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: chest pain, shortness of breath major surgical or invasive procedure: cardiac catheterization history of present illness: 61 yo male transferred from with chest pain and concern for stemi, found to have depressed ef but no intervenable acute coronary dz, transferred to ccu from cath lab with hypotension. per report, pt had normal day on , lifted weights in am hours - felt fine but admitted to sweating 'much more than usual.' after lifiting, had 10 minutes of chest discomfort, not assoc with breathing, then went away. had stable day, no acute issues, lied on beach and ate 'pounds' of licorice, then went out with friends, drank 2 bottled heinekens, went to bed. awoke semi-acutely in am on day of presentation with shortness of breath. at , ekg notable for mild st-elevations in i, ii, ?stemi vs. pericarditis, pt clinically sob, taken to cath lab. cath showed no acute coronary stenoses, bedside echo showed global hypokinesis, apex>base, rvedp 12, pcwp 22, ci 1.6. on review of symptoms, he denies any prior history of stroke, tia, deep venous thrombosis, pulmonary embolism, bleeding at the time of surgery, myalgias, joint pains, cough, hemoptysis, black stools or red stools. he denies recent fevers, chills or rigors. he denies exertional buttock or calf pain. all of the other review of systems were negative. cardiac review of systems is notable for absence of chest pain, dyspnea on exertion, paroxysmal nocturnal dyspnea, orthopnea, ankle edema, syncope or presyncope. past medical history: pmh: 1. obsessive compulsive disorder 2. cocaine abuse history (heavy 97-99, intermittemntly currently) 3. glaucoma cardiac risk factors: (-) diabetes, dyslipidemia, hypertension current medications: 1. klonopin prn allergies: seasonal allergies social history: significant for the absence of current tobacco use. +etoh hx of '' drinks per week, mostly beer, with red wine. pt married, has three high school/college aged children. pt former emergency room physician in , 'retired' a >5 yrs ago, moved with family to . now currently works construction intermittently, sometimes moonlights in er. reports cocaine abuse issue in 97-99, then has used intermittently. on initial history today, reported cocaine use 10-14 days ago, ~'1 gram.' then on repeat questioning, reported significant use the day prior to admission. pt also sexually active with multiple female partners over past 2 years, last tested >1yr ago, was (-). has never had std. family history: there is no family history of premature coronary artery disease or sudden death. father died at age 59 with "hypertensive cardiomyopathy," reportedly had 'clean cath a month before' passing. mother has no hx of coronary disease, alive, with dementia. physical exam: vs: t 98.6, bp 96/55 on dopa, hr 94, rr 14, 2l 98% gen: wdwn middle aged male in nad, resp or otherwise. oriented x3. mood, affect appropriate. pleasant. heent: ncat. sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. neck: supple with jvp at jaw angle at 20 degrees elevation in bed. cv: pmi located in 5th intercostal space, midclavicular line. rr, normal s1, s2. no s4, no s3. no friction rub. chest: no chest wall deformities, scoliosis or kyphosis. resp were unlabored, no accessory muscle use. no crackles, wheeze, rhonchi. abd: obese, soft, ntnd, no hsm or tenderness. no abdominial bruits. ext: no c/c/e. no femoral bruits. skin: no stasis dermatitis, ulcers, scars, or xanthomas. pulses: right: carotid 2+ without bruit; femoral 2+ without bruit; 2+ dp left: carotid 2+ without bruit; femoral 2+ without bruit; 2+ dp pertinent results: ekg on admission notable for mild st-elevations in i, ii with concern for stemi vs. pericarditis. a subsequent ekg showed st segment elevations in leads i, avl and v5-v6 which were consistent with acute lateral myocardial ischemic process. an ekg with right-sided chest leads demonstrated no evidence of right ventricular transmural ischemia. the final ekg done on showed persistent st segment elevation in leads i and avl. the st segment elevation previously recorded in leads v5-v6 had resolved. ekg on demonstrated prominent t wave inversions in leads v4-v6 with biphasic t waves in leads v2-v3 and t wave inversions in the inferior leads suggestive of anterior and inferior ischemia. compared to the previous tracing of the anterior t wave abnormalities are new. . ett performed on demonstrated - the left atrium is normal in size. the estimated right atrial pressure is 10-20mmhg. left ventricular wall thicknesses are normal. the left ventricular cavity size is normal. there is severe global left ventricular hypokinesis (lvef = 15-20 %). right ventricular chamber size is normal with mild global free wall hypokinesis. the number of aortic valve leaflets cannot be determined. no aortic regurgitation is seen. the mitral valve appears structurally normal with trivial mitral regurgitation. there is no pericardial effusion. . echo on - compared with the prior study of showed left and right ventricular systolic function are markedly improved. the left atrium is mildly elongated. there is mild regional left ventricular systolic dysfunction with very mild hypokinesis of the distal septum and anterior walls. the remaining segments contract normally and overall systolic function is preserved (lvef = 55-60 %). the estimated ci is normal (>=2.5l/min/m2). transmitral and tissue doppler imaging suggests normal diastolic function, and a normal left ventricular filling pressure (pcwp<12mmhg). right ventricular chamber size is normal with focal hypokinesis of the apical free wall. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic regurgitation. the mitral valve appears structurally normal with trivial mitral regurgitation. there is no mitral valve prolapse. there is borderline pulmonary artery systolic hypertension. there is no pericardial effusion. . cardiac cath performed on demonstrated: coronary angiography of this right dominant system revealed nonobstructive coronary artery disease. the lmca and lcx were without angiographically evident flow limiting stenosis. the lad had a 40% lesion after d1. the rca had a 30% mid vessel lesion. resting hemodynamics revealed elevated right and left sided filling pressures with rvedp of 12 mm hg and mean pcwp 22 hg. pasp was elevated at 42 mm hg. systemic arterial pressure was low at 70-80 mm hg with map 46 mm hg. cardiac index was depressed at 1.64 mm hg. . hemodynamics: elevated pcwp 20, ci 1.6 . laboratory data: cxr : findings: the cardiac silhouette remains at the upper limits of normal. no convincing evidence of vascular congestion. however, there is some increasing prominence of the azygos vein region, raising the possibility of some right-sided heart failure. . 04:15am blood ck(cpk)-215* 12:36pm blood ck(cpk)-359* 04:15am blood ck-mb-11* mb indx-5.1 12:36pm blood ck-mb-33* mb indx-9.2* 04:25am blood ctropnt-1.05* 04:25am blood ck-mb-49* mb indx-9.7* probnp-3913* . urine bnzodzp-neg barbitr-neg opiates-neg cocaine-pos amphetm-neg mthdone-neg asa-neg ethanol-neg acetmnp-neg bnzodzp-neg barbitr-neg tricycl-neg . wbc-19.5* rbc-5.17 hgb-15.5 hct-44.2 mcv-86 mch-29.9 mchc-35.0 rdw-13.2 plt ct-344 wbc-6.0 rbc-4.23* hgb-12.6* hct-36.8* mcv-87mch-29.7 mchc-34.1 rdw-13.1 plt ct-205 . pt-13.7* ptt-28.3 inr(pt)-1.2* pt-12.5 ptt-22.7 inr(pt)-1.1 . calcium-8.8 phos-3.7 mg-1.9 glucose-89 urean-15 creat-1.1 na-139 k-3.9 cl-102 hco3-29 angap-12 . alt-22 ast-67* ck(cpk)-503* alkphos-80 totbili-0.9 totprot-7.4 albumin-4.7 globuln-2.7 ferritn-127 . tsh-5.9* t4-5.2 . 05:38am blood type-art po2-60* pco2-44 ph-7.29* caltco2-22 brief hospital course: this is a 61 yo male presenting with shortness of breath and found to have clinical heart failure without underlying coronary artery disease in the setting of intermittent cocaine abuse. during evaluation at an osh, there was concern for an stemi and the patient was transferred to the cath lab. he was found to have no identifiable coronary disease, but he did have compromised systolic function with depressed ef and increased pcwp. the patient was transferred to the ccu with hypotension requiring pressors which have since been weaned off. the patient was re-echoed and his systolic function improved (lvef 55-50%) with only very mild hypokinesis of the distal septum and anterior walls. transient systolic dysfunction and subsequent hypotension was likely secondary to recent cocaine abuse by the patient. . cad/ischemia: the patient did not have a prior history of cad. cardiac cath showed no acute stenoses. during hospitalization, the patient was started on lisinopril 2.5mg daily to prevent cardiac remodeling. pt was also put on aspirin 81mg daily for secondary cardioprotective effects. . pump: cardiac cath revealed a compromised ef (lvef 15-20%) with a pcwp of 20. he was given iv lasix in the cath lab to help improve systolic function. cxr on admission showed signs of 'mild chf.' he demonstrated cardiogenic failure with a compromised ci at 1.4, and did not meet criteria for impella support. initial echo showed akinesis in ant septum, ant free wall and apex, hypokinesis in inferior septum and inferior wall, normal basal aspects, lvef 20-30%, and no effusions or valvular problems. the patient required a dopamine drip to maintain cardiac output, and was eventually weaned once ci and svr improved. a repeat echo on showed lvef improved to 55-60%, ci normal (>2.5), mild regional lv systolic dysfunction with mild hypokinesis of distal septum/anterior walls. clinical heart failure is likely secondary to cocaine abuse. additional workup yielded rpr -, t4 nml. lyme serology and hiv testing pending. . rhythm - no baseline ekg was available for comparison. however, pt's rhythm was sinus for duration of hospitalization. . valves - valves were normal on echo. . hypotension - this was likely due to pump failure as described above, and has since improved. . respiratory failure - on admission, pt had 2l o2 requirements with cxr findings of mild chf and no identifiable signs of infiltrate or other pathology. respiratory compromise was likely secondary to pulmonary edema. during hospitalization, oxygenation rapidly improved and pt was satting well on room air at discharge. . renal failure - baseline cr was elevated upon admission to 1.4. pt had received contrast during cath. the slight rise in creatinine was likely due to poor perfusion. cr levels have since normalized. . etoh/cocaine - the pt's actual intake amount of etoh and cocaine is unclear but his urine tox screen came back positive. ast was mildly elevated at 67, alt normal at 22, and bili 0.9. in previous discussions regarding substance abuse problems, the pt was not interested to talk to anyone during this stay. he has a psychiatrist who he sees as an outpatient about these issues. social work was consulted and gave the patient referrals for substance abuse options on but the patient prefers to do one on one counseling with his psychiatrist. . psych- on the day of discharge the primary team was called by his wife who reported the patient was expressing suicidal ideation. when dr. was asked about this he denied suicidal ideation and reported he and his wife had one of their typical arguments and he stated "maybe it would have been better for you if i had died" which his wife misinterpreted as suicidal ideation. psych was consulted and reported he had no acute psychiatric contraindication to discharge. close follow up was set up with his psychiatrist dr. . psych also recommended that dr. discuss restarting zoloft with his psychiatrist. . glaucoma- the patient continued his home medications: latanoprost and timolol. . fen - the patient was maintained on a cardiac diet. electrolytes were repleted as necessary, and the patient was diuresed intermittently with lasix to maintain euvolemia. . code - pt is full code. medications on admission: klonopin prn lumigan 0.03 % drops sig: one (1) ophthalmic at bedtime. istalol 0.5 % drops, once daily sig: one (1) ophthalmic qam. discharge medications: 1. lumigan 0.03 % drops opthalmic once daily at bedtime. 2. istalol 0.5 % drops opthalmic once daily qam. 3. aspirin 81 mg po daily. 4. klonopin oral (resume home dosing) 5. lisinopril 2.5 mg po once a day. discharge disposition: home discharge diagnosis: primary: 1. non-ischemic cardiomyopathy secondary to cocaine 2. substance abuse secondary: 1. glaucoma discharge condition: good discharge instructions: you were admitted to for chest pain with compromised systolic heart function. the etiology of the dysfunction is unclear, but is likely related to your drug abuse. the following new medications have been started: -lisinopril 2.5mg daily for heart and blood pressure -aspirin 81mg daily for secondary cardiovascular protection . you were evaluated by inpatient psychiatry and they have suggested that you may benefit from restarting the zoloft. please discuss this with your psychiatrist at your next follow up appointment. if you develop cheset pain, jaw pain, or chest pressure with pain radiating into arm, or if you have any concerns about your medical condition, please call 911 or present to the nearest ed. . it is also recommended that you have a lipid panel blood test collected and have results faxed to your pcp. is important to assess your need for a cholesterol-lowering drug. followup instructions: please make an appointment to follow-up with: 1. cardiology: you have a follow up appointment with dr. on wednesday at 1pm. building, . call with any questions. 2. pcp: . : tuesday at 1:30pm. , . . please call to register prior to this appointment. 3. psychiatrist: dr. : wednesday at 3pm in er. this apppointment is only to touch base. please schedule a routine appointment (call ) for monday . procedure: combined right and left heart cardiac catheterization coronary arteriography using two catheters diagnostic ultrasound of heart diagnostic ultrasound of heart pulmonary artery wedge monitoring diagnoses: other primary cardiomyopathies congestive heart failure, unspecified unspecified glaucoma alcohol abuse, unspecified acute respiratory failure unspecified disorder of kidney and ureter cocaine abuse, episodic acute systolic heart failure other specified hypotension obsessive-compulsive disorders family history of other cardiovascular diseases 

Answer: The patient is high likely exposed to