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 / codeine / sulfa (sulfonamides) attending: chief complaint: chest pain major surgical or invasive procedure: cardiac catheterization with stent placement angiography of mesenteric and renal arteries esophagogastroduodenoscopy history of present illness: 54 yo f with cad s/p 4 stents, +smoker, dm2, htn, pvd, hypercholesterolemia, family history of premature cad now with chest pain. she states she was sitting in her living room around 8 p.m. when she started to feel sob. went upstairs and sat on a stool and states began to have cp. cp described as stabbing in the middle to l chest, radiating to l arm and jaw. states she was feeling hot but no diaphoresis, n/v. +sob. took 3 ntg each 15 mins apart with no relief so called ems. states the pain was similar to that she had when she had her previous mi's. ems found her tachycardic and gave 6 adenocard, 25mg cardizem, 1" nitropaste, and asa. . at she arrived with a hr of 140 in afib. bp was 195/106. was given 25mg cardizem. hr was still 140 and a diltiazem drip was started. she converted to nsr with hr in the 60's and the diltiazem drip was stopped. nitropaste was removed. trop was was 0.16 and ecg was concerning for st elevations and pt was sent in helicopter to for possible cath. . on arrival to pt stated she was having some cp and was started on nitro gtt. cp went away, but nitro was titrated up to 90 mcg for high systolic bp's in the 180's-190's. hr in the 60's. she was given 25mg metoprolol po and 12.5mg captopril po. stated she still had a small tingling sensation in her l jaw, and c/o headache, but otherwise was cp free. . she states she has been having cp with sob at least 1-2 times per week for the last few weeks. states it comes on both at rest and when she is walking or doing other activities. states exerting herself does not bring on the cp. it usually resolves with 2 ntg's and is accompanied by sob. states lately the episodes have been coming more often and seem to last longer. past medical history: -cad s/p 4 stents at --cath at showed lad with diffuse disease, 70% focal stenosis mid segment. stent placed to mid rca. lvef 45% with global hypokinesis. -htn -dm2 -h/o renal artery stenosis s/p b stents -h/o pvd s/p stents in bilateral le's -hypercholesterolemia -s/p partial hysterectomy -s/p cholecystectomy -fatty liver -h/o etoh abuse -obesity -cerebral aneurysm clipping social history: lives with husband. 2 sons and one daughter. is disabled s/p aneurysm clipping. smokes 1 ppd. drinks a beer "once in awhile", no h/o withdrawal sx's. son is coming home from today. family history: mother had dm and died of mi at age 59. father died of throat and lung cancer age 61. physical exam: pe: 98.6 hr 72, bp 187/80, rr 16, o2sat 100% on 2l nc gen: in nad. heent: perrla, eomi, op clear and moist. cv: rrr, + hsm at lusb. lungs: ctab abd: +ttp of ruq. +bs. no rebound or guarding. ext: no c/c/e. pulses: no palpable pulse r groin, l femoral very faint. pt 2+ bilaterlly, dp: 2+ l, 1+ r. pertinent results: 02:05am wbc-13.2* rbc-4.27 hgb-12.6 hct-36.0 mcv-84 mch-29.5 mchc-34.9 rdw-15.3 02:05am plt count-286 02:05am pt-12.0 ptt-22.7 inr(pt)-1.0 02:05am asa-neg ethanol-neg acetmnphn-neg bnzodzpn-neg barbitrt-neg tricyclic-neg 02:05am ck-mb-13* mb indx-12.3* ctropnt-0.16* 02:05am lipase-48 02:05am alt(sgpt)-21 ast(sgot)-33 ck(cpk)-106 amylase-72 tot bili-0.2 09:30am ck-mb-48* mb indx-15.6* ctropnt-0.60* 09:30am ck(cpk)-308* 09:30am glucose-178* urea n-14 creat-1.3* sodium-137 potassium-4.4 chloride-105 total co2-21* anion gap-15 . ecgs: at osh: nsr at 66 nl axis, nl intervals, poor r wave progression. q in iii. 2mm st elevation in iii comp to prior. 1mm st elevation v2-v3 present on old ecg. -at 01:23 - nsr at 73, nl axis, nl intervals. twi v6 old comp to prior. 1mm st elevations v1-v3 old comp to prior from . brief hospital course: . # cad: she was diagnosed with a non-st elevation mi and was started on iv heparin and loaded with clopidogrel. as she was asymptomatic at the time, the plan was made to stabilize her with antiplatelet agents and plan for catheterization on . she had recurrent chest pain the next day and was started on integrilin, after which time she was chest pain-free. her peak ck was 347, mb 49, and troponin t 1.68. she underwent cardiac catheterization on , with pci to the an 80% stenotic lesion of the ostial rca. she was continued on asa 325, plavix, lipitor 80, and beta blocker. she had no further chest pain. she was discharged to pcp follow up with establishment of cardiology follow up. . # chf: tte on with ef 50%, mild lvh, mildly dilated ascending aorta with no ai. she was volume overloaded on exam after her procedure and was diuresed with iv lasix. she was maintained on a beta blocker, ace-inhibitor, and oral lasix. she was euvolemic on discharge. . # atrial fibrillation: she has a history of paroxysmal atrial fibrillation with rvr at the outside hospital that converted with diltiazem. she had an episode of rvr in ccu, that was treated with diltiazem gtt, after which she converted to nsr. she was maintained on a beta blocker and was in sinus rhythm on discharge. she was not started on anticoagulation due to her recent gi bleed. . # htn: she is not adherent to her medication regimen as an outpatient. her hypertension was thought to be a likely trigger for her af w/ rvr. she was severely hypertensive in the ccu to the 230s/100s. her blood pressure was controlled in the ccu with labetalol and nifedipine gtt. she was hypertensive off the drips on the floor. her severe renal artery stenosis was thought to be the main cause for her refractory hypertension. she was discharged on carvedilol, lisinopril, and furosemide. she was discharged to follow up with her pcp for further titration of her medications. . # gi bleed: she had melenic stools in the cath holding area on while on aspirin, clopidogrel, iv heparin, and integrilin. she had patent celiac and mesenteric arteries on angiography, so ischemic bowel was thought to be unlikely. gi was consulted and performed an egd that showed gastric erosions and duodenitis as the only sources of upper gi bleed. she was started on iv pantoprazole and carafate with close monitoring of her hematocrit. she required a total of 8u prbc. her hematocrit stabilized and her diet was advanced. she had no further episodes of melena during her stay. she was encouraged to have a colonoscopy as an outpatient as she has never had one before. . # rp bleed: she had severe hypertension during the cardiac catheterization requiring nitroprusside. her renal arteries were engaged during the cath, and she was found to have severe in-stent restenosis of her right renal artery, but attempts at intervention were unsuccessful. in the cath holding area, she became hypotensive and had a large melenic stool. she was taken back to the cath lab where she was found to have patent celiac and superior mesenteric arteries, but had bleeding from the right kidney which was stopped with balloon tamponade. no further chest pain. a ct abdomen was performed that showed a large perinephric hematoma extending into the retroperitoneum. transplant surgery was following. surgical intervention was not indicated as she was hemodynamically stable. repeat ct showed stable hematoma and her hematocrit stabilized. . # arf: she has known ras s/p stenting, and was thought to likely have some hypertensive nephropathy as well. her baseline creatinine was unknown. her creatinine was 1.5 on the day of cath, and her fena was 0.9%, indicating a prerenal state. angiography showed right renal artery in-stent restenosis. she likely had some hypoperfusion to the r kidney in setting of bleed. she also received a large dye load for aniography of coronaries, mesenterics, renals, and iliacs. her left kidney appeared atrophic on imaging. her creatinine increased to 1.6 and was then stable for several days. she was discharged on an ace-inhibitor, with pcp follow up for further management. . # glucose intolerance: she was hyperglycemic throughout her stay. she has no known diagnosis of diabetes. her hga1c was 6.7. she was maintained on an insulin sliding scale. . # code status: full . medications on admission: aspirin 325 daily states she last saw her pcp 2 months ago who recommends she take many other meds but she has not been able to afford them. discharge medications: 1. atorvastatin 80 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 2. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 3. aspirin 325 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 4. furosemide 40 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 5. carvedilol 6.25 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 6. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po once a day. disp:*30 tablet, delayed release (e.c.)(s)* refills:*2* 7. lisinopril 10 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* discharge disposition: home with service facility: gentiva discharge diagnosis: primary: non-st elevation mi congestive heart failure, systolic gi bleed, source unknown hypertension renal artery stent restenosis renal failure, likely acute on chronic secondary: peripheral vascular disease primary: non-st elevation mi congestive heart failure, systolic gi bleed, source unknown hypertension renal artery stent restenosis renal failure, likely acute on chronic secondary: peripheral vascular disease discharge condition: good, hematocrit stable, chest pain free, bp fairly well-controlled, creatinine stable discharge instructions: it is very important that you take all of your medications as prescribed. . if you experience chest pain, shortness of breath, dizziness, bloody or black stools, or other concerning symptoms, please call your doctor or go to the er. followup instructions: 1) please call your pcp, . (, to schedule a follow up appointment within the next week. you should have your hematocrit and renal function labs checked. please discuss colonoscopy with dr. . procedure: coronary arteriography using two catheters angiocardiography of left heart structures other endoscopy of small intestine injection or infusion of platelet inhibitor left heart cardiac catheterization angioplasty of other non-coronary vessel(s) arteriography of femoral and other lower extremity arteries arteriography of other intra-abdominal arteries transfusion of packed cells insertion of drug-eluting coronary artery stent(s) cranial or peripheral nerve graft insertion of one vascular stent excision of lingual thyroid percutaneous transluminal coronary angioplasty [ptca] procedure on single vessel procedure on single vessel diagnoses: subendocardial infarction, initial episode of care coronary atherosclerosis of native coronary artery diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute kidney failure, unspecified other specified disorders of arteries and arterioles atrial fibrillation hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure other complications due to other vascular device, implant, and graft accidents occurring in other specified places chronic or unspecified duodenal ulcer with hemorrhage, without mention of obstruction atherosclerosis of native arteries of the extremities, unspecified duodenitis, with hemorrhage other specified gastritis, with hemorrhage 

Answer: The patient is high likely exposed to