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: prednisone attending: chief complaint: amaurosis fugax and syncope major surgical or invasive procedure: l internal carotid artery stent placement. history of present illness: 82 yo male with symptomatic stenosis admitted to ccu after carotid stent placement. pt has severe vascular disease - 90% stenosis, 30-60% stenosis, cad - nqwmi in (found 2vd - 70% ostial rca, to lcx distally with collateral flow). pt also has pvd and ?ras. sig risk factors include dm, hyperlipidemia, heavy tobacco use. pt tolerated procedure well. of note he did have low bp on arrival before procedure started (had taken captopril at home). he was asymptomatic with sbp in the 70's. was brought to the ccu on neosynephrine. pt is relatively poor historian - unable to explain why he had procedure. per notes, pt began to become symptomatic with l sided amaurosis fugax x 2 episode (pt describes vision going dark all around a pinpoint of light in the center of his vision) and syncopal episode ~1month prior where he was sitting in a chair and lost consciousness although he maintained his seated position but had urinary incontinence. past medical history: 1. severe chronic obstructive pulmonary disease on 1.5-3l home o2. 2. cad - s/p nqwmi in as above. 3. diabetes mellitus - controlled by diet and glyburide. 4. common bile duct stones - had cholangitis ~1month ago with placement of percutaneous drain. cck planned for . 5. s/p benign lung nodule removal . 6. s/p appy. social history: pt lives with wife. smoked 4 ppd x 40 years, quit 9 months ago. used to drink 6 beers/night but has not had much etoh in the last 2 months. denies other drug use. family history: mother died of cancer (unknown type) in her 80's. father died in 80's of unknown disease. no known h/o cad, cva's, pvd. physical exam: af, hr 71, bp 150/70 rr 11, o2sat 100% on 3l nc. gen: in nad heent: perrla, eomi, no sceral icterus neck: supple, no lymphadenopathy. cv: decreased heart sounds. +s1, s2. no m/r/g appreciated. pulses 1+ r carotid. l carotid pulse not palpable. b dp/pt not dopplerable. lungs: (ant auscultation) cta bilaterally. no wheezes or crackles abd: s/nt/distended. +bs. no hsm. percutaneous biliary drain in place with tan/brown drainage. ext: no c/c/ trace edema b le. cold feet. eczema on r hand. neuro: a&ox3. cn ii-xii in tact. strength 5/5 throughout. sensation in tact to light touch. pertinent results: stent report: 1. access was retrograde via the right cfa. 2. thoracic aorta: type i arch without flow-limiting disease. 3. renal arteries: bilateral disease, mild on the rra. the lra had a focal 80% lesion. 4. subclavian arteries: the rsca had a focal 60% lesion after the origin of the vertebral. the lsca had mild disease. 5. carotid/vertebral arteries: the right vertebral is patent without lesions. there was mild disease at the origin of the left vertebral. the cerebellar arteries are normal. the basilar system filled the left mca from a patent pcom. the rcca was normal. the had a 60% lesion and filled the ipsilateral aca, mca and contralateral aca via the acom. the lcca was normal. there was a focal 90% lesion at the bifurcation. the filled the ipsilateral mca. 6. successful stenting of the was performed with a 7.0 x 40 mm precise stent. 7. right femoral angiography demonstrated severe diffuse disease in the rcfa with almost complete obstruction of distal filling from the 6f sheath. final diagnosis: 1. severe stenosis. 2. stenting of the . 3. severe left ras. 4. severe right cfa disease. brief hospital course: 82 yo man with severe vascular disease with symptomatic disease, 90% stenosis on u/s with amaurosis fugax and possible syncopal episode now s/p carotid stent with good restoration of flow. 1. cv: s/p stent: keep pt on asa, plavix, atorvastatin. sbp was kept between 140-160 initially to keep flow brisk in setting of new stents and then overnight as neo was weaned bp started to fall. neo was increased for a few hours, but then bp remained stable and neo was titrated off. etiology for hypotension was felt to most likely be increased vagal tone after surgery. pt will continue to refrain from taking bp meds for the next few days and follow up for a bp check on . b. cad: continue asa, plavix, simvastatin. restart bp meds (bb and ace) as outpt after bp check. 2. pulm: copd - continue inhalers and nebs prn. nasal cannula o2 to keep sats ~92%. 3. renal: ras seen on cath. dr. likely to place stents in future. cr remained stable after surgery. 4. id: stable. 5. gi: percutaneous biliary drain in place. scheduled for surgery in . 6. gu: pt voided easily with good uop. restart proscar on discharge. 7. heme: post-procedure hct stable. no s/sx hematomas. no bruits. 8. endo: niddm. continue riss and restart glyburide as outpt. diabetic diet. 9. neuro/psych: reports no recent etoh. pt showed no s/sx of withdrawal. 10. ppx: dvt ppx - encouraged ambulation. pt/ot helped. eating. 11. comm: with pt and family. 12. code: full 13. dispo: to home with good follow up on with dr. and with dr. on . medications on admission: lasix 20 mg daily imdur 30 mg daily proscar 5 mg daily glyburide 2.5 mg daily captopril 25 mg twice daily asa 325 mg daily simvastatin 10 mg daily amitriptyline 10 mg dialy serevent discus 50 mcg twice daily flovent 220 mcg 2 puffs twice daily albuterol/atrovent inhalers prn albuterol/atrovent nebulizer prn 2-4 times daily plavix 75 mg dialy discharge medications: 1. aspirin 325 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po qd (once a day). 2. clopidogrel bisulfate 75 mg tablet sig: one (1) tablet po qd (once a day) for 30 days. 3. salmeterol xinafoate 50 mcg/dose disk with device sig: one (1) disk with device inhalation q12h (every 12 hours). 4. fluticasone propionate 110 mcg/actuation aerosol sig: two (2) puff inhalation (2 times a day). 5. albuterol sulfate 0.083 % solution sig: two (2) puffs inhalation q6h (every 6 hours) as needed. 6. ipratropium bromide 0.02 % solution sig: one (1) neb inhalation q6h (every 6 hours). 7. albuterol 90 mcg/actuation aerosol sig: 1-2 puffs inhalation q6h (every 6 hours) as needed. 8. ipratropium bromide 18 mcg/actuation aerosol sig: two (2) puff inhalation q4-6h (every 4 to 6 hours) as needed. 9. simvastatin 10 mg tablet sig: one (1) tablet po qd (once a day). 10. amitriptyline hcl 10 mg tablet sig: one (1) tablet po hs (at bedtime). 11. glyburide 2.5 mg tablet sig: one (1) tablet po once a day. 12. proscar 5 mg tablet sig: one (1) tablet po once a day. discharge disposition: home discharge diagnosis: 1. severe vascular disease 2. severe chronic obstructive pulmonary disease on 1.5-3l home o2. 3. cad 4. diabetes mellitus - controlled by diet and glyburide. 5. common bile duct stones - had cholangitis ~1month ago with placement of percutaneous drain. cck planned for . discharge condition: stable discharge instructions: please do not take your bp medications (furosemide, isosorbide, and captopril) until you see dr. on friday, . if you develop changes in vision, new numbness, or loss of consciousness, call dr. right away. followup instructions: please follow up with dr. on friday to have your blood pressure checked. dr. can restart your bp medications at this time if it is appropriate. call to verify your appointment. also, please follow up for vascular study where: cc clinical center radiology phone: date/time: 11:00 provider: , m.d. where: cardiac services phone: date/time: 2:00 procedure: angioplasty of other non-coronary vessel(s) insertion of non-drug-eluting peripheral (non-coronary) vessel stent(s) diagnoses: other iatrogenic hypotension coronary atherosclerosis of native coronary artery unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled chronic airway obstruction, not elsewhere classified occlusion and stenosis of carotid artery without mention of cerebral infarction atherosclerosis of renal artery other dependence on machines, supplemental oxygen transient retinal arterial occlusion 

Answer: The patient is high likely exposed to