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: motor vehicle crash major surgical or invasive procedure: 1. right ulna/radius fracture orif 2. dual chamber icd placement history of present illness: 74-year-old male patient transferred from an osh for a motor vehicle collision. patient was restrained driver who struck a tree after ?loc. presents with diagnosis of rue comminuted fracture and left mandibular condyle fracture. arrived in ed in stable condition with gcs 15, splint to rue. patient had repeat ct and xrays. rue fracture was reduced by ortho under conscious sedation. the patient was admitted to the trauma service for further management. past medical history: 1. cad s/p cabg ' 2. st. 3. hypothyroidism 4. atrial fibrillation 5. hypertension social history: 1. wife in nursing home 2. denies etoh, tobacco abuse family history: nc physical exam: on arrival vs: t 101 bp 143/90 hr 82 rr 20 sat 100 ra gen: nad, gcs 15 heent: perla, eomi, l ear and nostril blood, op clear, c-spine non-tender, trachea midline, no jvd cardio: s1s2, rrr pulm: ctab, no crepitus : soft, nt/nd, rectal: nl tone, guaiac neg pelvis: stable ortho: rue: obvious mid-forearm deformity, no tenting or open wound, radial pulse palpable, tls spine non-tender/no deformities. pertinent results: 07:20pm wbc-12.5* rbc-3.58* hgb-11.3* hct-33.4* mcv-93 mch-31.5 mchc-33.7 rdw-15.4 07:20pm plt count-164 07:20pm -neg ethanol-neg acetmnphn-neg bnzodzpn-neg barbitrt-neg tricyclic-neg 07:32pm glucose-130* lactate-1.6 na+-138 k+-4.3 cl--101 tco2-28 07:20pm urea n-36* creat-0.8 07:20pm amylase-68 07:20pm calcium-9.6 phosphate-3.0 magnesium-1.8 ## rue xray : right forearm, 2 views: overlying cast obscures fine osseous detail. comminuted fractures through the midshafts of the right radius and ulna are identified with anterior displacement of the distal fracture fragments and approximately 1.5 cm of overlap between the fracture fragments. additionally, a comminuted fracture through the distal radius is identified which is minimally displaced. possible fracture through the base of the ulnar styloid is also likely present which is minimally displaced. ## ct face : 1) fracture/dislocation of the left mandibular condyle. 2) fracture of the anterior wall of the external auditory canal. the bone fragments from this wall of the temporal bone are located within the external auditory canal causing obstruction of this canal. ## echo : 1. the left atrium is moderately dilated. the left atrium is elongated. 2. left ventricular wall thicknesses are normal. the left ventricular cavity size is normal. there is severe global left ventricular hypokinesis. overall left ventricular systolic function is severely depressed, ef 30%. resting regional wall motion abnormalities include inferior and inferolateral akinesis. 4. right ventricular chamber size is normal. right ventricular systolic function is normal. 5.the aortic root is mildly dilated. the ascending aorta is moderately dilated. 6. a bileaflet aortic valve prosthesis is present. the aortic prosthesis appears well seated, with normal leaflet/disc motion and transvalvular gradients. 7.the mitral valve leaflets are mildly thickened. mild (1+) mitral regurgitation is seen. 8.there is no pericardial effusion. ## ct head : 1) small subarachnoid hemorrhage in the left temporal lobe/sylvian fissure. 2) increased soft tissue swelling over the left temporal region. brief hospital course: neuro: mr. was admitted to the tsicu for close observation and hourly neurological checks. a repeat head ct performed on revealed a small left insular sah which remained stable. he remained neurologically stable throughout his stay. the neurosurgery team recommended tight bp control. this was achieved with iv metoprolol and labetolol. no further issues or concerns. ## cardio: a cardiology consult was requested to assess for a potential cardiac cause for the patient's mvc in light of the frequent atrial and ventricular ectopies observed on telemetry and his cardiac history. also an echocardiogram revealed an ef of 30% with severe global lv hk attributed to previous ischemia. the patient received blood transfusions for a falling hematocrit below 28. his coumadin was initially held. this was reinstituted with a heparin drip immediately after his second orthopedic procedure. on the coumadin was held for placement of an icd which was done on . the patient will follow up at the clinic one week after the placement. the patient coumadin was restarted the evening following the icd placement. he had no cardiac events and his hematocrit remained stable throughout. he was discharged on toprol 50 qd, lisinopril 20 , , coumadin 5 qd. ## ortho: the patient's comminuted fracture of the right ulna and radius was surgically corrected by the orthopedic surgeons on hd#2. secondary closure was preferred due to concerns for compartment syndrome. he underwent fasciotomy closure on . the patient's arm was placed in a cast with recommendations for non-weight bearing for three weeks. he will follow up in the orthopedic clinic with dr. two weeks after discharge. ## orl: the patient's left mandibular condyle fracture was assessed by the ent service and recommendations were made to treat conservatively with prophylactic antibiotic ear drops. the patient had minor complaints of jaw movement limitations. he initially failed a swallow test for reasons which could not be identified and subsequently passed it and had no problems feeding. recommendations were also made to follow up with dr. at the clinic. this issue remained stable and no further concerns were identified. he was discharged on a soft diet for 5 weeks. ## dispo: physical therapy has been following the patient and recommended transition to a rehabilitation facility. the patient was transferred to an extended care facility in stable condition. medications on admission: 1. atenolol 25 2. coumadin 5 3. lisinopril 20 4. 81 5. synthroid 0.75 discharge medications: 1. ciprofloxacin 0.3 % drops sig: four (4) drop ophthalmic tid (3 times a day) for 3 days. 2. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed. 3. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 4. lisinopril 20 mg tablet sig: one (1) tablet po daily (daily). 5. levothyroxine sodium 75 mcg tablet sig: one (1) tablet po daily (daily). 6. toprol xl 50 mg tablet sustained release 24hr sig: one (1) tablet sustained release 24hr po once a day. 7. oxycodone-acetaminophen 5-325 mg tablet sig: one (1) tablet po q4-6h (every 4 to 6 hours) as needed. 8. warfarin sodium 5 mg tablet sig: one (1) tablet po 6x/week (mo,tu,we,th,fr,sa). 9. warfarin sodium 2.5 mg tablet sig: one (1) tablet po 1x/week (). discharge disposition: extended care facility: seaview discharge diagnosis: 1. right ulna/radius fractures 2. left mandibular condyle fracture 3. external auditory canal fracture 4. cardiac dysrhythmia discharge condition: good discharge instructions: you were hospitalized for a broken right forearm and a right facial fracture. your broken arm was surgically repaired by the orthopedic surgery team. your facial bone will heal and does not require any surgery at this time. it is likely that your accident was due to an irregular heart beat. a pacemaker was placed in your chest to prevent against any further events. please take your medications as prescribed. please call the trauma clinic to schedule a follow up visit in days . also, call dr. at the clinic for a follow up visit in weeks . you also have a follow up appointment at the pacemaker clinic on at 11:30. please call the neurosurgery clinic to schedule a follow up appointment in weeks . followup instructions: 1. trauma clinic in days 2. clinic with dr. in weeksprovider: 3. device clinic where: cardiac services phone: date/time: 11:30 4. clinic in 2 weeks with dr. 5. clinic in weeks md, procedure: arterial catheterization implantation or replacement of automatic cardioverter/defibrillator, total system [aicd] open reduction of fracture with internal fixation, radius and ulna transfusion of packed cells closed reduction of fracture without internal fixation, radius and ulna transfusion of other serum other incision of soft tissue other fasciectomy diagnoses: thrombocytopenia, unspecified abnormal coagulation profile unspecified essential hypertension unspecified acquired hypothyroidism atrial fibrillation aortocoronary bypass status heart valve replaced by other means hemorrhage complicating a procedure other specified cardiac dysrhythmias syncope and collapse other motor vehicle nontraffic accident involving collision with stationary object injuring driver of motor vehicle other than motorcycle closed fracture of base of skull with subarachnoid, subdural, and extradural hemorrhage, with brief [less than one hour] loss of consciousness closed fracture of mandible, condylar process other early complications of trauma closed fracture of shaft of radius with ulna 

Answer: The patient is high likely exposed to