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: cymbalta / ativan attending: chief complaint: chest pain major surgical or invasive procedure: stress mibi history of present illness: 39 m w/ cad s/p mi, s/p multiple pci p/w cp. pt started to have cp when he was walking in a park w/ his wife. it was his "familiar" cp. it went away by itself but came back again. he called 911 and went to osh when he was still having the cp. there his ekg was normal and his first set of enzymes showed trop i 0.00 (nl <0.08) at 1817 on (no ck available). he was started on iv heparin and iv nitro. he also received iv morphine. he was cp free by 8 pm. his second set of enzymes showed trop i 0.486 (nl <0.034) and ck 184 (nl <170)at 0430 on . repeat ekg again showed nsr and no sig st-t changes from previous. he was xferred here for further mgmt. . in the ccu he denies cp, sob. the cp did not recur since last night. . on review of systems, he denies any prior history of stroke, tia, 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, palpitations, syncope or presyncope. past medical history: -end-stage renal disease secondary to crescentic iga nephropathy, as diagnosed on renal biopsy in , on hemodialysis for approximately five months before receiving a living-related renal transplant in from his mother. renal biopsy of the allograft in showed chronic allograft nephropathy. -coronary artery disease status-post imi in and multiple percutaneous coronary interventions. -diastolic heart failure -hypertension. -hyperlipidemia. -history of upper extremity deep venous thrombosis, maintained on coumadin anticoagulation -reactive airway disease -s/p ccy -peripheral neuropathy -gerd -splenomegaly . cardiac risk factors: diabetes(-), dyslipidemia, hypertension social history: he lives with his wife. does not work->on disability. tob: h/o 5pack yr, quit for 10yrs, restarted 1 yr ago at 6cig/day etoh: rare illicits: none family history: father with h/o dm, cad s/p mi, bladder ca, renal cell ca; mother with h/o cad, breast ca physical exam: vs - 97 125/58 80 96/ra gen: wdwn middle aged male in nad. oriented x3. mood, affect appropriate. heent: ncat. sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. no xanthalesma. neck: difficult to assess jvd cv: pmi located in 5th intercostal space, midclavicular line. rr, normal s1, s2. no m/r/g. no thrills, lifts. no s3 or s4. chest: no chest wall deformities, scoliosis or kyphosis. resp were unlabored, no accessory muscle use. ctab, no crackles, wheezes or rhonchi. abd: soft, ntnd. no hsm or tenderness. abd aorta not enlarged by palpation. no abdominial bruits. ext: no c/c/e. no femoral bruits. skin: no stasis dermatitis, ulcers, scars, or xanthomas. pulses: right: carotid 2+ femoral 2+ dp 2+ pt 2+ left: carotid 2+ femoral 2+ dp 2+ pt 2+ pertinent results: 10:25pm ptt-61.6* 03:43pm glucose-127* urea n-36* creat-2.1* sodium-142 potassium-5.2* chloride-110* total co2-24 anion gap-13 03:43pm ck(cpk)-147 03:43pm ck-mb-10 mb indx-6.8* ctropnt-0.25* 03:43pm calcium-9.4 phosphate-1.7* magnesium-1.8 03:43pm wbc-7.9 rbc-3.43* hgb-10.9* hct-30.9* mcv-90 mch-31.7 mchc-35.3* rdw-14.9 03:43pm plt count-181 03:43pm pt-26.6* ptt-150* inr(pt)-2.6* tte : the left atrium is normal in size. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. there is mild regional left ventricular systolic dysfunction with thinned and akinetic (mildly aneurysmal) basal inferior and inferolateral segments. right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) are mildly thickened. there is no aortic valve stenosis. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. the estimated pulmonary artery systolic pressure is normal. there is a trivial/physiologic pericardial effusion. compared with the report of the prior study (images unavailable for review) of , basal inferior hypokinesis was reported previously. overall left ventricular systolic function is probably similar. ett-mibi: interpretation: 39 yo man s/p multiple pcis was referred to evaluate an atypical chest discomfort and elevated troponins. the patient completed 7 minutes of a modified protocol representing a poor exercise tolerance; ~ 5 mets. the exercise test was stopped secondary to rapidly progressive anginal symptoms. early in exercise, the patient reported an anterior chest burning/heaviness and bilateral arm discomfort and fatigue. rapid progressive of these symptoms were noted during stage iii of exercise and exercise was terminated; symptoms . the symptoms resolved quickly following rest and administration of o2 nc being absent 2 minutes post-exercise. no significant st segment changes were noted during the procedure. the rhythm was sinus with no ectopy noted. the blood pressure response to exercise was appropriate. in the presence of beta blockade, and exercise-limiting symptoms, the peak exercise heart rate was blunted. impression: anginal-limiting symptoms in the absence of ischemic st segment changes. nuclear report sent separately. cardiac catheterization: report pending. rca stenoses treated with 4 taxus stents. discharge cr 2.1, hct stable. brief hospital course: #. cad: pt had chest pain, similar to the ones he has had in past and had enzyme elevation although no ekg changes. he ruled for a nstemi with ck peak of 147. he was treated with heparin gtt, continued on nitro gtt and plavix loaded. the nitro was quickly weaned off without recurrence of angina. he was continued asa, toprol xl, acei, and plavix. statin was increased given cholesterol not at goal. ett-mibi was aborted for angina after 1 minute of excercise. therefore he underwent cardiac catheterization with 4 taxus stents to his rca. #. diastolic chf: last echo in 02 showed ef of 45-55% and on tte here ef same however new apical akinesis. he was continued on acei, statin, beta blocker, and asa. #. h/o dvt: coumadin was held in preparation for potential cath and was restarted prior to discharge. #. s/p renal xplant: creatinine stable at 2-2.5. renal was consulted and confirmed cyclosporine and prenisone doses and patient was continued on this regimen. he was given mucomyst and bicarbonate prior to cardiac catheterization #. neuropathy: patient was continued on oxycodone and methodone per his home regimen with short-acting oxycodone prn as patient has adr with tylenol (a reported interaction between his coumadin and acetominophen). #. code: full medications on admission: -aspirin - 325 mg tablet qd -neoral 75 -folic acid 1 qd -b6 50 qd -b12 100 qd -lisinopril 10 qd -methadone - 20 mg tid -metoprolol succinate 100 qd -oxycodone - 15 mg q6 prn -oxycodone - 20 mg tid -pantoprazole - 40 mg -pravastatin sodium - 80mg qhs -prednisone - 10 mg every other day -warfarin - 2 qd discharge medications: 1. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 2. cyclosporine modified 25 mg capsule sig: three (3) capsule po q12h (every 12 hours). 3. prednisone 10 mg tablet sig: one (1) tablet po every other day (every other day). 4. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 5. pyridoxine 50 mg tablet sig: one (1) tablet po daily (daily). 6. cyanocobalamin 100 mcg tablet sig: one (1) tablet po daily (daily). 7. outpatient lab work please check inr, chem 7 and cbc on tuesday . please call results to dr. at . 8. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). :*30 tablet(s)* refills:*2* 9. nitroglycerin 0.3 mg tablet, sublingual sig: tablet, sublinguals sublingual prn (as needed) as needed for chest pain: if you still have chest pain after 3 tablets, call 911. 10. methadone 10 mg tablet sig: two (2) tablet po tid (3 times a day). 11. metoprolol succinate 100 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po once a day. 12. oxycodone 20 mg tablet sustained release 12 hr sig: one (1) tablet sustained release 12 hr po tid (3 times a day). 13. lisinopril 10 mg tablet sig: one (1) tablet po daily (daily). 14. pravastatin 80 mg tablet sig: one (1) tablet po once a day. 15. nitroglycerin 0.3 mg tablet, sublingual sig: one (1) sublingual as directed: please use for chest pain, can repeat once, if does not relieve the pain, contact your md. :*30 tabs* refills:*2* discharge disposition: home discharge diagnosis: non st elevation myocardial infarction acute on chronic congestive heart failure chronic kidney disease s/p renal transplant for iga nephropathy left upper extremity dvt on chronic coumadin therapy hyperlipidemia peripheral neuropathy on chronic narcotics hypertension discharge condition: good discharge instructions: you had a small heart attack and a cardiac catheterization showed occlusions in your right coronary artery; you had 4 taxus stents placed in your right coronary artery with good effect. because of these stents you have been placed on plavix, which you must continue for one year at least. otherwise we have not changed any of your medications. your coumadin has been held for several days in the hospital. you should resume your regular 2mg coumadin daily and followup in your coumadin clinic on monday for an inr check. we decided against giving you lovenox. weigh yourself every morning, md if weight > 3 lbs in 1 day or 6 pounds in 3 days. follow a 2000mg sodium diet. please call dr. or dr. if you have any unusual chest pain, nausea, sweating, trouble breathing, increasing bruising, bleeding or tenderness in your right groin. no baths or pools for one week. you may shower and change the dressing on your right groin to a band-aid. no lifting more than 10 pounds for one week. no driving for 48 hours after the catheterization. if you have chest pain lasting longer than 10 minutes, or that does not respond to 2 nitroglycerine then call 911. if you have other concerning symptoms like shortness of breath, light-headedness, then seek medical attention. followup instructions: primary care: provider: , md phone: date/time: 10:00 nephrology: provider: , m.d. phone: date/time: 2:30 cardiology: phone: date/time: at 2:20pm. procedure: coronary arteriography using two catheters left heart cardiac catheterization insertion of drug-eluting coronary artery stent(s) excision of lingual thyroid percutaneous transluminal coronary angioplasty [ptca] procedure on single vessel insertion of four or more vascular stents diagnoses: subendocardial infarction, initial episode of care coronary atherosclerosis of native coronary artery congestive heart failure, unspecified acute on chronic diastolic heart failure other complications due to other cardiac device, implant, and graft unspecified hereditary and idiopathic peripheral neuropathy kidney replaced by transplant 

Answer: The patient is high likely exposed to