolution of hyperkalemic changes. . # cards ischemic: hx of known cad. he came in with atypical chest pain. it resolved rather promptly although we initially treated with a heparin gtt while checking serial enzymes given his risk for disease. he received two sets of negative enzymes and our suspicion for ischemia was low. we stopped heparin gtt prior to d/c. . # cards rhythm: sinus brady in the ed. this can be hyperkalemia. it resolved after hd and likely improvement of k. . # htn: we held his acei as mentioned above. we discharged patient on toprol xl 50 and added amlodipine 5 in setting of holding the acei. we discussed this with his pcp and further adjustments will be made on an outpatient basis . # cards pump: a repeat echo suggested slightly worsened ef from previous but otherwise no change. we seemed well volume regulated with hd. . # hyperlipidemia: continue statin . # code: full medications on admission: allergies: cefepime . current medications: 1. aspirin 81 mg po daily 2. sevelamer 800 mg po tid 3. b complex-vitamin c-folic acid 1 mg po daily 4. isosorbide mononitrate 30 mg 24 hr po daily 5. atorvastatin 80 mg po daily 6. lisinopril 20 mg po daily 7. metoprolol tartrate 25 mg po tid 8. pregabalin 25 mg po daily 9. pantoprazole 40 mg q12h discharge medications: 1. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 2. sevelamer 800 mg tablet sig: one (1) tablet po tid (3 times a day). 3. isosorbide mononitrate 30 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po daily (daily). 4. atorvastatin 80 mg tablet sig: one (1) tablet po daily (daily). 5. amlodipine 5 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 6. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po once a day. 7. pregabalin 25 mg capsule sig: one (1) capsule po once a day. 8. toprol xl 50 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po once a day. disp:*30 tablet sustained release 24 hr(s)* refills:*2* discharge disposition: home discharge diagnosis: primary diagnoses: hyperkalemia bradycardia chest pain, nonischemic secondary diagnoses: coronary artery disease diabetes esrd on hd discharge condition: good. patient with normal hemodynamics, no pain, ambulating. discharge instructions: you came in with high potassium and slow heart rate. we treated you with dialysis and adjusted your medications slightly. . weigh yourself every morning, call your doctor if your weight gain is greater than 3 pounds. . adhere to 2 gm sodium diet . please take all medications as directed. medication changes include: -discontinue taking your lisinopril -addition of new medication: amlodipine 5mg daily (prescription provided) -continue your toprol xl at 50 daily please follow up with your appointments as directed followup instructions: please call your primary care physician, . ( and set up a follow up appointment in the next weeks. please follow up with the previously scheduled appointments: 1.) provider: , dpm phone: date/time: 9:30 2.) provider: scan phone: date/time: 8:45 3.) provider: , md phone: date/time: 1:00 procedure: hemodialysis diagnoses: hyperpotassemia end stage renal disease coronary atherosclerosis of native coronary artery pure hypercholesterolemia congestive heart failure, unspecified aortocoronary bypass status percutaneous transluminal coronary angioplasty status hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease other specified cardiac dysrhythmias other chest pain diarrhea diastolic heart failure, unspecified diabetes with renal manifestations, type ii or unspecified type, not stated as uncontrolled 

Answer: The patient is high likely exposed to