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: past medical history: 1. hypertension 2. hypercholesterolemia 3. cardiomyopathy with an ejection fraction of 20 in , but this has resolved with a normal ejection fraction of 70% in . 4. history of gout allergies: no known drug allergies. medications on transfer: 1. heparin ggt 2. colchicine 0.6 mg q. day 3. norvasc 10 mg p.o. q. day 4. diovan hydrochlorothiazide 160 and 12.5 q. day 5. metoprolol 100 mg p.o. b.i.d. 6. vicodin prn 7. lipitor 20 mg p.o. q. day 8. celexa 10 mg p.o. q. day social history: he smoked cigars. previously he did smoke one to two packs of cigarettes per day for five to six years. he drinks six beers per week. family history: his father died of lung cancer at age 46 and his mother is alive with chronic obstructive pulmonary disease and hypertension. physical examination: afebrile, vital signs stable, blood pressure 130/80, temperature 97. awake, alert and oriented times three, smiles with midline tongue. pupils are equal and reactive to light. extraocular motions are intact. there is a mild left inferior quadrant anopsia on confrontation. neck is supple with full range of motion and no lhermitte sign. lungs are clear to auscultation bilaterally. heart is regular rhythm and normal rate, no murmurs or gallops. abdomen, positive bowel sounds, soft, nontender. extremities, without edema. neurological, strength is full in all groups. sensory is intact. finger-to-nose and rapid alternating movements are within normal limits. there is no clonus, no drift, no romberg and gait is narrow-based. reflexes are moderately brisk but symmetric. toes are downgoing. laboratory data: white count 10.6, hematocrit 43, platelets 313, inr 1.7, pt 15.8 and ptt 61.4. sodium 135, potassium 4.2, chloride 98, and bicarbonate 25, bun 25, creatinine 1.2, glucose 100, calcium 9.7, magnesium 2.2, phosphate 4.5. impression: a 35 year old man with symptomatic vertebrobasilar insufficiency who likely will need repeat cerebral angiogram and consideration of interventional procedure. hospital course: mr. was admitted to the neurosurgical service under the care of dr. . his heparin was continued with goal ptt between 60 and 80. magnetic resonance imaging of the brain revealed evidence of acute ischemic infarctions in the distribution of the posterior circulation. there were several infarctions involving the occipital lobes bilaterally and the splenium of the corpus callosum with posterior lateral aspect of the right thalamus. these were reportedly not different from those seen at county hospital. cerebral angiogram while in-house revealed significant stenoses of the vertebrobasilar system with the right side worse than left. after further consideration, mr. was taken back to the angiogram suite for another angiogram where the right vertebral artery stenosis at the vertebrobasilar junction successfully treated with balloon angioplasty. he tolerated the cerebral angiogram without problems and underwent angioplasty of the right vertebral artery at the vertebrobasilar junction. he was continued on plavix and aspirin 325 mg q. day along with heparin. post procedure he was admitted to the intensive care unit for close monitoring where he had some upsy clonus postoperatively. this improved within the next day, however, he had some sustained horizontal nystagmus bilaterally with a torsional component which appeared to be peripheral in nature, however, given his recent vertebral angioplasty there was a concern for vertebral distribution asthenia. therefore he underwent a repeat imaging study which revealed no change from previous. he also had magnetic resonance angiogram which did not show any evidence of acute changes. over the next several days he improved clinically and his nystagmus improved as well as his vertiginous symptoms. he was stable and transferred back to the floor. he began to ambulate with assistance and his symptoms improved. he was kept in-house on heparin drip and warfarin was started after a hypercoagulable workup was initiated. hypercoagulable workup revealed a sedimentation rate of 16, homocysteine of 13.5, was negative, c3 129, c4 135. prothrombin mutation analysis is pending. factor is pending, cardiolipin antibody is pending, ch50 is pending. at the time of this dictation, mr. is clinically stable with an inr of 2.3 and ptt of 75 with a heparin drip running at 950 units/hour. our goal inr is 2.5 to 3. when he achieves this level it would be appropriate to decrease his aspirin from 325 q. day to 81 mg q. day. his plavix should be continued at 75 mg q. day. mr. is clinically stable and appropriate for transfer back to county as per his wish. discharge condition: improved. discharge status: discharge to county hospital. discharge medications: 1. protonix 40 mg p.o. q. day 2. aspirin 325 mg p.o. q. day 3. plavix 75 mg p.o. q. day 4. warfarin 5 mg p.o. q. day 5. zopedem 5 mg p.o. q. day 6. citalopram 10 mg p.o. q. day 7. atorvastatin 10 mg p.o. q. day 8. dexamethasone 2 mg p.o. q.i.d. 9. insulin sliding scale 10. heparin ggt at 900 units/hour. please check ptt on arrival to county hospital and adjust as needed for goal ptt of 60 to 80 mg discharge diagnosis: 1. bilateral vertebrobasilar disease, status post right vertebral artery angioplasty at the vertebrobasilar junction. secondary diagnosis: 1. hypertension 2. hypercholesterolemia 3. history of gout follow up: the patient should follow up with dr. , neurosurgery at in one months time. , m.d. dictated by: medquist36 procedure: angioplasty of other non-coronary vessel(s) arteriography of cerebral arteries diagnoses: other primary cardiomyopathies pure hypercholesterolemia unspecified essential hypertension personal history of tobacco use occlusion and stenosis of vertebral artery with cerebral infarction 

Answer: The patient is high likely exposed to