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: penicillins / egg / inhaler companions attending: chief complaint: chest pain major surgical or invasive procedure: s/p cath history of present illness: 84 year old male with transfer from , admitted on with vague complaint of chest pain, troponin of 0.05 signed out ama return this am to with 10/10 sscp and found to have ste in v2-v4. transferred to . pressure of 165/109 --- dropped to 107/58 post meds. was given lopressor 5 mg iv, lipitor, plavix 300 mg, asa, morphine sulfate 2 mg, nitro drip , heparin and integrilin and taken to cath. cath showed: co- 5.17 ci: 2.97 pcwp: 14 pa: 40/19 (27) lmca nl lad- 70% proximal, 95%ulcerated distal, 90% origin large d1 lcx: 80% proximal, ulcerated 90% om1, om2 mild disease rca: 50% distal before pda mid lad balloon angioplasty. rota severe residual 2vd iabp placed for risk of ischemia 10x10cm rfa hematoma past medical history: copd back pain social history: retired engineer quit smoking in 's no alcohol no drug use family history: father- age 65 physical exam: afebrile hr: 70 bp: 154/72 rr: 16 98% on 2 liters gen: nad cv: rrr, nl s1, s2, no m/r/g pulm: cta-ant abd: soft, nt, nd, nabs ext: 1+ dp, tp pulses r groin- 10x 10 cm soft hematoma, slight ooze, no bruit pertinent results: 10:56pm ck(cpk)-202* 10:56pm ck-mb-22* mb indx-10.9* 10:56pm hct-31.3* 04:01pm glucose-104 urea n-13 creat-0.7 sodium-140 potassium-4.3 chloride-106 total co2-22 anion gap-16 04:01pm alt(sgpt)-9 ast(sgot)-27 ck(cpk)-148 alk phos-64 tot bili-0.6 04:01pm ck-mb-19* mb indx-12.8* ctropnt-0.32* 04:01pm albumin-3.4 calcium-8.1* phosphate-3.3 magnesium-1.5* cholest-112 04:01pm triglycer-56 hdl chol-49 chol/hdl-2.3 ldl(calc)-52 04:01pm wbc-11.5* rbc-3.85* hgb-11.8* hct-33.7* mcv-87 mch-30.7 mchc-35.2* rdw-12.6 04:01pm neuts-92.4* bands-0 lymphs-5.0* monos-2.2 eos-0.4 basos-0.1 04:01pm hypochrom-normal anisocyt-normal poikilocy-normal macrocyt-normal microcyt-normal polychrom-normal 04:01pm plt count-193 04:01pm pt-15.6* ptt-64.5* inr(pt)-1.5 09:42am type-art o2 flow-5 po2-139* pco2-51* ph-7.33* total co2-28 base xs-0 intubated-not intuba 09:42am k+-3.3* 09:42am hgb-10.9* calchct-33 o2 sat-98 09:20am ck(cpk)-94 09:20am ck-mb-12* mb indx-12.8* ctropnt-0.24* 06:40am blood wbc-6.9 rbc-3.36* hgb-10.7* hct-30.0* mcv-89 mch-31.7 mchc-35.5* rdw-13.0 plt ct-142* 05:52am blood hct-29.5* 05:09am blood wbc-8.9 rbc-3.54* hgb-11.0* hct-31.1* mcv-88 mch-31.0 mchc-35.3* rdw-13.0 plt ct-140* 04:01pm blood wbc-11.5* rbc-3.85* hgb-11.8* hct-33.7* mcv-87 mch-30.7 mchc-35.2* rdw-12.6 plt ct-193 06:40am blood neuts-78.7* bands-0 lymphs-14.1* monos-3.5 eos-3.4 baso-0.3 06:45am blood pt-14.5* ptt-53.1* inr(pt)-1.3 06:45am blood glucose-83 urean-16 creat-0.7 na-140 k-4.0 cl-103 hco3-34* angap-7* 05:39am blood alt-8 ast-23 ld(ldh)-217 alkphos-56 amylase-45 totbili-0.6 01:40am blood ck-mb-9 ctropnt-0.24* 05:09am blood ck-mb-19* mb indx-8.1* ctropnt-0.34* 10:56pm blood ck-mb-22* mb indx-10.9* 04:01pm blood ck-mb-19* mb indx-12.8* ctropnt-0.32* 09:20am blood ck-mb-12* mb indx-12.8* ctropnt-0.24* 04:01pm blood triglyc-56 hdl-49 chol/hd-2.3 ldlcalc-52 radiology final report art dup ext lo uni;f/u 1:19 pm art dup ext lo uni;f/u reason: assess for bleed, hematoma, fistula medical condition: 84 year old man with r groin hematoma s/p intraaortic balloon pump reason for this examination: assess for bleed, hematoma, fistula history: right side intraaortic balloon pump now with hematoma. findings: duplex and color doppler of the right inguinal area demonstrates no evidence of a pseudoaneurysm, av fistula, or hematoma cardiology report echo study date of patient/test information: indication: left ventricular function. myocardial infarction. preoperative assessment. patient on iabp. height: (in) 70 weight (lb): 130 bsa (m2): 1.74 m2 bp (mm hg): 104/60 hr (bpm): 66 status: inpatient date/time: at 16:38 test: portable tte (complete) doppler: full doppler and color doppler contrast: none tape number: 2004w417-1:36 test location: west ccu technical quality: suboptimal referring doctor: dr. . dr. . measurements: left ventricle - diastolic dimension: 4.0 cm (nl <= 5.6 cm) aorta - valve level: *3.9 cm (nl <= 3.6 cm) interpretation: findings: left ventricle: normal lv cavity size. depressed lvef. lv wall motion: regional lv wall motion abnormalities include: mid anteroseptal - hypo; mid inferoseptal - hypo; anterior apex - akinetic; septal apex- akinetic; inferior apex - akinetic; lateral apex - akinetic; right ventricle: normal rv chamber size and free wall motion. aorta: mildly dilated aortic root. aortic valve: mildly thickened aortic valve leaflets. mitral valve: mildly thickened mitral valve leaflets. mild mitral annular calcification. mild (1+) mr. tricuspid valve: normal tricuspid valve leaflets. general comments: suboptimal image quality - poor echo windows. suboptimal image quality as the patient was difficult to position. conclusions: the left ventricular cavity size is normal. lv systolic function appears depressed. resting regional wall motion abnormalities include distal septal and apical akinesis/hypokinesis. views are suboptimal so regional wall motion could not be fully assessed; estimated ejection fraction ?40%. right ventricular chamber size and free wall motion are normal. the aortic root is mildly dilated. the aortic valve leaflets are mildly thickened. the mitral valve leaflets are mildly thickened. mild (1+) mitral regurgitation is seen. electronically signed by , md on 17:11. physician: , . cardiology report c.cath study date of *** not signed out *** brief history: patient is an 84 year old man with former tobacco use and a history of cva. he presented to an outside hospital with chest pain and st elevations. he was transferred to for emergent catheterization. indications for catheterization: stemi procedure: right heart catheterization: was performed by percutaneous entry of the right femoral vein, using a 7 french pulmonary wedge pressure catheter, advanced to the pcw position through a 8 french introducing sheath. cardiac output was measured by the fick method. left heart catheterization: was performed by percutaneous entry of the right femoral artery, using a 6 french right catheter, advanced to the ascending aorta through a 7 french introducing sheath. coronary angiography: was performed in multiple projections using a 6 french jl4.5 and a 6 french al1 catheter, with manual contrast injections. intra-aortic balloon counterpulsation: was initiated with an introducer sheath using a cardiac assist 9 french 30cc wire guided catheter, inserted via the right femoral artery. percutaneous coronary revascularization was performed using rotational atherectomy. conscious sedation: was provided with appropriate monitoring performed by a member of the nursing staff. hemodynamics results body surface area: 1.74 m2 hemoglobin: 12.9 gms % fick **pressures right atrium {a/v/m} 9/9/8 right ventricle {s/ed} 41/9 pulmonary artery {s/d/m} 41/19/27 pulmonary wedge {a/v/m} 18/18/15 aorta {s/d/m} 121/76/91 **cardiac output heart rate {beats/min} 85 rhythm sinus o2 cons. ind {ml/min/m2} 125 a-v o2 difference {ml/ltr} 42 card. op/ind fick {l/mn/m2} 5.2/3.0 **resistances systemic vasc. resistance 1277 pulmonary vasc. resistance 185 **% saturation data (nl) pa main 76 ao 100 **arterial blood gas inspired o2 concentr'n .31 po2 139 pco2 51 ph 7.33 other hemodynamic data: the oxygen consumption was assumed. **arteriography results morphology % stenosis collat. from **right coronary 1) proximal rca diffusely diseased 2) mid rca diffusely diseased 2a) acute marginal normal 3) distal rca discrete 50 4) r-pda diffusely diseased 4a) r-post-lat diffusely diseased 4b) r-lv diffusely diseased **arteriography results morphology % stenosis collat. from **left coronary 5) left main normal 6) proximal lad discrete 70 6a) septal-1 diffusely diseased 7) mid-lad diffusely diseased 8) distal lad discrete 95 9) diagonal-1 discrete 90 10) diagonal-2 diffusely diseased 12) proximal cx discrete 80 13) mid cx diffusely diseased 13a) distal cx diffusely diseased 14) obtuse marginal-1 discrete 90 15) obtuse marginal-2 diffusely diseased 16) obtuse marginal-3 normal **ptca results lad **baseline stenosis pre-ptca collateral grade (0-2) 0 **technique ptca sequence 1 guiding cath 7f xb3.5 guidewires pt graph initial balloon (mm) 1.5 final balloon (mm) 2.5 # inflations 9 max pressure (psi) 300 **result stenosis post-ptca dissection (0-4) 0 success? (y/n) y ptca comments: initial angiography revealed an ulcerated 95% stenosis of the distal lad, which was heavily calcified. we planned to treat this lesion with ptca and stenting if possible. eptifibatide was initially continued but then stopped due to a large groin hematoma. a 7 french xb lad3.5 guide provided adequate support for the procedure. the lesion was crossed with a pt which was placed in the distal vessel. a 1.5x15 mm maverick balloon was used for pre-dilation for 3 inflations at 12, 10 and 14 atm. next, a 2.0x18 mm highsail balloon was used for four inflations at 16, 16, 16 and 24 atm. however, we were unable to fully expand the balloon. the wire was therefore exchanged for a rota floppy wire which was positioned in the distall vessel. rotational atherectomy was then performed with a 1.5 mm burr. we then re-exchanged for a pt2 wire and ptca of the mid and distal lad was performed with a 2.5x20 mm maverick balloon for two inflations at 6 and 14 atm. we attempted to deliver a 2.5x18 mm cypher des but could not advance the stent beyond the proximal lad due to residual stenosis and severe calcification. final angiography showed a 30% residual stenosis, no dissection and timi 3 flow. a 30cc iabp was inserted at the end of the procedure to prevent ischemia with good diastolic augmentation. the patient left the lab in stable condition. technical factors: total time (lidocaine to test complete) = 2 hours 18 minutes. arterial time = 1 hour 15 minutes. fluoro time = 39.1 minutes. contrast: non-ionic low osmolar (isovue, optiray...), vol 315 ml premedications: asa 325 mg p.o. anesthesia: 1% lidocaine subq. anticoagulation: heparin 5000 units iv other medication: fentanyl 62.5mcg iv midazolam .5mg iv dopamine gtt 0-20mcg/kg/min iv integrilin 9cc/h iv potassium slow infusion started neosynephrine gtt 0-20mcg/min iv midazolam .5 mg iv diltiazem 500mcg ic prbc 1 unit cardiac cath supplies used: .014 , pt , 300cm .014 , rota gold wire .014 , rota gold wire .014 , choice pt xs, 300cm .014 , pt 2, 300 2.0 guidant, voyager 15 1.5 , maverick, 15 2.0 guidant, highsail, 18 2.5 , maverick, 20 6f cordis, xblad 3.5 7f cordis, xblad 3.5 6f cordis, jl 4.5 st 6f cordis, xblad 4.0 7f cordis, xblad 3.5 1.5 , rotalink plus 5f bard, pacing wire 7f arrow, iabp 30cc 200cc mallincrodt, optiray 200cc 100cc mallincrodt, optiray 100cc 7f cordis, jl 3.5 sh comments: 1. selective coronary angiography of this right dominant system revealed severe two vessel coronary artery disease. the lmca had no angiograpically apparent stenosis. the lad had a 70% proximal lesion and a distal 95% lesion. the d1 had a 90% lesion at its origin. the lcx had an 80% proximal lesion. the om1 had a 90% lesion. the rca was ectatic throughout and had a 50% distal lesion. 2. resting hemodynamics revealed elevated left sided filling pressures with a preserved cardiac output. 3. successful rotational atherectomy and ptca of the mid and distal lad with a 2.5 mm balloon. final angiography showed a 30% residual stenosis, no dissection and normal flow (see ptca comments). 4. successful placement of a 30cc iabp with good diastolic augmentation. 5. patient developed large right groin hematoma soon after arterial and venous access obtained. integrilin was stopped at that time and heparin alone was used for anti-coagulation for the remiander of the procedure. final diagnosis: 1. three vessel coronary artery disease. 2. acute stemi managed by pci. 3. successful rotational atherectomy and ptca of the lad. attending physician: , . referring physician: , . cardiology fellow: , j. , attending staff: , radiology final report carotid series complete port 2:14 pm carotid series complete port reason: pre-op for cabg medical condition: 84 year old man with stemi and severe cad reason for this examination: pre-op for cabg preop carotid for cardiac bypass: findings: minimal bilateral plaque, normal velocities, ica to cca ratios and antegrade flow of both vertebral arteries. impression: widely patent common and internal carotid arteries bilaterally. dr. brief hospital course: ct surgery was consulted for possible cabg and patient was on iabp 1:1. heparin was started once the hematoma was stable, however no plavix, integrilin was given. while in hospital, patient seemed delusional and at times manic. sw and psych were consulted to determine patient compentency as patient was initially refusing surgery. he was determined to be competetent and eventually agreed for surgery. patient was started in asa/ statin/ bb. patient had several episodes of atypical chest pain and vague abdominal pain without ekg changes. therefore, he was started on a gi cocktail to help manage his symptoms. the iabp was removed as it was not providing much diastolic augmentation and ct had delayed surgery until a neurology would see the patient to rule out dementia (neuro did eventually rule this out). patient also had a drop in hct in house and therfore a groin ultrasound was obtained which ruled out a pseudoaneurysm. in addition, because of the increasing abdominal pain, pain with swallowing, and patient complaints of loss of appetite and nausea, gi was to be consulted as there was some question as to whether this patient had achalasia. dr. at had performed an egd and found esophageal distension with retained food in esophagus with tight ge juctions, but benign appearing. there was a fresh antral ulcer after passing through les with difficulty. he was dilated at this time of the study with a balloon. gi decided that the patient should have a swallow study. admist all this, ct surgery stated that the patient was no longer a surgical candidate. the patient then decided to leave ama even though the primary team explained the risks to his health if he did this. mr. was on no mood altering med and has been deemed to have the capacity to make his own decisions. he understood the risks of leaving ama, which included death. patient signed ama forms and left without prescriptions. medications on admission: primatine mist discharge medications: left ama without scripts discharge disposition: home facility: ama discharge diagnosis: cad copd ?achalasia back pain discharge condition: stable discharge instructions: left ama without scripts followup instructions: left ama without scripts procedure: combined right and left heart cardiac catheterization coronary arteriography using two catheters injection or infusion of platelet inhibitor implant of pulsation balloon angiocardiography of right heart structures transfusion of packed cells diagnoses: subendocardial infarction, initial episode of care coronary atherosclerosis of native coronary artery acute posthemorrhagic anemia hematoma complicating a procedure cardiac catheterization as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure chronic obstructive asthma, unspecified achalasia and cardiospasm 

Answer: The patient is high likely exposed to