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: a.c.e inhibitors attending: chief complaint: shortness of major surgical or invasive procedure: comments: 1.coronary angiography demonstrated a right dominant circulation with severe three-vessel disease. lmca had no angiographically apparent cad. lad had a proximal mildly calcified 80-90% stenosis close to the take off of d1 and d2, which was in close proximity to d1. lcx was 80% stenotic proximal to trifurcation of lcx, om1 and om2. rca was totally and thrombotically occluded after the takeoff of acute marginal. distal rca was filled via collaterals from lcx. 2.resting hemodynamics post angiography revealed normal aortic pressure. both right and left sided filling pressures were mildly elevated. there was a gradient of 13 mmhg across the pulmonic valve. fick calculated cardiac output and cardiac index was 5.6 l/min and 3.3 l/min/m2, respectively. 3. successful ptca/stenting of the rca with overlapping 3.5x13mm hepacoat (prox), 3.0x28mm hepacoat (more distal), 2.75x18mm hepacoat (more distal), 2.5x18mm (more distal), 2.75x18mm (hepacoat) and 2.25x23mm hepacoat (more distal). final angiography revealed no residual dissection and normal flow (see ptca comments). final diagnosis: 1. severe three vessel coronary artery disease. 2. there was 13 mmhg gradient across the pulmonic valve. 3. mildly elevated right and left sided filling pressures. 4. pci of the rca. history of present illness: yo woman with cad, recently admitted to with nstemi ck peak 233, (medically managed), was at rehab when developed chest pain and shortness of . brought to hospital where ekg changes were noted (diffuse st dep, and ? ste v1-v2), given lovenox, intubated for respiratory distress. patient was then transferred to for cardiac catheterization, with a thrombosed rca, and 3vd. past medical history: 1. coronary artery disease. 2. pacemaker (pacesetter a-v pacer) placement for sick sinus syndrome (installed for bradycardia) 3. hypertension. 4. hypercholesterolemia. 5. gastroesophageal reflux disease. 6. chronic renal insufficiency with a baseline creatinine of 1.4 to 1.7. 7. anemia secondary to renal disease. 8. constipation. 9. hypothyroidism. social history: the patient lives alone. her daughter with her care. she never smoked. she does not drink alcohol. family history: non-contributory physical exam: gen: elderly, intubated, sedated heent: moist mucus membranes. chest: clear anteriorly. good air movement heart: s1, s2, s3 . rr. sys murmur best at llsb, palp thrill over l chest. abd: soft, non-tender. no hsm. echymoses and oozing blood from previous lovenox injections groin: mild hematoma. bandage soaked in blood ext: warm and dry, good peripheral pulses neuro: sedated and intubated pertinent results: 11:50a 7.42 / 35 / 86 / 23 / 0 type:art; intubated; o2:60; rate:18/; tv:500; peep:5 hgb:11.2 calchct:34 freeca:1.12 other blood gas: temp: 36.1 vent: controlled 09:30a 7.37 / 36 / 241 / 22 / -3 type:art; intubated; o2:100; aado2:454; req:76; rate:16/; tv:500; peep:5; mode:assist/control hgb:12.3 calchct:37 freeca:1.19 other blood gas: temp: 36.1 vent: controlled 09:19a chem 10 143 108 34 168 3.8 19 1.6 ck: 208 mb: 28 mbi: 13.5 trop-*t*: 1.19 comments: note updated reference ranges as of notified 1150t ctropnt > 0.10 ng/ml suggests acute mi ca: 8.9 mg: 1.5 p: 4.6 alt: 25 ap: 83 tbili: 0.3 alb: 3.4 ast: 39 ldh: dbili: tprot: pt: 15.9 ptt: 150 inr: 1.6 comments: note new normal range as of 12am of 150 is highest measured ptt 07:15a pt: 13.8 ptt: 31.0 inr: 1.2 comments: hemolyzed, slightly note new normal range as of 12am of 06:12a 7.27 / 46 / 96 / 22 / -5 type:art; intubated; o2:100; aado2:589; req:94; rate:14/; tv:500; peep:5; mode:assist/control hgb:13.0 calchct:39 o2sat: 97 brief hospital course: cad: upon arrival to , pt had diffuse st depressions and st elevations in v1, v2. taken to cath, was found to have thrombosed rca with pci and 3 vessel disease. rca was successfully stented with a cypher stent. reopro was continued for 12 hours, then, the patient was placed an asa, plavix, and atorvastatin. of note patient is intolerant to acei's with a document rise in cr, so valsartan 80 was started on discharge pump: ef was 30% on arrival, post-cath = 20%, +mr, with apical hypokinesis and severely depressed lv function. patient was on afterload reducers (hydralazine, isordil) on admission, however was hypotensive, so those meds were held. -pcwp 11 on cath, wet on exam, so diuresis was started, with poor response to lasix. the patient subsequently diuresed spontaneously when bp increased to normal levels. -the patient was still in mild chf upon the discharge, so discharged home on a dose of po lasix 40mg po qd rhythm: patient has a av pacer installed for a hx of bradycardia. remained in nsr hospital stay, except for few episodes of asx a-fib that were medically treated. patient went in and out of v-paced rhythm with hr of 75. pacer was interrogated by ep they determined that the battery needed to be replaced but could not do it this admission to to mrs. pneumonia. follow up at device clinic will be scheduled (dr. pulm: the patient was extubated successfully of the day of cardiac cath, with persistent o2 requirement, at time of discharge she was on 2l nc saturating between 92-95%_. -pt developed cough with a blood-tinged sputum when cxr on revealing mild chf and post rll infiltrate consistent with bronchopneumonia, patient was started on renally dosed levaquin. arf: baseline renal insufficiency. pt's cr actually improved and was stable at 1.4 at the time of discharged. fen: patient was placed on 2g na heart healthy diet, but did not take very good , was supplemented with boost shakes and breakfast pudding. heme: pt had a drop in hct from 34-27 and was trasfused 2 units of prbcs with good hct response. hct on discharge was stable at 34.4. -due to apical akinesis, dr. , patient's primary cardiologist recommdation started anti-coag with coumadin with heparin bridge on discharge. ptt was 76 at the time of discharge. heparin and coumadin therapy to be tailored at rehab medications on admission: asa 325 metoprolol 25 imdur 30 qd hydrazalize 25 qd zocor 40 qd pronotix 30 qd vit d/calciterol cac03 1300mg po qd plavix 75 po qd colace 100 senna nitro sl prn mylanta prn aranesp injection q 3 weeks levothyroxine 50 qd discharge medications: discharge disposition: extended care facility: & rehab center - discharge diagnosis: nstemi/post cath chronic renal insufficiency anemia on aranesp hypothyroidism on levothyroxine gerd neurosensory hearing lost discharge condition: fair afebrile, ambulatory, on oxygen 2l by nc, vital signs stable discharge instructions: weigh yourself every morning, md if weight > 3 lbs. adhere to 2 gm sodium diet any bleeding noted--please call your doctor weigh yourself every morning, md if weight > 3 lbs. adhere to 2 gm sodium diet any bleeding noted--please call your doctor : 2l call dr. when you are discharged from rehab to set up an appointment to determine if you need another cardiac catheterization. changes in medications: do continue aranesp at previous dose metoprolol 25mg by mouth three times a day--new frequency levothyroxine 25mg by mouth every day--new dose do not take imdur do not take hydralazine do not take zocor your new medications are: valsartan 80mg by mouth once per day for your blood pressure lactulose 15mg by mouth once a day as needed atorvastatin 80mg by mouth once a day heparin (weight based scale) iv x5 days--blood thinner coumadin 5mg by mouth every night--blood thinner for low ef and akinetic apex(dose may be changed based on your doctors ) lasix 40mg by mouth once a day--for getting rid of levofloxacin 250mg by mouth every other day--for your pneumonia protonix 40 mg by mouth every day--for reflux disease followup instructions: provider: , m.d. where: medical specialties phone: date/time: 11:00 provider: , md where: phone: date/time: 2:00--please repeat thyroid function tests since levothyroxine dose was changed provider: , where: phone: date/time: 1:20 cardiology: , (: call for an appointment after you are discharged from rehab. to discuss pci intervention to lmca and continuation of anti-coagulation. device clinic: : :30pm (dr. . please call to confirm procedure: insertion of non-drug-eluting coronary artery stent(s) combined right and left heart cardiac catheterization coronary arteriography using two catheters injection or infusion of platelet inhibitor angiocardiography of right heart structures diagnoses: other primary cardiomyopathies subendocardial infarction, initial episode of care coronary atherosclerosis of native coronary artery mitral valve disorders congestive heart failure, unspecified iron deficiency anemia secondary to blood loss (chronic) unspecified acquired hypothyroidism atrial fibrillation bronchopneumonia, organism unspecified 

Answer: The patient is high likely exposed to