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: sob major surgical or invasive procedure: cardiac catheterization with stenting and returned to cath history of present illness: 66 yo f critical as (valve area 0.6), cad s/p pcix4, severe diastolic chf, severe pulmonary transferred from with respiratory distress. she was in usoh until 1 day pta, when she devleoped sob. ems came and pt was able to walk out of the house to meet them. shw was given nitro sl, lasix, and oxygen by nrb en route to hospital and her respiratory condition deteriorated. she was intubated in the ed, with abg 7.01/60/83. she was given insulin gtt. she ws given ativan and morphine for sedation when she became agitated and pulling at tubes. the patient has been evaluated by ct surgery who was planning valve surgery. the pt is a jehovah's witness, so she refuses blood products. she started epo in , with the plan to optimize her for an elective aortic valve replacement past medical history: rheumatic fever as child, aortic stenosis with regurgitation, morbid obesity (bmi 51), dm2 (hgb a1c 6.9%), dyslipidemia (tc 256), oa, chronic low back pain, ccy , umbilical hernia repair , ex lap with loa small bowel obstruction in social history: lives in , former smoker 60 pack year history quit 35 years ago, no alcohol/drugs. jehovah's witness family history: cad, diabetes physical exam: gen: sedated, intubated heent: peerl, mild jvd chest: good air movement in both sides. cv: holosystolic murmur lusb, radiating to carotids abd: obese, nd, nabs, no organomegaly ext: trace edema pertinent results: 10:49pm type-art rates-14/ tidal vol-700 peep-10 o2-70 po2-93 pco2-38 ph-7.40 total co2-24 base xs-0 -assist/con intubated-intubated 10:49pm hgb-16.6* calchct-50 o2 sat-96 06:28pm glucose-211* urea n-21* creat-0.8 sodium-140 potassium-4.2 chloride-103 total co2-20* anion gap-21* 06:28pm albumin-3.5 calcium-8.5 phosphate-3.7 magnesium-1.5* 06:28pm urine color-yellow appear-clear sp -1.018 06:28pm urine blood-mod nitrite-neg protein-neg glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-5.0 leuk-neg 06:28pm urine rbc-* wbc-* bacteria-rare yeast-none epi-0-2 06:28pm urine hyaline-* 06:28pm urine mucous-mod . echo : lv ef 35% mild lvh. nl cavity sz. : hypo inferior, lateral, anterior walls including apex. rv: nl size/fxn. tr gradient 31. ao stenosis: 0.9 gradient 27. pk vel 3.5. + ar, 2+ mr . echo : lv ef 30-35% + ar, 1+ mr : anterior, lateral, inferior hypokinesis no masses/vegetations mitral or aortic valve. . cath : lmca: patent lad: 90% mid lcx: 90% ostial om1 and thrombus after the stent rca: 80% mid after the stent no stent placed, awaiting avr/cabg. rhc: cvp 19, pa 43/26. pcwp 24. co 3.72 ci 2.41 . comments: 1. selective coronary angiography demonstrated three vessel coronary artery disease in this right dominant circulation. the lmca was without angiographically apparent flow limiting disease. the lad had a 90% stenosis in the mid vessel prior to the diagonal branch. the lcx circulation had a 90% stenosis at the ostium of the om1 and thrombus in and distal to the previously placed om1 stent. the om2 was without flow limiting disease. the rca had a patent ostial stent and had an 80% mid rca stenosis near the site of the previous ptca. 2. resting hemodynamics from right heart catheterization demonstrated elevated right and left sided filling pressures (rvedp=19mmhg and mean pcwp=24mmhg). there was mild pulmonary arterial hypertension present (43/26). cardiac output and index were mildly depressed at 3.7 l/min and 2.4 l/min/m2 respectively. 3. left ventriculography was not performed due to elevated filling pressures. 4. ptca of the previously placed om1 stent using a 2.5mm balloon with excellent results (see ptca comments). final diagnosis: 1. three vessel coronary artery disease. 2. elevated right and left sided filling pressures. 3. nstemi treated with ptca of previously placed lcx-om1 stent. . cath : comments: 1. cardiogenic shock due to a combinatin of myocardial infarction, myocardial ischemia, severe as and impaired lv function. 2. possibility of ongoing ishchemia from the lad an the rca lesions. 3. critical clinical state due to above and other co-morbities 3. issues with blood transfusions as patient is a jehova's witness. final diagnosis: 1. three vessel coronary artery disease. 2. severe aortic stenosis. 3. severe systolic ventricular dysfunction. 4. successful pci and bare metal stent placement on the lad and the rca with no complications brief hospital course: a/p 66 yo f critical as (valve area 0.6), cad s/p pcix4, severe diastolic chf, severe pulmonary transferred from with respiratory distress and demand ischemia. during hospitalization, recieved angioplasty x2. plan is to consider surgery for avr. . 1. cardiac: coronaries: on the evening of admission, the pt arrived at the ccu with ecg not suggestive of acute infarct, the cardiac enzymes were found to be elevated, and in the setting of sudden onset of sob, hemodynamic decompensation, and known h/o cad, this was assessed as concerning for acute infarct, pt was sent emergently to the cath lab. in cath lab, pt was found to have 3 vessel dz with 90% om1, no thrombus. this lesion was ballooned, not stented with the plan for possible avr/cabg. after discussions with ct surgery, the decision was made to return to cath for stenting to lad and rca on . there were no complications. the pt was extubated a couple of days prior to disharge. she was hemodynamically stable and tranferred out of ccu for one day of additional monitoring. . pump/: the pt arrived on decompensated heart failure likely acute mi on top of chronic severe as. the pt required mechanical ventilation and diuresis for the first week of hospitalization. right heart cath confirmed elevated filling pressures, pcwp 24 cvp 19. bb, ace were held during the hospitalization because the blood pressure could not tolerate. plan is to consider valve surgery for critical as. this decision is complicated by the patient's status as a jehovah's witness, she will not accept blood transfusion. . rhythm: sinus rhythm. . 2. mrsa pna: the pt had a fever to 101 and a wbc 19.3 on admission. she was required mechanical ventilation for prolonged respiratory failure for the first week in the hospital. this was related to decompensated heart failure and mrsa pna. she completed a course pf empiric antibiotics for mrsa pna. . 3. gi bleed: ng tube was guaiac positive, with small coffee grounds initially at ccu. after the first hour, the ng lavage showed no gross blood. -follow crit. follow ng lavage for blood. . 4. diabetes: the pt was managed with riss. she will resart her home nph regimen as an outpatient. medications on admission: 1. epoetin alfa 10,000 unit/ml solution sig: one (1) injection qmowefr (monday -wednesday-friday). 2. simvastatin 40 mg tablet sig: two (2) tablet po daily (daily). 3. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 4. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 5. insulin please start your insulin as had been discussed prior to discharge. 6. lisinopril 7. metoprolol 8. zetia discharge medications: 1. epoetin alfa 10,000 unit/ml solution sig: one (1) injection qmowefr (monday -wednesday-friday). 2. simvastatin 40 mg tablet sig: two (2) tablet po daily (daily). 3. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 4. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 5. insulin please start your insulin as had been discussed prior to discharge. discharge disposition: home with service facility: vna discharge diagnosis: unstable angina discharge condition: good discharge instructions: please make sure to take all medicines as directed. particularly, take apirin and plaivx every day without missing a single dose. not taking the aspirin and plavix can lead to heart attack. . weigh yourself every morning, md if weight > 3 lbs. adhere to 2 gm sodium diet . please follow directions regarding blood sugar as discussed prior to discharge. please start your insulin dose at 20 units in am and 20 units in pm and increase the dose by 3-5u each dose if your blood sugars remains elevated. please check your blood sugars 4 times a day. if your blood sugar is below 70 and does not improve after drinking juice, call your doctor or go to the emergency room. followup instructions: provider , md where: cardiac services. . phone: date/time: 1:30 procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of non-drug-eluting coronary artery stent(s) coronary arteriography using two catheters left heart cardiac catheterization coronary arteriography using a single catheter enteral infusion of concentrated nutritional substances arterial catheterization insertion of other (naso-)gastric tube pulmonary artery wedge monitoring right heart cardiac catheterization diagnoses: subendocardial infarction, initial episode of care coronary atherosclerosis of native coronary artery pure hypercholesterolemia diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled unspecified septicemia severe sepsis infection with microorganisms resistant to penicillins other chronic pulmonary heart diseases percutaneous transluminal coronary angioplasty status hypopotassemia rheumatic heart failure (congestive) acute respiratory failure hypotension, unspecified cardiogenic shock long-term (current) use of insulin osteoarthrosis, unspecified whether generalized or localized, site unspecified methicillin susceptible pneumonia due to staphylococcus aureus hematemesis abdominal aneurysm without mention of rupture rheumatic aortic stenosis with insufficiency 

Answer: The patient is high likely exposed to