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: epinephrine / amiodarone / ambien attending: chief complaint: chest pain major surgical or invasive procedure: cardiac catheterization with drug eluting stent to left circumflex artery, balloon catheterization to om branch history of present illness: mr. is an 89 year old gentleman with a pmh significant for cad s/p multiple pcis most recently in , ischemic cardiomyopathy with an lvef 25-30%, paf, and cva transferred from an osh for cardiac catheterization after vf arrest. the patient initially presented to osh on with chest pain. per review of records, the chest pain woke him from sleep at 2 am described as epigastric pain and did not improve with sl ntg. he then was taken to an osh ed, where he was found to be in atrial fibrillation with rvr with lateral std. while in the osh ed, he developed left-sided chest pain different from intial chest pain that resolved with ntg and morphine. his labs at that time were notable for elevated cardiac biomarkers to ck 42, mb 3.1, tnt 0.22. cardiology was consulted with recommendation for cardiac catheterization. prior to catheterization, however, the patient had vf arrest on with rosc after defibrillation x2, cpr, calcium, and amiodarone. at that point, the patient was started on heparin gtt, integrillin gtt, and taken to cardiac catheterization. cardiac catheterization demonstrated 60% proximal and mid-lad, 80-90% lcx, 100% proximal rca, some in-stent resteonsis of om with iabp placed. ct surgery was consulted for possible cabg, which the family deferred pending transfer to for further evaluation and repeat cardiac catheterization. of note, the patient received 4 units prbcs at osh for a hct of 28.7. in addition, the patient was also admitted to on for chest pain that resolved without intervention. . currently, the patient is resting comfortably without complaints. denies cp/sob, f/c/s, n/v/d, abd pain, ha, palpitations, pain radiating to jaw, arms, or back. . ros: as above, he denies change in weight or bowel habit, cough, fever, arthralgias or myalgias. all other review of systems negative. past medical history: 1. cardiac risk factors: +dyslipidemia, +hypertension 2. cardiac history: - cad: pci history * ptca om & ptca/des to lcx * bms lcx * ptca lad * ptca/stenting proximal and mid-lad . - ischemic cardiomyopathy ef 25-30% - aortic regurg (2+ by tte) - atrial fibrillation - lbbb . 3. other past medical history: l cva w/o residual deficit microcytic anemia b/l hct ~34% hypothyroidism depression gerd social history: retired chemist and inventor. married, four children. able to ambulate independently and accomplish all adls without difficulty. quit smoking in . has a glass of wine each day. no illicit substances. family history: htn in mother, died of mi at 49; , polycythemia in father (may have been related to benzine exposure in shoe industry), died of stroke at 72; sister with cad. physical exam: vs: 98.3 61 135/65 11 98%ra gen: age appropriate male supine in bed heent: perrl, eomi, sclerae anicteric. mmm, op clear without lesions, exudate, or erythema. neck supple. cv: regular s1+s2, audible iabp pulm: faint early inspiratory crackles bilaterally abd: s/nt/nd, audible iabp ext: no c/c/e 1+ dp bilaterally pertinent results: osh resistance 280/18% plt inhibition . in-house . cardiac biomarker peak tnt 2.21 ck mb 14 ck 449 . 01:33pm glucose-108* urea n-15 creat-1.0 sodium-132* potassium-4.1 chloride-100 total co2-27 anion gap-9 01:33pm alt(sgpt)-43* ast(sgot)-27 ld(ldh)-315* alk phos-74 tot bili-0.9 01:33pm albumin-3.2* calcium-8.4 phosphate-3.3 magnesium-2.2 01:33pm wbc-9.1 rbc-4.44* hgb-12.1* hct-37.4* mcv-84 mch-27.4 mchc-32.5 rdw-16.5* 01:33pm neuts-79.0* lymphs-11.7* monos-6.5 eos-2.4 basos-0.4 01:33pm plt count-177 01:33pm pt-14.9* ptt-45.4* inr(pt)-1.3* 06:54pm urine eos-negative 06:54pm urine rbc-0-2 wbc-<1 bacteria-occ yeast-none epi-0 06:54pm urine blood-sm nitrite-neg protein-tr glucose-neg ketone-tr bilirubin-neg urobilngn-4* ph-6.5 leuk-neg 06:54pm urine osmolal-532 06:54pm urine hours-random urea n-436 creat-60 sodium-76studies: ecg: sinus with 1:1 conduction. na, ivcd. laa. lbbb, 1-2 mm std v4-v6, std i. . cxr : cardiomegaly, mild cephalization. no effusions or consolidations. . cardiac cath ptca comments: initial angiography showed severe diffsue disease throughout the lcx system with new tight lesion just proximal to the stent placed in . the om branch (was treated with poba in ) was also diffusely and severely diseased throughout. we planned to treat this with ptca and stenting, if feasible. a 6 french 4.0 xb guide provided adequate support. heparin was commenced prophylactically. the patient also was receiving ntg gtt and the iabp was set on 1:1 with augmented bp of 140 mmhg and mean of 65 mmhg. a choice pt extra support wire crossed the lesion with minimal manipulation and positioned into the distal av groove lacx. the proximal lcx stent was predilated with a 2.5x12 mm quantum maverick rx at 12 atm x2 followed by deployment of a 2.5x15 mm promus rx des at 12 atm, postdilated with a 2.75x8 mm quantum maverick balloon at 22 atm. we then advanced the wire into the jailed om branch and performed several pobas starting with a 2.0x12 mm voyager rx at 6-12 atm followed by 2.76x15 mm quantum maverick balloon (at 6-8 atm), each left up for 30-45 seconds. final angiography showed excellent flow into the lcx system with 0% residual stenosis within the stent and 40% residual stenosis in the om branch (due to rapid recoil). no apparent dissection or distal emboli. the iabp was then adjusted under flouroscopy 9advande 3 cm). the patient left the cath lab free from angina and in stable condition. brief hospital course: mr. is an 89 year old gentleman with a pmh significant for cad s/p cabg and multiple pcis most recently in , ischemic cardiomyopathy with an lvef 25%, paf, and transferred from an osh for cardiac catheterization after vf arrest. underwent cardiac cath with des to lcx proximal to prior stent, but etiology of vf arrest unclear, possible ischemic vs. prolonged qt from citalopram. . # coronaries: patient with severe cad s/p cabg with osh diagnostic cardiac catheterization demonstrating possible in-stent restenosis of om 1 after recent pci with in-hospital vf arrest at osh concerning for ischemic event. underwent cardiac cath here with des to lcx proximal to prior stent, 60% lad and 100% rca not intervened on. unclear if lcx lesion led to arrhythmias. had iabp which was removed following cath. being discharged on , , bb, statin, moexipril (home acei). . # pump: patient with known chronic systolic chf with lvef 25-30%. was euvolemic with minimal pulmonary vascular congestion on cxr and minimal signs of volume overload on exam. continued on home metoprolol, lasix with goal -500-even in-house and discharged on home lasix dose. discharged on bb, digoxin, moexipril. . # rhythm: patient with a history of paf with report of af with rvr on initial presentation although available ecgs demonstrate sinus rhythmn. patient also with vf cardiac arrest at osh, with longest qtc recorded as 511 msecs prior to vf, 0.48 now in-house. possible etiologies to vf arrest include acs versus r on t with prolonged qtc. celexa discontinued for ?qtc prolongation and possible precipitant of vf. des to lcx as above for possible ischemic component of vf. did not receive amiodarone as history of pulmonary toxicity. pt has outpatient f/u with outpatient cardiologist dr. to assess need for icd with low ef and s/p vf arrest. d/c'ed on low dose bb. . # hyponatremia: baseline serum sodium of mid-130s, likely secondary to chf, remained stable in-house. . # anemia: baseline hct in 30s and at baseline throughout hospitalization. . # cva: continued and . . # hypothyroid: continued levothyroxine. . # depression: citalopram discontinued as above. . # gerd: zantac prn . code: full (confirmed) communication: , (wife) medications on admission: atorvastatin 80 mg daily citalopram 30 mg daily 75 mg daily digoxin 125 mcg daily 60 mg daily folate 1 mg daily lasix 20 mg daily isosorbide mononitrate 30 mg po bid ketoconazole cream prn levothyroxine 75 mcg daily toprol xl 25 mg daily moexipril 7.5 mg daily ntg sl prn zantac - dose unknown coumadin 2 mg mwf 81 mg daily discharge medications: 1. ranitidine hcl 150 mg tablet sig: one (1) tablet po daily (daily). 2. aspirin 325 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 3. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily): do not stop taking unless dr. tells you to. . disp:*30 tablet(s)* refills:*11* 4. levothyroxine 75 mcg tablet sig: one (1) tablet po daily (daily). 5. atorvastatin 80 mg tablet sig: one (1) tablet po daily (daily). 6. fexofenadine 60 mg tablet sig: one (1) tablet po once a day as needed for allergies. 7. moexipril 7.5 mg tablet sig: one (1) tablet po daily (daily). 8. furosemide 20 mg tablet sig: one (1) tablet po daily (daily). 9. digoxin 125 mcg tablet sig: one (1) tablet po daily (daily). 10. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 11. nitroglycerin 0.4 mg tablet, sublingual sig: 1-2 tablets sublingual every 5 minutes x2 as needed for chest pain. 12. metoprolol succinate 25 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po once a day. 13. outpatient lab work please check inr on and call results to dr. at 14. imdur 30 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po twice a day. 15. warfarin 1 mg tablet sig: two (2) tablet po every mon/wed/fri: please take on sat as well. 16. ketoconazole 2 % cream sig: one (1) topical as needed. discharge disposition: home with service facility: homecare discharge diagnosis: ischemic cardiomyopathy with chronic systolic dysfunction: ef 30% ventricular fibrillation cardiac arrest acute blood loss anemia paroxysmal atrial fibrillation stroke discharge condition: medically stable, vitals stable. discharge instructions: you were transferred here for a catheterization because of a dangerous heart rhythm and chest pain. you received a drug eluting stent to your left circumflex artery. you will need to be on and aspirin daily for at least one year, do not stop taking unless dr. tells you to. weigh yourself every morning, call dr. if weight > 3 lbs in 1 day or 6 pounds in 3 days. adhere to 2 gm sodium diet fluid restriction: no more than 6 cups per day. medication changes: 1. stop taking your celexa, this may have contributed to your dangerous heart rhythm. 2. check your inr on monday . this can be done by the vna. . please call dr. if you have any trouble breathing, chest pain, abdominal pain, vomiting, fevers, swelling in your legs or any ohter concerning symptom. followup instructions: cardiology: provider: , md phone: date/time: 2:30. please call office when you get home to see if you need an earlier appt. primary care: , j. phone: date/time: wednesday at 10:45am. procedure: coronary arteriography using two catheters nonoperative removal of heart assist system 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: coronary atherosclerosis of native coronary artery esophageal reflux congestive heart failure, unspecified acute posthemorrhagic anemia hyposmolality and/or hyponatremia unspecified acquired hypothyroidism atrial fibrillation aortocoronary bypass status depressive disorder, not elsewhere classified other specified forms of chronic ischemic heart disease other left bundle branch block chronic systolic heart failure 

Answer: The patient is high likely exposed to