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: fluorescein / shellfish attending: chief complaint: shortness of breath and throat tightness major surgical or invasive procedure: cardiac catheterization () history of present illness: 60 yo f with dmii, htn, and hl who presented to yesterday with severe dyspnea and throat tightness. she had been at the country club when she began to notice shortness of breath, which became severe quickly. she drove to the fire station, where ems was called and she was brought to . in the ed, she was thought to be in flash pulmonary edema, and found to have an nstemi with elevated troponins. she was given lasix, nitro and oxygen with improvement in her symptoms. nitro drip was started for blood pressure control. a heparin drip was started for acs. a tte was performed showing lvef of 35% with global hypokinesis. she was seen by her cardiologist, who recommended transfer to for cath. on arrival to the ccu, she is feeling well, without significant dyspnea. she still has some tightness in her throat that has not improved since the start of her symptoms. review of systems on review of systems, she 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. she denies recent fevers, chills or rigors. she denies exertional buttock or calf pain. cardiac review of systems is notable for absence of chest pain, paroxysmal nocturnal dyspnea, orthopnea, ankle edema, palpitations, syncope or presyncope. all of the other review of systems were negative. past medical history: coronary artery disease systolic congestive heart failure type 2 diabetes, complicated by neuropathy, nephropathy, retinopathy and s/p toe amputation hyperlipidemia hypertension cataracts glaucoma s/p right carpal tunnel release, s/p right thumb, ring, and little finger trigger finger releases social history: retired administrative assistant. has a 21 year old daughter. , lives alone. - tobacco history: never - etoh: none - illicit drugs: none family history: - brother - mi - maternal grandfather - mi at age 50 - maternal uncle - first cabg in - mother - hypothyroid and htn physical exam: admission- gen: obese, well-appearing, no acute distress heent: moist mucus membranes, no erythema or exudate neck: supple, no jvd cv: rrr, distant heart sounds lungs: crackles bilateral halfway up lungs abd: soft, non tender, obese ext: 1+ pitting edema, amputation of r toe, skin breakdown under r 4th toe pulses: 1+ bilateral dp/pt . discharge: vitals: 98.1 hr 74 bp 128/58 99% on room air gen: obese, well-appearing, no acute distress heent: moist mucus membranes, no erythema or exudate neck: supple, no jvd cv: rrr, distant heart sounds, no murmur heard lungs: crackles bilateral bases abd: soft, non tender, obese, nondistended ext: trace pitting edema, amputation of r toe, skin breakdown under r 4th toe pulses: 2+ bilateral dp/pt pertinent results: admission- 07:43pm blood wbc-7.3 rbc-3.94* hgb-11.0* hct-34.5* mcv-88 mch-27.9 mchc-31.8 rdw-14.0 plt ct-178 07:43pm blood pt-11.8 ptt-59.7* inr(pt)-1.1 07:43pm blood glucose-201* urean-30* creat-1.1 na-135 k-3.7 cl-98 hco3-24 angap-17 07:43pm blood calcium-8.6 phos-3.6 mg-2.0 cholest-161 07:43pm blood %hba1c-6.9* eag-151* 07:43pm blood hdl-42 chol/hd-3.8 ldlmeas-96 cardiac enzymes- 07:43pm blood ck(cpk)-998* ck-mb-37* mb indx-3.7 ctropnt-1.71* 05:19am blood ck(cpk)-874* ck-mb-21* mb indx-2.4 05:54am blood ck(cpk)-427* ck-mb-8 . preliminary cath report: 1. selective coronary angiogaphy in this left dominant system demonstrated 2 vessel coronary artery disease. the coronary arteries were heavily calcified. the lmca was patent. the lad was a small vessel with luminal irregularities, but was free of angiographically obstructive coronary artery disease. the lcx had a 80% proximal lesion in a tortuous segment prior to a large om branch. the rca was a small non-dominant vessel that was diffusely diseased, including at the ostium. the rca also had a subtotal occlusion in the proximal segment. after review of the angiogram and considation of the patient's diabetes, patent lad, small non-dominant rca, and tortuous proximal lcx which would not necessarily be easily navigable with a stent or balloon, it was decided that medical management would be the best option. 2. limited resting hemodynamics revealed mild systemic arterial hypertension with a central aortic blood pressure of 140/66. the lvedp was severely eleveated at 31 mmhg. 3. the right femoral artery was closed with a 5 french exoseal. final diagnosis: 1. two vessel coronary artery disease. 2. severely elevated lvedp consistent with systolic heart failure. 3. mild systemic arterial hypertension. 4. right femoral artery closed with exoseal device. . ekg: baseline artifact. sinus rhythm with a single ventricular premature beat. borderline voltage for left ventricular hypertrophy in lead avl. st-t wave abnormalities. consider strain/ischemia. borderline low precordial voltage. no previous tracing available for comparison. clinical correlation is suggested. . discharge labs: 10:40am blood wbc-8.0 rbc-4.37 hgb-12.7 hct-40.5 mcv-93 mch-28.9 mchc-31.3 rdw-14.0 plt ct-230 05:19am blood pt-11.4 ptt-69.2* inr(pt)-1.1 10:40am blood glucose-140* urean-46* creat-1.1 na-140 k-5.4* cl-101 hco3-25 angap-19 02:45pm blood na-140 k-4.4 cl-102 10:40am blood calcium-8.7 phos-4.3 mg-2.4 07:43pm blood %hba1c-6.9* eag-151* 07:43pm blood hdl-42 chol/hd-3.8 ldlmeas-96 brief hospital course: summary: 60 y/o f with type 2 dm, htn, and hl who presented to an osh with shortness of breath and throat tightness, transferred to for management of nstemi and acute chf exacerbation. . # nstemi: cardiac cath showed lcx and rca disease with patent lad. recommendation was made for aggressive medical management. patient was started on aspirin 81mg daily as patient previously unable to tolerate higher dose secondary to gi intolerance. she was initiated on metoprolol, and her simvastatin was increased to 40mg daily (patient unable to tolerate atorvastatin in the past). given her decreased blood pressure after initiation of metoprolol, her ramipril dose was decreased. of note, her throat tightness may be her anginal equivalent. . # acute exacerbation of congestive heart failure: tte at osh showed lvef of 35% with global hypokinesis, and the etiology of her acute exacerbation is likely secondary to acs. she was initially diuresed with iv lasix, which was transitioned to home po lasix prior to discharge. . # type ii dm: long-term diabetes complicated by neuropathy, nephropathy, and retinopathy. she is s/p toe amputation due to poor peripheral circulation and neuropathy. hba1c was 6.9% indicating good control. given her high insulin requirements, was consulted. . # chronic kidney disease: secondary to long-standing diabetes. creatinine stable at 1.1 this admission. . # htn: treated with metoprolol and ramipril as above . # hld: simvastatin in lieu of atorvastatin given history of intolerance. . # vertigo: the patient endorsed symptoms consistent with peripheral vertigo, which she has had in the past. she was initiated on meclizine for treatment, and will need follow-up. . # pannus abrasion: the patient had two small abrasions under her pannus on the right. recommended that she follow-up with her primary doctor, and apply vasoline and cover with gauze or a bandage to prevent further damage. . ======= transitional issues: -titrate ramipril and metoprolol rehabilitation -repeat tte in weeks -monitor abrasions under pannus on right -monitor vertigo symptoms, meclizine initiated medications on admission: simvastatin 20mg qhs metformin 1000mg lantus 84 units qhs humalog ss up to 150 units daily lasix 60mg daily ramipril 20mg daily alphagan 0.2% eye drops both eyes discharge medications: 1. simvastatin 40 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 2. metformin 1,000 mg tablet sig: one (1) tablet po twice a day. 3. lantus 100 unit/ml solution sig: eighty four (84) units subcutaneous at bedtime. 4. humalog ss up to 150 units daily 5. furosemide 40 mg tablet sig: 1.5 tablets po daily (daily). 6. ramipril 10 mg capsule sig: one (1) capsule po once a day. 7. brimonidine 0.15 % drops sig: one (1) drop ophthalmic q12h (every 12 hours). 8. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). disp:*30 tablet, chewable(s)* refills:*0* 9. metoprolol succinate 25 mg tablet extended release 24 hr sig: three (3) tablet extended release 24 hr po daily (daily). disp:*90 tablet extended release 24 hr(s)* refills:*0* 10. meclizine 12.5 mg tablet sig: one (1) tablet po tid (3 times a day). disp:*90 tablet(s)* refills:*0* discharge disposition: home discharge diagnosis: non-st elevation myocardial infarction coronary artery disease acute on chronic systolic heart failure type 2 diabetes hypertension hyperlipidemia discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you were admitted for a heart attack. this also caused fluid to build up in your lungs. we treated you with medications to reduce blood pressure, heart rate, and to remove the extra fluid from your lungs. it will be very, very important to follow-up closely with your outpatient doctors. taking your medications as prescribed, coupled with a healthy diet and exercise will help reduce your risk for future problems with your heart. . you also have some skin abrasions near your groin area. you should apply vasoline to these areas and cover with gauze or a bandage. you should make sure to show this area to your primary doctor in follow-up. . please weigh yourself every morning, and call your doctor if your weight increases by more than 3 pounds. . please note the following medication changes: -increase simvastatin to 40mg daily to lower your cholesterol -decrease ramipril to 10mg daily -start aspirin 81mg daily to help prevent future heart attacks -start metoprolol to help lower your heart rate -start meclizine to help with vertigo (dizziness) followup instructions: -please call your cardiologist, dr. (), and schedule a follow-up appointment within 7-10 days of discharge from the hospital. -please call your primary care physician, ., d. () and schedule a follow-up appointment within one week of discharge from the hospital procedure: coronary arteriography using two catheters left heart cardiac catheterization diagnoses: subendocardial infarction, initial episode of care coronary atherosclerosis of native coronary artery congestive heart failure, unspecified diabetes with neurological manifestations, type ii or unspecified type, not stated as uncontrolled polyneuropathy in diabetes unspecified glaucoma chronic kidney disease, unspecified other and unspecified hyperlipidemia diabetes with other specified manifestations, type ii or unspecified type, not stated as uncontrolled long-term (current) use of insulin acute on chronic systolic heart failure diabetes with renal manifestations, type ii or unspecified type, not stated as uncontrolled diabetes with ophthalmic manifestations, type ii or unspecified type, not stated as uncontrolled background diabetic retinopathy unspecified cataract cardiomyopathy in other diseases classified elsewhere hypertensive heart and chronic kidney disease, unspecified, with heart failure and with chronic kidney disease stage i through stage iv, or unspecified 

Answer: The patient is high likely exposed to